What is Long and Short-Term Disability?
Long and short-term disability refers to insurance benefits designed to provide financial support if you’re unable to work due to illness, injury, or other incapacitating conditions.
- Short-term disability (STD) coverage is designed to address the immediate financial impact of a temporary inability to work due to injury, illness, or other reasons. These benefits usually cover a shorter duration, acting as a crucial bridge during the initial phase of incapacity, providing support until you can return to work or transition to long-term disability coverage.
- Long-term disability (LTD) coverage is a crucial financial safety net if you face a debilitating health condition or injury expected to persist for an extended duration, often exceeding one year. Generally, this form of insurance provides a percentage of your salary, acting as a source of income replacement during a prolonged period away from work.
Who Can Make a Short or Long-Term Disability Claim?
Short and long-term disability claims eligibility is contingent upon specific criteria—and insurance companies often take a stringent stance when evaluating your situation.
Short-Term Disability Eligibility
Short-term disability claims typically require individuals to meet the following criteria:
- Employment Status: You must be actively employed and covered by a short-term disability insurance policy through your employer. If your employer doesn’t provide this, you must have a private insurance package.
- Medical Certification: A certified medical professional must provide documentation supporting the individual’s incapacity to work due to a qualifying medical condition.
- Waiting Period: Short-term disability policies often have a waiting or elimination period, during which the individual must be unable to work before benefits kick in.
- Coverage Period: Usually, short-term disability benefits only last for a maximum of six months, depending on the insurance policy.
For example, if an individual underwent surgery and is expected to be on medical leave for six weeks, they may meet the eligibility criteria for short-term disability, allowing them to claim benefits during their recovery period.
Please note that eligibility is nuanced, and you may need to meet other requirements not mentioned in this list.
Long-Term Disability Eligibility
Long-term disability claims typically involve stricter criteria, including:
- Duration of Incapacity: The person’s health condition must be anticipated to last beyond a specified period, often one year or more.
- The End of Other Benefits: Long-term disability insurance usually begins when short-term disability coverage, sick leave, and EI sickness benefits end.
- Medical Documentation: Comprehensive medical documentation is required, demonstrating the severity and persistence of the health condition. This includes statements from a medical professional about your inability to perform essential duties for your job.
- Coverage Period: While each plan is different, you may be eligible to receive benefits for up to two years, after which your situation will be re-evaluated to see if you will remain covered.
For example, if a person is diagnosed with a chronic illness that significantly impacts their ability to work, they may qualify for long-term disability benefits to support them during this extended period of incapacity.
Please note that eligibility may differ from policy to policy, and this list of requirements is not exhaustive.
Understanding the intricate policies, documentation requirements, and legal nuances associated with long and short-term disability claims is pivotal. Our team of dedicated short-term and long-term disability lawyers in Ottawa specializes in guiding clients through the complicated processes involved in these claims, ensuring they receive the compensation they deserve during challenging times.
How to Access Short-Term and Long-Term Disability Benefits
Many employment insurance packages offer long-term and short-term disability benefits, depending on the plan your employer offers.
If your employer does not provide a disability package, you may have also opted to purchase a private insurance package to ensure you have coverage should you need it.
Keep in mind that possessing disability insurance coverage doesn’t automatically mean you are fully covered. Insurance policies vary, and some insurance companies make it hard to access disability benefits. When making a disability claim, the insurance company will insist on proof of disability before agreeing to pay out any disability benefits. This is where our lawyers can step in to help.
Insurance Companies Can Deny Disability Claims
Insurance companies may make it difficult for you to access short-term and long-term disability benefits, even if you’re paying premiums for them. They may deny your claim even if medical professionals and specialists support it. When this happens, you may be left injured, unable to work, and without any compensation to aid your recovery.
This is where we can help. Our team of short-term and long-term disability lawyers can step in, represent you, and deal directly with the insurance company on your behalf.
How Much Can You Receive from Disability Insurance?
The amount you can receive from disability insurance, whether short or long-term, depends on various factors, including the specific terms of the insurance policy and your income.
Generally, disability insurance can replace between 60 and 85% of your income, up to a maximum amount. For short-term disability, the benefit period is limited, spanning a few weeks to several months. For long-term disability, the benefit period can extended for years or until the individual reaches retirement age, depending on the terms outlined in the policy.
