What Medical Conditions Automatically Qualify for Disability?

Medical conditions that prohibit an individual from performing the regular duties of their job for an extended period of time may make them eligible to receive long-term disability benefits. However, automatic approvals from insurance providers are unlikely. In order to begin receiving benefits payments for long-term disabilities, claimants may be required to submit thorough medical proof, and exhaust other compensatory options available to them.

That said, certain medical diagnoses often allow eligible claimants to claim long-term disability benefits. Some of these conditions include:

• Chronic pain or complex regional pain syndrome (CRPS)
• Depression or bipolar mood disorder
• Migraines or headaches
• Disorders of the back or neck
• Lyme disease
• Lupus or other autoimmune disorders
• And more

Agencies Offering Benefits for Long-Term Disability in Ontario

If you pay into a group health insurance plan provided by your employer, you may be able to apply for long-term disability benefits through your insurance provider. If your employer’s insurance policy does not provide long-term disability coverage, you may choose to pay for a private insurance policy. Most policies prohibit or limit the amount of coverage for pre-existing conditions, namely medical conditions sustained before paying into the insurance policy. If you received the medical diagnosis preventing you from working after paying your insurance policy’s premiums for a substantial period of time, you may be eligible to collect long-term disability benefits.

Eligible claimants may also be able to apply for disability benefits through the Canada Pension Plan (CPP). Benefits provided from the CPP are designed to offset the payment amount provided by insurance companies. This means that, once an individual begins receiving CPP payments, the amount of their regular monthly benefits payment from their insurer will be reduced. In Canada, generally speaking, the combined sources of long-term disability coverage allow eligible recipients to collect payments amounting to between 60-70% of their regular wages.

Applying for Long-Term Disability Benefits in Canada

Before applying for long-term disability benefits, claimants may be required to submit to medical assessments, in order to determine their condition’s level of severity. Medical professionals may then be able to issue an official prognosis and an estimated length of recovery time. Depending upon the length of time it takes you to recover from your illness or injury, you may only require short-term disability benefits.

Short-term disability benefits are available for medical conditions preventing individuals from returning to work for several weeks or months. When your condition persists and you exhaust the short-term disability benefits available to you, as well as any paid sick leave or vacation time you may be able to collect, you may be eligible for long-term disability benefits.

After collecting long-term disability benefits payments for two years, your insurance policy’s eligibility requirements may be adjusted. In order to initially qualify for long-term disability benefits, the recipient’s medical condition must prevent them from performing the duties of their current job. However, depending on the terms of an individual’s insurance policy, after a two-year period, recipients may only be eligible to continue collecting benefits payments if their condition prevents them from performing the duties of any job, even those unrelated to their current occupation.

Throughout the duration of an individual’s long-term disability leave, they may be required to participate in medical examinations, treatments, and rehabilitation. If it is determined that a benefits recipient’s recovery has been sufficient enough for them to return to work, their insurance provider may choose to terminate their payments.

Contact Preszler Injury Lawyers Today

If you have received a serious medical diagnosis and are unsure if you’re eligible to collect long-term disability benefits, Preszler Injury Lawyers may be able to discuss your condition, review the terms of your insurance policy, and provide useful assistance and advice. Call Preszler Injury Lawyers today at 1-800-JUSTICE to receive a free, initial consultation.