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What is Disability Insurance?

Disability insurance serves as financial protection in the event of an unexpected injury or illness. An individual may enjoy such coverage through an employer, the Canadian Pension Plan or through a private insurance policy.

This coverage may be available as short-term disability insurance, long-term disability insurance or both, depending on the policy. Long-term disability insurance may prove to be a valuable asset for an individual or family in the wake of a serious injury.

An Overview of Long-Term Disability Insurance

Long-term disability insurance provides coverage for lost wages when an illness or injury prevents you from being able to work. Coverage types and limitations vary from policy to policy. For instance, some long-term disability insurance policies may exclude certain types of illness.

Other factors to consider when assessing a long-term disability insurance policy:

  • how the policy defines “disability” and “total disability” for the purposes of coverage;
  • any waiting periods (the period you must wait from the time of injury until the time when your coverage kicks in);
  • the amount of monthly benefits;
  • the duration for which benefits are available;
  • your right to appeal in the event of claim denial;
  • whether your insurance provider can reduce benefits at any point during coverage; and
  • whether your provider can cease payments at any point during your period of disability.

Carefully review these factors before purchasing a long-term disability insurance policy.

Eligibility for Long-Term Disability Benefits

To receive long-term disability benefits, you must meet the requirements stated in your policy.

Standard requirements include:

  • your disability has been diagnosed and verified by a qualified medical professional;
  • your disability has made it impossible for you to continue working and/or participate in normal daily activities; and
  • your disability is expected to continue for an extended period of time or indefinitely (short-term injuries and illnesses may qualify you for coverage under short-term disability insurance).

Your policy may specify other eligibility requirements unique to the plan. For example, you may receive long-term disability benefits through the Canadian Pension Plan only if you have met the plan’s contribution requirements.

What to Know Before You Apply for Long-Term Disability Benefits

A long-term disability insurance claim must be supported by objective evidence.

Your claim may include such evidence as:

  • physician statements;
  • an official diagnosis from a qualified medical professional (this may include verification from a specialist when applicable, such as an oncologist in the case of cancer);
  • diagnostic results (X-rays, blood tests, etc.);
  • treatment records;
  • work records (demonstrating past income and work history/timeline);
  • employer statements (this may include a summary of your job duties, etc.) and
  • more.

This information is crucial in verifying your claims of a long-term, debilitating injury or illness and your right to disability benefits.

What to Do if Your LTD Claim Has Been Denied

You may be met with a claim denial for long-term disability benefits, even if you have paid all of your premiums and have a valid case for coverage. Contact a disability lawyer in Ontario as soon as you are able. The Preszler Injury Lawyers offers free case evaluations and can help you pursue options to appeal the denial. Call 1-800-JUSTICE®.

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