Short and long term disability claims are likely to rise exponentially as employers begin the process of calling employees back to work. A huge surge of claims should be anticipated as the psychological impacts, after months of quarantine, will be widely felt and cannot be overstated.
While some of us are ready and able to go back to work, others (for very legitimate mental health reasons) won’t be ready to return to work in the initial stages of any return to work plan.
Employees who fall into this category and who are fortunate to have access to disability plans should review their plans carefully.
A typical plan covers an initial disability leave where the employee is unable to perform their own occupation due to disability. Claims based on psychological or other subjective illnesses are often denied by insurance companies at first instance. Insurers deny these claims knowing that many potentially legitimate claims will not be contested.
When applying for disability insurance it is important that you have the support of your family physician or other treating doctors to support your disability. A disabling condition must be a medical condition. To be clear, a disability claim will not be appropriate for employees who are unable to return to work for non-medical reasons such as child care responsibilities, for which there are other avenues to explore.
Keep in mind that workplace specific stressors are often excluded under disability plans and employees completing applications will want to be careful to avoid including language that could trigger an exclusion under the policy.
Employees and medical professionals should be cautious when estimating the length of any disability period on their applications as insurers rely on those estimates should a disability period exceed them.
I believe that disability insurers are about to see a wave of claims like they have never experienced before. The prudent thing to do will be to approve these claims recognizing the extreme mental health stresses that Ontarians are under. However, even approved claims are likely to face added scrutiny in an environment of unprecedented claim levels.
My recommendation is to speak to a lawyer in the early stages of your claim and when and if your claim is denied.
Note: Thomson Rogers will provide free zoom consultations for employees wishing to discuss their LTD claims and denials.