Statistics show that nearly one-third of people with severe disabilities continue to work. If you’re one of those people, you might be thinking, “I need help. But is my medical condition eligible for disability benefits in Ontario?
This is both a common and complicated question. This is common because 22% of Canadians aged 15 and over report having at least one disability (many of which are mental health related). And it’s complicated because the eligibility criteria aren’t clear.
So what conditions are eligible for disability benefits?
Many medical conditions can potentially qualify for disability benefits. However, it all depends on the degree of disability and whether the disability meets the requirements of your benefit plan and program. The determining factor is the level of impairment rather than the name of your diagnosis.
What are the challenges?
Each medical condition comes with its own challenges.
Mental illness, for example, is an invisible disease that cannot be detected in a diagnostic test. But one in three workplace disability claims in Canada is related to mental illness! In many cases, an insurance company will dismiss a doctor’s assessment as not convincing enough. “Insurance companies don’t tell you that they’re looking for every way not to pay benefits,” said Samantha Share, assistant managing director at Share Lawyers. “They often refer to the fact that they asked their medical adviser to review the claim and base their decision to deny benefits on the review opinion of the documents from this anonymous medical adviser.”
Other common tactics used by the insurance company are to deny claims based on a missing or unclear diagnosis, lack of treatment for the disease, or the assumption that the symptoms of the disease do not are not serious enough to prevent the claimant from working in his own or any other occupation.
Just because you were denied your benefits doesn’t mean you have to go back to work and fight your symptoms. Don’t be fooled by the initial reaction of the insurance company.
You can fight for what you deserve.
Disability insurance policies are not all the same
To be eligible for long-term disability benefits, you must establish that your medical condition prevents you from performing your job or any job for which you are qualified. However, different insurance companies, such as RBC Insurance, Manulife and Sun Life (to name a few) use different (but similar) language to define what constitutes total disability under their respective long-term disability policies, and it is important to review and understand the precise definition of total disability that would apply to your claim. Use this free online tool to find out how an experienced lawyer can help you manage your claim.
What medical conditions qualify for long-term disability?
Assuming you don’t have an excluded condition, you may be eligible for long-term disability benefits if your medical condition prevents you from doing your regular job. Some common injuries and medical conditions are:
- Back injuries
- Brain damage
- Bipolar disorder
- Chronic fatigue syndrome
- chronic pain
- Chron’s disease
- Eating disorders
- broken bones
- gender dysphoria
- Head trauma
- Heart disease
- Herniated disc
- hip replacement
- Inflammatory bowel disease
- Mental health problems
- Multiple Chemical Sensitivity
- Multiple sclerosis
- nerve damage
- Neurological disorders
- Parkinson’s disease
- Pelvic injuries
- Psychiatric disorders
- Post-traumatic stress disorder (PTSD)
- Severe migraines
- Sleeping troubles
- Spinal cord and nerve injuries
- Ulcerative colitis
- Dizziness and blurred vision
- COVID 19 and COVID Long
Although some conditions may not appear to be disabilities, they can nevertheless negatively affect a person’s life. They may need care, support and expert legal assistance to ensure their application is approved.
Have your disability benefits been denied at Midland? What’s your next step?
Applicants who are denied disability benefits should use one of the free online tools available to find out if they have a valid disability case and should not wait to call a disability attorney. The longer they wait, the longer they will remain without income. Samantha Share said: ‘A disability lawyer can initiate the appeal or prosecution process immediately. They can also make suggestions as to other forms of income that may be available to the applicant during the waiting period.