Mental health issues have become increasingly prevalent across Ontario and Canada. In fact, according to the Canadian Mental Health Association, nearly 50% of Canadians will experience a mental illness by the age of 40. Mental health issues can significantly affect your ability to function in day-to-day life, especially when it comes to your job. If you have a mental illness that is interfering with your ability to work or earn income, you may be eligible for long-term disability (LTD) benefits.
Long-term disability insurance is normally available to employees whose employers offer disability insurance coverage. They are meant to provide income replacement for disabled employees who meet their policy’s definition of “totally disabled.” Typically, LTD benefits range from 60% to 80% of the claimant’s regular salary. Your employer may offer LTD benefits through a group plan, or you may be covered by your own private insurance company. Other common sources of long-term disability benefits include:
- Canada Pension Plan Disability
- Workers’ Compensation & WSIB Benefits
- Ontario Disability Support Program
- Disability Tax Credit
- And more
While an estimated 30% of short-term and long-term disability claims in Canada are attributed to mental health issues, they are often considered “invisible disabilities”. This can lead to skepticism from employers and insurers alike when employees apply for disability benefits.
If you are thinking about applying for LTD benefits for a mental health condition, it’s important that you know your legal rights and obligations. With an understanding of qualification criteria and the application process for long-term disability benefits, you can feel more confident moving forward. If you have questions about your application or a denial you are facing, contact our Toronto long-term disability lawyers at Goodman Elbassiouni LLP today.
Does Mental Illness Qualify as a Disability in Ontario?
In Ontario, mental illness is recognized as a disability when it prevents an individual from performing their job duties or supporting themself financially. According to the Future Skills Centre, over 40% of Canadians have taken time off work in the last five years due to mental-health concerns. A wide range of mental health issues are considered just as legitimate as physical disabilities.
Common mental health conditions that may qualify for long-term disability benefits include:
- Depression
- Anxiety, including Generalized Anxiety Disorder (GAD)
- Post-Traumatic Stress Disorder (PTSD)
- Panic Disorders
- Postpartum Depression
- Chronic Fatigue Syndrome (CFS)
- And more
As with any physical disability, it is up to your insurer or employer to approve or deny your LTD application based on the severity of your condition. They will assess your mental illness and the effect that it has had on your job to determine whether you meet their definition of “totally disabled”. Every LTD policy and its accompanying terms will be different. This is why you need to read your policy carefully and consult with an experienced long-term disability lawyer when you’re pursuing benefits for a mental illness.
Common Challenges to Receiving Benefits for Mental Health Disabilities
Although there has been significant progress made to destigmatize mental illness in the province, you may still face unique challenges when pursuing long-term disability benefits for a mental health disability. Unlike physical disabilities, mental health disorders often lack visible symptoms. This can make it harder to prove your impairment to employers and insurers.
Some common reasons for denied mental health related LTD claims include:
- Lack of Medical Documentation: You must be able to provide detailed medical evidence of the mental health condition you are dealing with. This might include assessments from psychologists, psychiatrists, and other physicians. If insurers find that there are inconsistencies in your medical records, or that they are not evidentially sufficient, they may deny your claim.
- Limited Treatment History: If you have gaps in your treatment or you have failed to follow prescribed treatment plans in the past (e.g., medication or therapy), it can negatively affect your LTD claim. This is because most insurance companies require proof that the claimant has actively pursued treatment before they approve benefits.
- Medical Credibility Issues: Mental health conditions can be marred by conflicting diagnoses or skepticism from reviewing medical professionals. This is normally because symptoms are subjective or more difficult to assess than physical disabilities. You should make sure that you see a licensed specialist for your diagnosis and keep thorough medical records on hand.
- Incomplete Applications: Many LTD denials occur when there are errors in application forms, missing details, or inconsistencies in your documentation. Although these mistakes are not unique to applications for mental health disabilities, they are still important to avoid nonetheless.
- Failure to Prove Work Impairment: An important part of any LTD claim is proving your inability to continue your work. If you cannot directly link your mental health disability to your inability to fulfill your job responsibilities, insurers may deny your claim.
Although there are many reasons your LTD claim may be denied, there are steps you can take to overcome common challenges. Always ensure that your documentation from medical providers is thorough and detailed. Working with a certified specialist can help you obtain an accurate diagnosis and increase the credibility of your evidence. In addition, a specialist can provide you with a comprehensive treatment plan, which may improve your claim’s chances of success.
If your long-term disability benefits have been denied, you should seek legal assistance immediately. A long-term disability lawyer can help you review your disability insurance policy, gather essential documentation, and submit an appeal when your application is rejected. To discuss your legal options when you have a mental health disability, you can schedule a consultation with our Toronto long-term disability lawyers today.
Applying for LTD Benefits for a Mental Health Disability? Speak With Our Long-Term Disability Lawyers Today
Mental health conditions can be debilitating and prevent individuals from working. Long-term disability insurance exists to provide financial support to disabled workers. However, obtaining them for your mental health disability can be challenging due to prevailing skepticism and high evidentiary standards.
At Goodman Elbassiouni LLP, our experienced long-term disability lawyers are committed to helping disabled individuals receive the benefits they deserve. For legal guidance on your mental health-related disability claim, contact our team today.
