When Do LTD Benefits Become Payable?

If an injury, illness, or other medical condition prevents you from performing the duties of your job, you may be eligible to claim long-term disability benefits.

Many long-term disability insurance providers have an “elimination period” built into their policies. Also known as a qualifying or waiting period, the length of time a policyholder is required to wait before they can receive long-term disability benefits is determined by insurance providers and varies between companies. Depending on the policy, elimination periods may only last as few as thirty days. But in some cases, elimination periods can last up to six months, or even longer.

During the mandatory waiting period before eligible claimants may begin receiving long-term disability benefits, they may be able to qualify for short-term disability benefits in order to receive some compensation for the income they are no longer able to earn due to their medical conditions.

The stipulations of individual insurance policies also dictate how long an individual can continue to collect long-term benefits. This length of time may also depend on a recipient’s medical condition, their ability to work in other occupations, and other factors. Some policyholders who are unable to return to the workforce because of their injuries may be able to continue collecting long-term disability benefits until the age of 65.

Receiving Compensation During the Elimination Period

If your medical condition prevents you from performing the duties of your job and you must wait through an elimination period before you can claim long-term disability benefits, there may be other compensation options available to you. Your employer or insurance company may provide coverage in the form of short-term disability benefits. If eligible, you may be able to access these benefits shortly after applying. You may also choose to utilize any sick leave and vacation days to which you may be entitled.

If you do not have access to these benefits through your employers, waiting for your long-term disability payments to begin can cause additional financial stress and emotional anxiety. Luckily, there may be other options available to you. Employment Insurance (EI) sickness benefits may offer up to 15 weeks of paid leave if you qualify. EI benefits might provide up to 55% of your normal income during the elimination period before your long-term disability benefits payments begin.

Understanding Long-Term Disability Benefits

Many employers provide standard group insurance policies as a benefit to their staff. If you are self-employed, would like expanded coverage, or if your employer does not provide insurance coverage, you may seek out an individual insurance plan.

Long-term disability benefits generally provide eligible recipients with a percentage of their regular income if a medical condition prevents them from returning to work. In Canada, most long-term disability plans replace between 60-70% of a recipient’s regular salary . The portion provided may vary between 60 and 85 percent of your regular salary or hourly pay, depending on the specifics of your policy.

Determining Continued Eligibility for Long-Term Disability Benefits

Eligibility requirements for long-term disability benefits may change over time. In order to initially qualify for long-term disability benefits, policyholders may have to prove that their medical conditions will not allow them to perform the duties of their current occupation. However, after receiving long-term disability payments for a lengthy period of time, generally two years or 104 weeks, benefits recipients may need to prove that their illness or injury prevents them from performing the duties of any job.

For example, if your previous job required physical activities you are no longer able to perform because of injuries you sustained, your insurance provider may determine that you are able to perform other jobs that do not require this level of physical activity. In these cases, your insurance provider may decide to stop issuing your benefits payments.

If a recipient’s medical condition prevents them from earning a living in any occupation or field, they may be eligible to continue collecting benefits up to the age of 65.

What to Do if Your Claim for Benefits Was Denied

If your insurance provider denied your claim for long-term disability benefits, even though you believe you should qualify, a long-term disability claims lawyer may be able to provide you with useful assistance and advice. With the assistance of a lawyer, you may be able to appeal the insurance company’s decision or litigate in court.

According to Ontario’s Limitations Act, claimants only have two years to file a lawsuit against their insurance company for a denied benefits claim. Filing an internal appeal with your insurance company may not affect the two-year time limit for legal action. During the limited window of time available to you, a long-term disability claims lawyer may be able to help you overturn an insurance company’s unfair decision.

Talk to Preszler Injury Lawyers Today

If you are unable to work because of a medical condition, but your insurance provider denied your claim for long-term disability benefits, Preszler Injury Lawyers may be able to help you appeal or litigate their decision. For a free initial consultation on your case, call Preszler Injury Lawyers today at 1-800-JUSTICE.