If a serious medical condition, such as an illness, physical injury, or mental condition prohibits you from performing the duties of your job for a significant amount of time, rendering you unable to earn a living, you may qualify to receive long-term disability benefits.
Generally speaking, the severity of a claimant’s injury or illness determines whether or not they will be able to collect long-term disability benefits. Consulting with a medical professional to assess your condition and provide an accurate diagnosis may help you determine whether or not you are eligible to file a claim for long-term disability benefits.
Examples of Qualifying Health Conditions
Many different physical injuries or illnesses may prevent employees from performing the duties of their jobs for a substantial amount of time, and therefore may entitle them to collect long-term disability benefits. Examples of injuries or illnesses include:
- Loss of vision
- Heart disease
- Back, neck, and cervical disorders
- Knee disorders
- Multiple sclerosis
- Chronic pain or complex regional pain syndrome
- And more
Employees may also qualify for long-term disability benefits if they are diagnosed with serious mental health conditions, such as:
- Bipolar mood disorder
- Post-traumatic stress disorder (PTSD)
How to Apply for Long-Term Disability Benefits
Depending on your insurance coverage, you may be able to apply for long-term disability benefits directly through your insurance company or your employer’s group insurance plan. In most cases, you may only be able to apply for long-term disability benefits after you have exhausted all other compensatory options available to you, such as sick leave, vacation time, and short-term disability benefits.
Once this elimination period expires, you may be required to submit thorough medical documentation of your condition along with your application in order to support your claim for benefits. The insurance company may then review your claim and either approve or deny your benefits.
Long-Term Disability Benefits and the Canada Pension Plan (CPP)
In some situations, eligible claimants may also be able to collect disability benefits from the Canada Pension Plan (CPP). In fact, if you are eligible, your insurance provider may require you to apply for CPP benefits to offset their payments to you.
CPP benefits are not provided in addition to the benefits you may receive from your insurance company. Instead, benefits from the CPP offset the compensation you would otherwise receive from your insurance company. If you receive CPP benefits payments, your insurer may reduce the monthly benefits payments they issue to you.
What to Do if Your Claim for Long-Term Disability Benefits Is Denied
If your insurance company or the CPP believes your medical condition prohibits you from returning to work, you may be entitled to receive monthly benefits payments as long as your condition persists.
However, your claim for long-term disability benefits may be denied for a number of reasons. If your claim is denied, a long-term disability claims lawyer may be able to help you dispute this decision.
If the insurance company denied your claim because they required additional medical documentation or another kind of clarification, an internal appeal made directly to the insurance provider might result in an overturned claim denial, allowing you to secure long-term disability benefits once the sufficient clarifying documents have been provided.
A long-term disability claims lawyer may also help you file an external appeal in the form of a lawsuit. In these situations, your eligibility for long-term disability benefits would be decided in court.
Contact Preszler Injury Lawyers with Questions About Your Claim
If you are unsure if your medical condition will qualify you to receive long-term disability benefits, Preszler Injury Lawyers may be able to discuss your situation to provide useful advice or assistance. For a free, initial consultation about your claim, call Preszler Injury Lawyers today at (416) 364-2000.