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Disability Insurance: Connecting the dots

Understanding the ins and outs of disability insurance will help you make your claim at the right time and in the right way.

If you suffer from a physical or mental condition because of an illness or major injury that prevents you from working, you may qualify for disability benefits. These benefits, available through the government or through private insurance, can help supplement your lost income during the time you are unable to work. Understanding the ins and outs of disability insurance will help you make your claim at the right time and in the right way.

Where do I go first?
Understanding private disability insurance
When do I make a claim?
What documentation do I need?

Where do I go first?

The government provides disability benefit programs for eligible Canadians who are unable to work because of an injury or illness. These federal programs include the following: Employment Insurance Sickness Benefits and the Canada Pension Plan Disability Benefit. If you reside in Quebec, you may be eligible for disability benefits under the Québec Pension Plan.

Workers’ Compensation is also available for people who have an accident at work, or develop occupational diseases. For more information on financial benefits available in Canada, visit Persons with Disabilities Online.

Government programs can be accessed in conjunction with a private disability policy. If you have bought an individual policy directly from an insurance company, you will need to contact your insurer or broker directly if an accident or sickness prevents you from working.

If you have a group health benefit plan through your employer or through a member association, you should contact your plan administrator (usually someone in the human resources department). They will help you coordinate with the insurer to begin your claim.

Understanding private disability insurance

There are two basic kinds of private disability insurance: short-term and long-term.

If you are unable to work for a short period of time, you may qualify for short-term disability (STD) insurance. Generally STD insurance supplements your lost income for approximately 2 weeks to 6 months, though it varies from policy to policy.

Long-term disability (LTD) insurance provides some compensation for lost income for an extended period of time. If you are unable to work for a prolonged period of time, as determined by your physician, you may want to consider making an LTD claim.

Policies will define “disability” differently from insurer to insurer. Some policies will consider you disabled if you cannot work at your current occupation, whereas other policies will consider you disabled only if you’re unable to work at all. Talk to your human resources department or consult your insurance brochure to determine the criteria required to qualify you as disabled (usually called the ‘extent of disability’) within your policy.

When do I make a claim?

Your insurance policy specifies the amount of time you have to file a claim after your injury or illness. This is usually called the ‘claiming period’ or ‘qualifying period’. This period of time will vary between insurance policies. If you don’t file your claim within the period set out by your insurer, your claim could be denied.

Be conscious of the wide range of benefit periods (the duration and quantity of payments that you will receive). If your disability claim is accepted, ask your insurer about the specific benefit periods in your plan.

What documentation do I need?

If you make a disability claim, your insurer will request information to determine your eligibility for disability benefits. Some of the documents your insurer may request include your personal information (name, date of birth, age, gender, etc.), social insurance number, a declaration from your employer, as well as a medical certificate obtained after a physician’s examination. The insurer uses the physician’s examination results to determine your eligibility for disability benefits.

Before you submit your disability claim, you should contact your insurer to find out what documentation you are required to provide.

Key Websites:

• Human Resources and Skills Development Canada: Canada pension plan disability benefits
• Human Resources and Skills Development Canada: Worker's compensation
• Service Canada: Employment insurance sickness benefits

Related Articles:

• Accessible Workplaces: Finding employment to fit your needs
• Managing a Disability: Locating services, support, and resources

References