According to the Canadian Mental Health Association (CMHA), approximately half of all Canadians may experience some kind of mental health illness by the time they reach the age of 40.
In the province of Ontario, if you have been diagnosed with a mental illness that prevents you from performing the regular duties of your occupation, you may be able to receive long-term disability benefits to help compensate you for a percentage of the wages you are no longer able to earn.
However, not all mental illnesses may entitle you to long-term disability coverage. Some insurance providers exclude coverage for certain conditions. Additionally, many insurance policies do not cover pre-existing conditions or medical diagnoses received before purchasing an insurance policy. Pre-existing conditions may include mental health issues diagnosed before a policyholder was insured.
Types of Mental Illnesses Covered by LTD Insurance
Although not all policyholders diagnosed with mental illnesses may be eligible to claim long-term disability benefits, if an individual’s severe mental health conditions prevent them from working for a significant period of time, they may qualify to receive benefits.
Policyholders diagnosed with the following disorders may not be able to return to the workplace as a result, and therefore, they may be eligible to receive long-term disability benefits:
- Major depressive disorder
- Bipolar disorder
- Obsessive-compulsive disorder
- Anorexia or bulimia nervosa
Depending on the severity of symptoms resulting from mental health disorders, insurers may determine that the claimant is eligible to receive long-term disability benefits. Visiting a mental health professional may help policyholders gauge the severity of their mental conditions, and provide them with official diagnoses that may be submitted as supporting documents along with their benefits application.
Applying for Long-Term Disability Benefits
If you have been diagnosed with a mental illness that prevents you from returning to work or performing routine activities, you may have different compensatory options available to you. Depending upon your situation, you may be able to file for benefits through:
- Your employer’s insurance policy
- A private insurance policy you purchased
- The Canada Pension Plan (CPP)
- And possibly other avenues
Eligible claimants may not be able to begin receiving long-term disability benefits immediately following their diagnoses. Payments may only begin if a claimant’s symptoms have prevented them from working for a significant period of time, and they have already exhausted other benefits available to them, such as sick leave, paid vacation, and short-term disability benefits.
If your application for benefits is successful, your insurance provider may provide you with a percentage of your regular salary. In Canada, long-term disability plans generally provide eligible recipients with 60-70% of their normal wages.
Challenges Associated with Claims for Long-Term Disability Benefits Covering Mental Health Conditions
Although many Canadians are diagnosed with legitimate mental health conditions, when medical conditions cannot be proven with physical evidence, it may be more difficult to prove the claim to an insurance provider.
Even though mental health disorders are one of the leading causes of disability in Canada, there are still significant stigmas surrounding mental health conditions. Because these conditions may not result in physical evidence, claimants seeking long-term disability benefits may be required to take additional steps to demonstrate the effects of their condition. These steps could include:
- Seeking regular treatment from a family doctor
- Regularly receiving treatment from a psychiatrist
- Attempting all psychological treatments suggested by mental health professionals
- Ensuring healthcare providers are properly documenting treatments received
- And possibly more
Receiving a second medical opinion about your diagnosis may also help to demonstrate the validity of your mental illness, and may prevent your claim for benefits from being unfairly denied.
Contact Preszler Injury Lawyers if Your Benefits Claim Has Been Denied
If you believe your officially diagnosed mental health condition should entitle you to long-term disability benefits but your claim has been unfairly denied, Preszler Injury Lawyers may be able to help you appeal the insurance company’s decision. To discuss your situation in a free, initial consultation, call Preszler Injury Lawyers at 1-800-JUSTICE.