Disability Claims: Short Term vs. Long Term Disability

short term disability long term disability insurance claims in ontario

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Disability Claims

If you are suffering from an injury or illness that’s preventing you from meeting the expectations of your job, then you might be eligible for disability benefits. These benefits could cover salary and pay for things like medical care and other expenses. As part of your claim, you must determine if your disability is short-term or long-term.

Short Term Disability

If the injury is severe but not prolonged, then a person would only be entitled to short-term disability. This benefit provides the recipient with financial support for a period decided by the insurance provider.

For each claim, the specific terms of a policy will dictate course of action. In many cases, these benefits can start shortly after the occurrence of the injury and last for anywhere from 15 to 52 weeks. Short-term disabilities serve the purpose of providing financial relief as a claimant waits for their long-term disability to kick in or for their condition to improve.

Calculated differently than long-term disability, short term benefits are based on a percentage of weekly salary and these benefits can be taxed differently.

Long Term Disability

In Ontario, some people are eligible for long-term disability if the injury or mental illness is severe and prolonged as stated in one’s policy. In these cases, the benefits are designed as replacement income for a longer period. Neither short-term nor long-term disability requires the injury to have occurred while carrying out the tasks of a job. But, if this was the case, then these benefits might be covered by the Workplace Safety and Insurance Act (WSIA) instead of the group or individual insurance provider.

With respect to eligibility, one difference between short-term and long-term disability, is that with long-term disability benefits, the claimant must typically prove total disability following the two year anniversary of becoming disabled. The test for total disability depends on the policy, but it typically tests a claimant’s inability to work to the required expectations of any occupation. If an application, supported by proper medical documentation, proves total disability then it stands a strong chance of being approved.

This is an arduous but necessary process. Working with a personal injury lawyer can help streamline one’s efforts and result in a stronger claim with a better chance at approval.

Salary Continuance

Salary continuance is a program implemented by many employers in the cases of some short-term absences due to disability, including sick or stress leaves. If this program is in place, then candidates for disability benefits might be able to receive salary continuance for 1-3 months as they recoup. One of the first conversations an injured person should have is with their HR rep or benefits administrator.

Short Term vs. Long Term Disability

Even though short and long-term disability benefits are similar, there are important differences between the two. Remember the following:

  • These are separate products provided by insurance providers.
  • Long-term disability tends to begin after the short-term benefits have ceased.
  • These benefits cannot run concurrently if the claimant is hoping to double up their replacement income.
  • Long-term disability benefits are more expensive and can be more customizable.
  • The cost for long-term disability is based on the usual insurance specifications like age and sex but is also based on the danger associated with one’s occupation.
  • Short-term disability tends to mainly be offered only through employers.

There are similarities in the application process for both, but long-term disability requires additional documentation. All documentation must show that the claimant meets the definition of “disability” as per the policy.

Employees suffering from mental illness can apply for either type of disability. The common ones are anxiety and stress related anguish. Most claims of this nature need documentation from a recognized psychiatrist or psychologist.

Relationship to CPP

Many insurance providers will tell their claimant to apply for Canada Pension Plan (CPP) disability benefits as part of a long-term disability plan. This common request is sometimes mandatory so be sure to consult your policy.

If a CPP claim for disability is rejected, it won’t necessarily affect a claim with a group or individual insurance provider.

Let our Personal Injury Lawyers Help

Being unable to work due to pain can be a difficult experience that impacts life. When the reality of injury and pain strike, it’s important to receive the aid and compensation that you deserve.

Located in Hamilton, Ontario, Mackesy Smye has a team of dedicated lawyers equipped to help prepare and defend your short and long-term disability claims. The goal with every case is to make sure our clients receive the help and care they need to keep their finances in order as they focus on healing.Contact us today to discuss your case.

Get started today with a free consultation

If you’re involved in a insurance or CPP disability dispute, contact us today for a no-obligation consultation to review the details of your case. Complete our secure online contact form, or call us at 1-905-525-2341.

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