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If you are dealing with a long-term disability in BC, it can be challenging to know how to navigate the legal landscape. You may be entitled to benefits from your employer, insurance companies, or government programs like the Canada Pension Plan and Persons with Disabilities. However, understanding these benefits and how to apply for them can be complex. In this blog post, we explore what long-term disability is, the types of benefits available, and how to apply for them. Additionally, we address common questions like how long you can be on disability in BC and whether your employer can terminate you while you’re on long-term disability. If you’ve been denied benefits, we also explain why insurance companies deny claims and the benefits of hiring a long-term disability lawyer to help you navigate the legal process.
Many employers will provide their employees with long-term disability insurance coverage. Usually, this coverage is obtained by the employer from an insurance company. Each insurance company will have its own insurance policy. The policy will define long-term disability. In most long-term disability insurance policies, there are two types of disability – short-term and long-term. To be eligible for long-term disability, you must be unable to work for longer than the short-term benefits last. Typically, but not always, this is 17 weeks.
Once your short-term disability benefits come to an end, you are eligible for long-term disability benefits so long as you are unable to work in your own occupation. You are eligible for long-term disability benefits even if there are other occupations you can work as. However, this situation changes at the 2-year mark. Even if you remain unable to work at your own occupation for 2 years, your long-term disability benefits will come to an end unless you are unable to work at any occupation for which you are suited based on your education and experience. This 2-year mark is quite often referred to as the “own occ-any occ” transition.
Unless your long-term disability insurance policy specifically excludes named disabilities or illnesses, all qualify for long-term disability insurance benefits so long as you are unable to work at your own occupation for first 2 years and thereafter you are unable to work any occupation. It is very important that your family doctor is prepared to stand behind you. This means that they are willing to give evidence at trial. Under the rules of court, they are only permitted to give evidence at trial if they provide your lawyer with a Medical Legal Report (MLR) and your lawyer serves this report on the insurance company’s lawyer no later than 84 days prior to your trial.
It usually does not matter what type of illness or injury you suffer from. So long as you have the necessary medical evidence to prove that you are unable to work, you qualify for long-term disability benefits.
It is important to remember that your long-term disability benefits are not taxable if you were paying the premium yourself. If your employer was paying the premiums, then your long-term disability benefits are taxable. For this reason, most employees will want to pay all long-term disability insurance premiums themselves.
Long-term disability insurance benefits are just one type of income a disabled worker may be entitled to. However, in almost all cases, these benefits are far superior than all other types of disability benefits. Your long-term disability benefits will typically be 66% of your pre-disability gross income. Given the fact that these benefits are not taxable so long as you are paying the premiums yourself, your long-term disability will be very close, if not equivalent, to what you were earning net of taxes prior your disability.
The Canada Pension Plan offers not just retirement benefits, but also disability benefits. There is no minimum age requirement for Canada Pension Plan Disability (CPP-D) benefits.
You are qualified to receive the CPP-D benefits if you: • are under 65 • have contributed enough to the Canada Pension Plan • have a mental or physical disability that regularly stops you from doing any type of substantially gainful work • have a disability that is long-term and of indefinite duration, or is likely to result in death If you are eligible for long-term disability benefits, you will almost certainly also be eligible for Canada Pension Plan Disability benefits (CPP-D). Unfortunately, almost all long-term disability insurance policies make it a requirement that you apply for CPP-D. The policy will also say that all CPP-D benefits you receive are deducted dollar for dollar from your long-term disability benefits. Caution – do not be lulled into failing to apply for CPP-D knowing that it will not be money in your pocket, but only in the pocket of your insurance company. If you fail to apply for CPP-D, the insurance company will deduct from your long-term disability insurance benefits an amount equivalent to the CPP-D you would have received had you applied. There is no asset limit that would prevent eligibility. Your assets will not disentitle you.In British Columbia, the provincial government provide a form of income assistance referred to as “Persons with Disabilities” (PWD). As distinct from CPP-D above, if your assets exceed $100,000, not including your home or your vehicle, you are not eligible for PWD benefits. Even worse, these benefits are not tied to any income you may have previously been earning. Instead, the provincial government arbitrarily sets the amount.
For example, you could get up to:
If you are receiving long-term disability benefits, you are not eligible for PWD. If you are receiving CPP-D, it will be deducted dollar for dollar from your PWD.
WorkSafe benefits are only payable if you are unable to work due to an injury you suffered while working. WorkSafe benefits are not taxable. If you are curious about how much you may be eligible to receive, please see this page for more information.
The disability tax credit (DTC) is a non-refundable tax credit that helps you, or your supporting family member, reduce the amount of income tax they may have to pay.
If you have a severe and prolonged impairment, you may apply for the credit. If you are approved, you may claim the credit at tax time.
By reducing the amount of income tax you may have to pay, the DTC aims to offset some of the extra costs related to the impairment.
You may be eligible for the Disability Tax Credit if a medical practitioner certifies that you have a severe and prolonged impairment in 1 of the specified categories, significant limitations in 2 or more of the specified categories, or receive therapy to support a vital function. To learn more about these categories and your potential eligibility, please see this page.
Your employer will have a specified process for applying for long-term disability benefits. Typically, your employer will provide you with the application form. Separately, your employer must fill out a form and send it to the insurance company. Finally, you must have your family doctor fill out and provide a form called an Attending Physician’s Statement (APS). The APS is sent directly to the insurance company by your doctor.
I would strongly recommend that you ask your doctor if you could work on the APS together. You do not want the APS to contradict what you are saying in your application form. Most doctors will be very agreeable to this reasonable request.
There can be several reasons why insurance companies deny long-term disability claims.
It’s important to note that insurance companies have a financial incentive to deny claims, as it saves them money. However, if a claim has been denied, it is possible to appeal the decision and pursue legal action if necessary.
In my opinion, insurance companies always put the interests of their shareholders ahead of the interests of people making claims.
Long-term disability insurance companies do not like lawyers. They do not like being held accountable. They do not like the threat of going to court. Over my many decades of practice, I have had many cases where the insurance company flatly denied my clients claim for long-term disability benefits. Then, after my client hired me and I started a lawsuit, they do an about face and pay the claim. If your claim for long-term disability benefits has been denied, I would strongly urge you to hire a lawyer familiar with suing long-term disability insurance companies.
Looking for a long-term disability lawyer in Vancouver, BC? Tim Louis can help. With over 40 years of experience, Tim Louis provides personalized and compassionate legal guidance to clients dealing with long-term disabilities. From filing claims to appealing denied claims, he has a track record of success in achieving positive outcomes for his clients. Contact us to learn more about how we can help you with your long-term disability case in Vancouver.
BC Government – Persons with Disabilities (PWD) Benefit: https://www2.gov.bc.ca/gov/content/family-social-supports/services-for-people-with-disabilities/disability-assistance/on-disability-assistance#:~:text=For%20example%2C%20for%20payments%20issued,single%20parent%20with%20one%20child
Government of Canada – Canada Pension Plan Disability Benefit: https://www.canada.ca/en/services/benefits/publicpensions/cpp/cpp-disability-benefit.html
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ABOUT VANCOUVER, BC BASED LAW FIRM SPECIALIZING IN LONG-TERM DISABILITY, PERSONAL INJURY, EMPLOYMENT LAW AND ESTATE LITIGATION.
At the law firm of Tim Louis and Company, we are committed to helping people through difficult times. Starting with a free consultation, we help people who need it most to get the compensation they deserve. Our practice includes Long-Term Disability, Personal Injury, Employment Law and Estate Litigation. With over four decades of experience, Tim Louis has helped people across British Columbia get legal help when they need it most.
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© Copyright 2024 by Tim Louis & Company Barristers & Solicitors
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