If I Was Denied CPP Disability Am I Disqualified From LTD?

No, if your CPP disability was denied, that does not stop you from accessing LTD. Long term disability (LTD) benefits available through your group or personal disability policy have different criteria for approval than Canada Pension Plan (CPP) Disability Benefits, at least in the beginning. Both programs provide income for policyholders who have a medical condition that prevents them from going to work.

However, CPP disability benefits are for those who may not be able to work any job, while LTD benefits are generally granted to those whose medical condition prevents them from working their own job, at least initially. If your condition prevents you from performing the primary tasks of your own position, you may still be eligible for LTD benefits after a CPP denial.

Understanding the Qualifications for CPP Disability Benefits

The qualifications for CPP disability benefits include language that the qualifying medical condition must be both prolonged and severe, preventing you from getting and keeping a job and earning a living in any occupation.

Your qualifying medical condition may be a physical injury or illness or a mental health condition. It must be serious enough that you cannot do any type of work on a regular basis, as well as long term or permanent, or likely terminal. You may not qualify for these benefits if your abilities, training, experience, and education would allow you to work another job, even if it is outside of your previous career or line of work.

Long Term Disability Benefits Work Differently

LTD benefits generally have an initial period where they cover policyholders whose medical conditions prevent them from working in their own occupation or a similar position. This means people who would not meet the “any occupation” criteria for CPP may qualify for LTD benefits, at least initially.

According to the Financial Consumer Agency of Canada, the “own occupation” criteria generally lasts for the first two to five years of drawing LTD benefits. Following the expiration of the “own occupation” period, LTD coverage may become “any occupation” coverage. When this occurs, you may need to meet similar criteria to the CPP rules to receive benefits.

The specific rules and timeline of your LTD plan are detailed in your policy.

Proving You Qualify for LTD Benefits

If you believe you qualify for LTD benefits but received a denial, you may be able to take action and challenge the decision. These carriers all offer a process for filing an internal appeal after a decision to deny your claim.

However, these appeals processes may only be useful in specific circumstances. It may be more effective for you to file an external appeal, or lawsuit, against your denial of LTD benefits. A Toronto disability lawyer may be able to help you understand your options and decide the best way to fight the denial of your LTD benefits.

Do Not Miss the Deadline for Filing a Lawsuit

There is also a strict deadline for filing a lawsuit based on your LTD benefits denial. You may have as little as two years to file a lawsuit to try and recover compensation for the benefits they denied you, per the limitations act. If you miss this deadline, you may lose the right to challenge the denial.

To ensure your right to fight the denial remains intact, reach out to an LTD lawyer as soon as possible after you receive your denial notice. The clock begins ticking on the date of your initial denial. Filing an internal appeal may not alter this time limit.

Talk to a Long Term Disability Legal Team

You may be able to get LTD benefits based on your qualifying illness or injury, even if you were denied CPP disability. A lawyer from Preszler Injury Lawyers may be able to help you understand your qualifications if you received a denial from your LTD insurance carrier, as well.

Our team serves Ontario. We may come to you if you cannot travel to our office for your initial consultation.

Call 1-800-JUSTICE today to discuss your disability benefits with a member of our team. An initial consultation with our firm is free.