how to file a claim for long-term disability benefits
disability benefits can be of great assistance and a lifesaver when you’re unable to work due to illness or injury.
3 minute read
according to disability credit canada, statistics show around 60 per cent of all long-term disability claims in ontario are denied each year.
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disability benefits can be of great assistance and a lifesaver when you’re unable to work due to illness or injury. however, the process of obtaining them can be quite daunting, complicated and feel like a labyrinth of paperwork.
if you’re applying for long term disability (ltd) benefits, you’ll find it helpful to know the simplified, step-by-step process to follow. understanding the process can be the difference between a smooth transition to receiving benefits and a stressful ordeal.
in 2022, 27 per cent of canadians aged 15 or older — or eight million people — had at least one disability, according to statistics canada. this represents an increase of 4.7 percentage points from 2017. in that timeframe, mental health concerns and pain-related issues contributed the most to the rise in canadian disability rates.
another helpful fact to keep in mind comes from disability credit canada’s website, which states that in ontario, industry statistics show that around 60 per cent of all long-term disability claims are denied each year.
most of the time, an ltd applicant will receive a letter from their insurance company informing him or her of their claim’s denial and inviting them to appeal the insurance company’s decision. this is done in the hopes that the insurance company can handle matters directly with you, the applicant, to avoid a lengthy legal battle.
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in my experience, insurance companies’ ltd appeals process is complex and quite difficult for the average person to navigate on their own.
to cut through the complexities, here are the steps to take to simplify the process.
step 1: understand the forms you need
typically, there are three forms you need to submit to apply for most long-term disability benefits. getting these forms right is the first hurdle to jump.
the first is your personal statement. this is where you provide details about your disability and how it affects your ability to work. the second form is your employer’s statement. this provides information about your job and your employment history. the third form is so important, it is a step on its own!
step 2: the physician’s statement – the key to your application
the third, and arguably the most important form, is the physician’s statement. this is a document from your healthcare provider detailing your medical condition, the treatment you’re receiving, and how the condition affects your ability to perform your job.
this document is crucial, and often the main one that the disability insurer will use to determine whether or not you qualify for benefits. it’s your physician’s expert opinion that can tip the balance in your favour.
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step 3: submit your forms and await adjudication
once you’ve completed and compiled your forms, the next step is to submit them to your disability insurer. they will then adjudicate, i.e., assess your application, based on the information you’ve provided, and make a decision.
this can be a nerve-wracking period, but remember that being thorough and honest in collecting and submitting your forms can increase your chances of a positive outcome. be patient and remain hopeful.
keeping these three simple steps in mind should help you feel more prepared to navigate the long-term disability benefits application process. remember, knowledge is power, and you’re now equipped with the key information to make this process manageable.
applying for long-term disability benefits doesn’t have to be a daunting process. by understanding the forms you need, particularly the importance of the physician’s statement, and being patient as your application is considered, you can navigate the process with confidence.
nainesh kotak, is the founder of kotak personal injury law, a firm focusing on protecting their client’s rights to justice and obtaining the compensation their clients deserve. he also serves as the chair of the long-term disability section of the ontario trial lawyers’ association.
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