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Long Term Disability Claims on the Rise in Ontario

Jun 25, 2019 | Initial Consultation, Long Term Disability Claims

Moussa Sabzehghabaei

Personal Injury Lawyer

Long term disability incidences have been on the rise in Ontario. RBC Insurance did a survey in 2018 that anticipated a 4.7% increase in long term disability rates that year. According to their survey, the increase in long term disability claims could be partly related to the growth of the Canadian economy. The report revealed that the gross domestic product affects the number of claims made every year.

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The increase in disability claims is likely to affect both Canadian employers and employees. Employers are advised to prepare for the future by making sure they are adequately staffed and budgeting appropriately to cater to costs related to disability claims. In 2016, Canadian businesses are said to have spent $7.5 billion on costs related to long term disability. This is the third largest cost businesses are spending on after health and dental benefits. RBC’s vice president Mr. John Carinci asked businesses to pay attention to this rising rate of LTD claims and manage those costs. This will ensure their operations continue smoothly and that they provide employees with the support needed.

What can employees do about the rising LTD claims?

As an employee, you shouldn’t be afraid to file a LTD claim. You may be required to fill in for an employee who is away due to a LTD claim. Your employer may have already come up with a contingency plan that will cater for these increased incidences and make sure you are adequately staffed.

According to Julie Gaudry, the senior director of group insurance at RBC, employers should communicate to their staff regarding the support available and contingency plans they have developed to prevent under staffing. Businesses that fail to prepare beforehand will be hardest hit when they are inadequately staffed especially in times of strong economic activity.

As employees, you are encouraged to seek opportunities for support from your employers. The report done by RBC showed that as the GDP decreases, the incidence rates of LTD claims also decrease. During these challenging economic times, it’s not uncommon for workers to feel stressed because of issues like their job security. As the economy begins to pick up, these issues build up and many employees consider taking time off to recover. That’s why disability incidences are expected to be on the rise as the economy picks.

A similar prediction was done in the previous year where the incidences for 2017 over 2016 figures were predicted and came to pass. This model can be a good tool to review each year and help prepare for long term disability claims.

What can employers do about the increase in LTD claims?

RTD highlighted some ways in which employers can best prepare for the increase in LTD claims. They include:

-          Supporting their employees through the Employee Assistance Program (EAP)

What is an EAP?

An EAP or an employee assistance program is a confidential and short term counselling service that is available to employees in Canada who are facing personal issues that are affecting their work performance. EAPs can be incorporated in a company’s plan to promote wellness for its employees. There are several licensed EAP service providers who can offer counselling. The purpose of EAP is to offer help and advice on how to address problems that are affecting work but aren’t necessarily caused by workplace issues. Employers who support their workers through EAP can help them to address non work-related issues before they become a disability.

-          Make plans to ensure adequate staffing

Employers should also take the initiative of planning their resource through contingency plans. They need to ensure the company has adequate staff to cater to its needs when the LTD claims increase.

-          Flexible group benefit plans

Employers can also explore more flexible group benefit plans such as an option to work part time until the individual fully recovers.

-          Helping workers understand their full benefits

It’s important for employers to communicate to their employees regarding their full benefits. They need to help their employees to understand what they are entitled to and how they can work towards full recovery e.g. accessing rehabilitation services.

What you need to know before filing a long-term disability claim in Ontario

Do you need to file a long-term disability claim? Let’s go over 5 important aspects you need to be aware of before filing your claim.

1.       Do you qualify for short or long-term disability?

Your employer should advise on whether your insurance policy covers both short-term and long-term disability benefits. Disability benefits can be accessed through your work insurance, Canadian Pension Plan or if you purchased the policy on your own. You may also speak to a disability benefits lawyer to help you determine what you qualify for.

2.       Do you have medical records to prove your disability?

Insurance companies are very keen when reviewing disability claims.  They will look closely at your medical records and try to find rely on any excuse to deny your claim. Keep a journal where you document your condition including all your doctor’s appointments.

3.       Gather evidence

Other than the medical records, retained experts including pain specialists, therapists, and vocational experts can assess your injuries and limitations preventing you from returning to work.

4.       Negotiate

We wouldn’t advice you to negotiate your claim on your own. Insurance companies will not always act with your best interest in mind and will certainly not obtain the necessary medical evidence and expert reports required to prove your claim. An experienced disability lawyer will develop a strong case by collecting all the documentation and expert witnesses to fight a fair benefits pay out for you.

5.       Don’t be afraid to appeal

If the insurance company denies your claim, don’t be afraid to appeal. There are many cases of denied claims which are taken to court and over-turned. Get legal advice from a long term disability lawyer who will take time to understand your case and fight in your corner.