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What Is the Purpose of an Elimination Period?


The elimination period for long-term disability (LTD) benefits is the time you must wait between the date you suffer an injury or illness and the date your disability benefits become payable. This period varies from policy to policy. The purpose of an elimination period is to give you the opportunity to get treatment and see how your illness or injury responds. You may be able to return to work using only paid leave or short-term disability.

The elimination period also gives your insurance carrier a chance to look at your claim and determine if they are going to approve you for long-term disability benefits. Many require you to submit your claim and other paperwork well before the end of the elimination period so that they can make a determination about your claim.

LTD Benefits Are Payable as Soon as the Elimination Period Ends

Sometimes people recover from injuries and illnesses faster than it was initially believed they would. Your recovery may not take months or leave you unable to return to your job permanently. You may be ready to go back to work before the elimination period ends.

If this does not happen, your long-term insurance provider has hopefully received your claim and paperwork before this time. By then, they should also have been able to determine if they will approve you for benefits before your elimination period expires.

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If they approve your claim, you can begin receiving benefits as soon as they become payable. This would prevent gaps in income between your sick pay or short-term disability and your long-term disability benefits.

However, there are many factors that could come into play, and your claim may not get approved. You may need to figure out another way to make ends meet while you fight the denial of your long-term disability benefits.

Filing a Claim and Getting Benefits from Your LTD Insurance Carrier

If your doctor tells you that you cannot work after an injury or illness, you will likely want to apply for all the disability benefits available to you. Initially, you may qualify for sick leave and short-term disability, but your long-term disability benefits may begin if you must miss a certain number of days at work. This is the purpose of the elimination period, which lasts for this period of days, as set by your policy.

Understanding Long-Term Disability Qualifications

Policy definitions of ‘disability’ can vary somewhat, but, in general, you should qualify if you cannot return to your standard job duties because of your illness or injury. There may later come a time when the policy standard changes and you must be unable to work any job to continue receiving long-term disability payments.

Not every claim for long-term disability benefits receives approval. If you learn during your elimination period that the insurer will not approve your claim, you may be able to take action to challenge this benefits denial. However, this is unlikely to be resolved during your elimination period.

You May Be Able to Fight an LTD Benefits Denial

While it is unlikely that we can navigate the system and get your denial overturned or reach a settlement negotiation before your elimination period ends, a lawyer may be able to help you fight a denial of your long-term disability benefits. If a lawyer can show the insurance carrier wrongfully denied your claim:

  • They may be able to file an appeal or lawsuit.
  • They may be able to negotiate an out-of-court settlement with the insurance carrier.
  • They may need to take your lawsuit to trial and present an argument for an award.
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Because you will not be receiving benefits when the elimination period ends if the insurer claims you do not qualify, you may want to reach out to our team right away when you learn about your denial.

You generally have two years from the date of your initial denial to take a case to court under the statute of limitations, but you will also be without income until you can return to work or get compensation through your LTD benefits provider. The sooner you start the better.

A lawyer may be able to help you take action to fight your denial. Depending on your eligibility, you may also be able to apply for Canada Pension Plan (CPP) Disability Benefits.

Talk to an Ontario Lawyer About Your Case

At Preszler Injury Lawyers, our Ontario personal injury lawyers may be able to help you build a compelling case and challenge a long-term disability insurance carrier’s decision to deny a qualifying claim. We serve Toronto and nearby areas. We may come to you if your injuries prevent you from traveling to our office.

Call 1-800-JUSTICE today to learn more.

 
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