Disability Blog

How do I apply for short-term disability benefits in Ontario?

In Ontario, short-term disability benefits are defined as financial support for people who are unable to fulfill the duties of their employment. It is granted when someone is disabled, either through injury or disease, and is not able to continue their job. This sort of financial support is very important because, on top of financial insecurity and struggling to maintain work performance, individuals with disabilities may need even more financial aid for extra costs that result from their disability, such as treatment, rehabilitation or medication. 

You might be eligible for short-term disability benefits as part of your job contract when you join a company, or for benefits offered through the Canadian government, in the form of different benefit plans such as the Canadian pension plan (CPP). If you have a disability and are not already receiving short-term disability benefits, it’s important to find out what short-term disability benefits are, if you are eligible or not, and how to apply for them. 

If you have a disability and have been denied disability benefits, reach out to speak with Lalande Disability Lawyers today. Our short-term disability lawyers are experienced and have worked for clients who have been denied their disability benefits since 2003. 

What are short-term disability benefits?

If you have a disability and cannot continue working, you may be entitled to short-term disability benefits. Depending on your work situation and contract, you may already have paid or unpaid sick leave from your company. Once you’ve used all of that up but are still unable to resume work, you may be eligible for short-term disability benefits.

In the province of Ontario, most people can stay on short-term disability benefits for up to 120 days; any disability requiring financial benefits for longer than that length of time is considered for long-term disability benefits, which requires a completely different application process. There are basically three types of short-term disability benefits that you may be eligible for:

Government plans: either federal or provincial disability benefit plans that are offered as a part of the country’s social security benefits. Examples include worker’s compensation (WSIB) plans, the Canadian pension plan (CPP), the Quebec pension plan, or unemployment insurance. 

Group benefit plans: disability benefit plans that are offered through your company. Typically, these sorts of plans are introduced during the hiring process, and you may remember opting into a short-term disability benefit plan. These disability benefit plans provide limited coverage but can be maintained with lower regular payments than other disability insurance packages. 

Individual benefit plans: Lastly, there are disability benefits that are offered via an insurance company. These private disability insurance plans are the most costly option but they offer the most comprehensive coverage. 

Am I eligible for short-term disability benefits? 

Perhaps the most important question that you might be wanting to know is: am I eligible for disability benefits? Many people may not even know that they, in fact, could be receiving financial aid to help with their disability, simply because they’ve never thought about disability benefits as an option that you might be eligible for. To figure out if you might have a case to claim disability benefits, here are some of the questions that you should be asking:

Do I have sick days remaining?

Companies provide sick leave for employees to be used in instances when they’re not able to work for extremely short periods of time, with anything longer than that considered grounds for short-term disability benefits. Your sick leave should be completely used up in order to apply for short-term disability benefits from your employer or from the federal Employment Insurance (EI) program or Canada Pension Plan (CPP). 

Are you disabled?

Short-term disability benefit is available for individuals who are not able to work because of disability. The word “disability” is defined as “not being able to perform the duties of the job”, the job that you were hired for. A common situation that will arise is that insurers – companies deciding whether or not to grant your claim for disability insurance – will openly doubt whether you are, in fact, not able to perform your job due to disability, as you claim. If your doctor can support your claim for short-term disability benefits with medical evidence, it will go a long way towards making your application for short-term disability benefits a smooth process. 

If you are uncertain whether your condition or situation makes you eligible for short-term disability benefits, the best thing to do is to speak to a lawyer who has experience with disability law and understands the interpretation of the term “disability” in this context, and they will be able to tell you what needs to be proven in order to be eligible for short-term disability benefits. 

Where do you live?

Laws surrounding disability and disability benefits differ from province to province, in terms of whether you’re entitled to disability benefits and how much disability pay you’re entitled to. It’s important to be working with a lawyer who understands the area where you are living since that will mean the greatest chance of being successful in your application for short-term disability benefits. 

Lalande Disability Lawyers have worked on cases for individuals seeking disability benefits in the province of Ontario since 2003. They have experience and understand what the province of Ontario considers a legitimate claim for short-term disability insurance. 

Is there any reason why I would be denied short-term disability benefits?

Everyone’s situation is unique, and the best way to answer that would be to have a conversation with a lawyer about your claim for disability benefits. 

However, it’s important to know that there are times when claims for short-term disability benefits may be turned down:

  • activities like sail gliding, parasailing or parachuting
  • participation in a riot
  • if you have spent time in prison
  • if you have attempted suicide or self-harm (whether proven sane or not)
  • if you have an addiction to alcohol or drugs

While it’s important not to generalize from this list, there have certainly been times when claims for short-term disability benefits have been refused, based on the details of each individual case. Your lawyer will be able to provide a more accurate recommendation on whether or not your case would be eligible or not for short-term disability benefits based on your personal background and details of your case. 

Applying for short-term disability benefits

After confirming that you are likely eligible for short-term disability benefits, it’s time to begin working on your short-term disability benefits application forms. If you are working for a company, this is something that you would get from the human resources (HR) department; alternatively, a benefits administrator from the association that you belong to will be able to provide you with the document as well. 

Short term disability claim form (or plan member statement)

The main document that you will submit as part of your short-term disability benefits application package is your claim form. The document will ask for relevant information to your case and will be used towards the decision of whether or not to grant short-term disability benefits: 

  • personal identification information
  • the cause of the disability
  • details related to the disability
  • the expected return to work date
  • benefits received (if any)

This information will be submitted to the disability insurance company, and a disability insurance adjuster will be responsible for judging whether or not your employer needs to pay you. It’s the responsibility of the insurance adjuster to figure out whether or not you are eligible for short-term disability benefits, how much should be paid, and how long you should receive benefits. 

Supporting documents

In addition to your short-term disability claim form, your disability benefits package will include a statement from the attending physician. This is a medical professional who has the medical background to understand and give an accurate assessment of your physical condition, as it relates to your working responsibilities; in most cases, either your family physician or specialist is responsible for creating this document. This statement will state: 

  • your physical condition
  • the recommendation of the medical physician regarding your fitness to return to work
  • other details related to why you should be considered for short-term disability benefits.

Lastly, the insurance adjuster will request additional information from your employer. (This is not something that you will be asked to collect, but something that the employer delivers directly to the adjuster). This is information regarding your work situation and work duties: 

  • your salary and tax deductions
  • if your disability was a result of a workplace injury or disease
  • if your claim was filed to WSIB
  • a job description including your duties, including what would be required to be able to physically continue to work at this position (i.e. Is it a job that requires squatting or standing, lifting something heavy on a regular basis, or sitting/standing for extended periods of time)

Still unclear about whether you should apply? Speak to Lalande Disability Lawyers

Living with a disability and trying to continue work is a burden that you should not need to carry alone. The short-term disability benefits system in Ontario is meant to support people like you, who have experienced a tragic experience that has left you living and working with a disability. It can be confusing for anyone to try and figure out whether you are eligible for short-term disability benefits and trying to figure it out all out can be frustrating for anybody. Rather than go at it alone, speak to us about your situation and let us see if there’s anything that we can do to help. 

Hamilton Disability Lawyer Matt Lalande and Lalande Disability Lawyers has recovered millions for the disabled people throughout Ontario who have been wrongfully denied or cut off their long-term disability benefits. Call us today @ 1-844-LALANDE or local in the Hamilton/Burlington/Niagara areas @ 905-333-8888 to schedule an online zoom consultation today. We can fight for you to get your disability benefits back.

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