Your Guide to Long Term Disability Claims in Ontario

A long-term disability can have severe consequences on a person’s wellbeing. Incidents like a car accident or a health condition like arthritis, heart disease, diabetes and cancer can prevent a person from working and living an ordinary life. To offer them support, many individuals can apply to make a long-term disability and can claim compensation through their personal or workplace insurance policies. However, these claims are often denied improperly, and some people miss out on the benefits they rightfully deserve.

In today’s post, Ristich Law will be looking at what long-term disability claims are and how Ontarians can start preparing for their claim today.

Long-Term Disabilities

A long-term disability is a broad term that can be understood as a medical or health condition that affects the livelihood of an individual for many months, years, or their entire life. It typically prevents them from doing ordinary activities like working, walking, socializing, learning, bending and lifting.

There is often some overlap between disabilities. For example, a physical disability like not being able to walk for long periods of time may lead a person to experience mental disorders like anxiety and depression. Meanwhile, those suffering from a mental disability such as anxiety may find that their psychological state causes them extreme difficulty in managing their physical symptoms. However, long-term disabilities can be roughly grouped into the categories below.

Physical Disability

The most common and visible long-term disability is a physical disability. A physical disability affects the body and can prevent you from carrying out your activities of daily living due to limitations in movement, strength, dexterity, or communication. Examples of a long-term physical disability include:

• Broken bones or fractures
• Loss of limbs
• Nerve-based conditions such as Multiple Sclerosis or ALS
• Concussions
• Heart Disease
• Soft tissue injuries
• Spinal cord injuries
• Vision loss

Psychological Disability

A psychological disability affects a person’s mood, their ability to handle their emotions, their motivation and their ability to make social interactions. These conditions are sometimes accompanied by physical symptoms and can also make ordinary activities such as socializing, working, and learning very difficult. They can be constant or cause significant, long-lasting flare ups, often aggravated by stress. Examples of a psychological long-term disability include:

• Anxiety & Panic Disorders
• Bipolar & Personality Disorders
• Depression
• PTSD (post-traumatic stress disorder)
• Psychotic illnesses (like Schizophrenia)
• Adjustment and Mood Disorders

Chronic Pain

Chronic pain is enduring pain or discomfort that does not go away after an extended period of time, usually 3-6 months. Like psychological conditions, it can also flare up due to certain lifestyle or biological factors like stress or diet. Chronic pain can be difficult to treat and sadly prevents many Canadians from working, concentrating, and enjoying a normal life, including their ability to return to work.

Chronic pain is often associated with previous physical trauma such as an accident, surgery or it can be caused by an autoimmune condition – where the body’s immune system attacks healthy cells. Examples of conditions that may cause chronic pain are:

• Arthritis
• Cancer
• CFS (chronic fatigue syndrome)
• Diabetes
• Fibromyalgia
• Orthopedic injuries

It is worth noting that some medical professionals are unaware of complex conditions such as fibromyalgia and chronic fatigue syndrome, making it more difficult to seek proper medical advice and treatment. If you are finding it difficult finding the right medical professional to help with your Chronic condition, Ristich Law can help.

Long-Term Disability Claims

Filing a claim for a long-term disability is a key step to getting the financial aid or compensation you need for a recovery. It is particularly important for those who cannot work for a period of time or need to pay for extra treatment to manage their condition.

Many Long-Term Disability policies have two definitions to meet the criteria to get your benefits. The first test is proving that you can’t do the job you were doing at the time of the onset of your disability. This test later changes to not being able to do any commensurate occupation.

Unfortunately, filing a long-term disability benefits claim can be a challenge. Many insurance companies will actively find evidence or arguments to deny you your claim or make you an offer lower than what you deserve. They will sometimes claim you have “insufficient medical evidence” or that they believe you do not suffer from a “total disability”. This is especially difficult when you are trying to focus on your physical and mental wellbeing at the same time.

Even after a denial, an insurance company may tell you that you must follow their appeals process to be entitled to your Long-Term Disability Benefits. That is not law in Ontario!

But your claim can still succeed with the proper documentation or evidence. This is exactly where an experienced long-term disability benefits lawyer advocating for you can help.

Types of Evidence

Documents, reports or other pieces of evidence help demonstrate to insurance companies the extent of your disability, how it may impact your livelihood, and help verify your need for financial benefits. Good examples of evidence needed for a successful claim or appeal are:

• Diagnostic test results (blood tests, X-rays, CT scans, biopsy report)
• Doctor’s notes (including from specialists and family physicians)
• Physiotherapist notes
• Surgical records
• Therapist reports

Your disability benefits lawyer will be able to guide you on acquiring evidence and will represent you during the process.

Long-Term Disability Benefits Lawyer in Toronto & Etobicoke

If you have been affected by a disability and wish to make a claim, our personal injury lawyers in Toronto and Etobicoke are here to advocate for you and your needs. At Ristich Law, we have more than 30 years of combined experience processing Long-Term Disability claims. Let our experience and knowledge get you the best possible outcome for your claim. Contact us today to learn more about how we can help you or visit our long-term disability benefits page to learn more about our services.