While both Canada Pension Plan Disability (CPPD) benefits and long-term disability (LTD) benefits offer a way for ill or injured workers to pay their bills when they are unable to work, there are many differences between CPPD and LTD. Canada Pension Plan Disability benefits are available to those who contributed to the Canada Pension Plan but are now unable to work in any occupation because of their prolonged and severe illness or injury.
Long-term disability benefits are generally available through your employer as a group plan or as a personal plan you purchase. They may provide benefits if your physical or mental health condition prevents you from completing the tasks associated with your own job. They only later transition to ‘any occupation’ benefits if your policy includes this type of clause.
Workers Obtain CPPD and LTD Coverage in Different Ways
In general, all workers in Ontario who are at least 18 years old likely contribute to the Canada Pension Plan (CPP). Contributions to the Canada Pension Plan are mandatory for most occupations and for adults who earn more than $3,500 per year as of 2020. Most employers pay half of the required contribution while the employee pays the other half.
Because most workers must contribute to the CPP and Canada Pension Plan Disability benefits are available to workers who contribute, most Ontarians who meet the medical criteria may be eligible for CPPD benefits.
Many employers offer LTD benefits, as well. However, this insurance is not mandatory. Many people have access to a group policy through their employer, a union or guild, trade association, or another work-related group. Self-employed workers, freelancers, and gig workers may invest in personal LTD policies in some cases.
“Own Occupation” Versus “Any Occupation” Coverage
There are significant differences in how CPPD and LTD policies define ‘disabled,’ at least initially. LTD policies usually offer ‘own occupation’ coverage for a certain period, often the first two to five years the policyholder qualifies for benefits. This means it may provide benefits for any policyholder whose medical condition prevents them from working their own job.
After the two- to five-year period passes, this changes. To remain eligible for disability benefits, you must have a medical condition that prevents you from working any job you might be eligible to work. CPPD requires you to meet this ‘any occupation’ requirement from the time of your initial claim.
Under some circumstances, such as when your medical condition is severe and prolonged, you may qualify for both LTD and CPPD. When this occurs, your long-term disability insurance carrier may lower your benefit amount accordingly to offset the additional benefits you are receiving from CPPD. You may be able to receive about two-thirds of your normal take-home pay but your policy dictates the specific amount.
There May Be Help Available if You Receive a Disability Denial
If your group or personal long-term disability insurance carrier denies your claim for benefits, but you have a qualifying illness or injury that prevents you from carrying out the tasks associated with your job, reach out to an LTD lawyer today. You may qualify to file an appeal or take your case to court to fight for the benefits you deserve.
A lawyer may be able to help you understand the difference between CPPD and LTD, as well as the criteria you must meet. They can also go over your options for challenging a denial if you meet that criteria. It is important you take action as soon as possible after you learn about the denial. You only have a limited time to fight it.
The Limitations Act of 2002, S.O. 2002, Chapter 24 sets a two-year time limit on taking these cases to court. If you miss this deadline, you may not be able to recover the disability benefits you need, even if you meet the qualifications.
Talk to a Disability Lawyer About Your Benefits Denial
If you are unable to work because of an illness or injury, you may qualify for disability benefits, regardless of whether your medical condition is permanent or only temporarily preventing you from handling the tasks associated with your job. However, it is not unusual for a long-term disability insurance carrier to deny qualified policyholders. Preszler Injury Lawyers may be able to help you understand what happened and explain your options.
Our disability lawyers serve all parts of Ontario. We may come to you if you are unable to come to our office to discuss your case. We may be able to handle your disability denial on a contingency basis, so you pay no fees upfront for our legal services and representation.
Call (416) 364-2000 today to talk to a member of our team about your case.