When you get injured, either on or off the job, it is sometimes impossible to work. The condition of being unable to work is known as a disability.
For many, disabilities are merely temporary. For others, disabilities will be a lifelong condition.
Disability insurance exists to make sure that you will be able to pay your bills while you are recovering from an accident or insurance. Employers usually offer these plans as part of their benefits packages, though not always. Private disability insurance is also available to Albertans who don’t have the option to purchase a plan through work.
What is Short-term Disability?
Short-term disability (STD) is a form of insurance that will cover your expenses for up to six months if your paid sick leave runs out while employed. The specific payout period will depend on your specific STD policy.
STD benefits usually pay 65% to 70% of your regular net pay and will do so to a predefined maximum, usually $5000 per month.
If you don’t have short-term disability coverage then you might be eligible for Employment Insurance (EI) benefits through the Canadian government.
Short-term disability insurers will always keep a close eye on timelines. Your doctor will provide expected an expected timeline for recovery and an expected timeline for when you may return to work. The insurance company will require you to put together a safe “return-to-work plan” that may involve light duty or reasonable accommodation.
What is Long-term Disability?
Long-term disability (LTD) coverage begins when STD benefits run out. The tend to cover 70% to 85% of your take-home pay.
You can get LTD benefits for up to two years if you are unable to work in your own occupation after an accident or injury. That is, you’re unable to work the exact job you were working when the accident or injury happened.
After two years, you have to prove that you can’t work in any occupation at all to continue receiving benefits, even if the occupations you can now work in pay significantly less than your former position did.
If you can prove that you can’t work at any occupation you will be able to receive benefits until you turn 65, at which point the Canadian Pension Plan will generally take over.
These are general definitions. You must pay close attention to how your plan handles disability as well. In some cases there may be very specific exclusions or pre-existing condition clauses that can impact your claim.
Can an Employer Fire You While You’re on Disability?
Technically employers are not supposed to fire you while you’re on short-term disability or on a job-protected medical leave unless they suspend or discontinue the business, and must offer you your job back if the business starts up again within 52 weeks after your leave ends. Employers are not supposed to discriminate against, lay off, or terminate an employee, or require them to resign, because of a request for a job-protected leave.
Employees are eligible for job-protective illness and injury leave if they’ve been employed at least 90 days with the same employer. If you are eligible you can take time off work without pay without risking your job. When you return to work you must be given the same job, or an equivalent. Your employer is not required to pay wages or benefits during a long-term leave unless such payments and benefits are outlined in an employment contract or collective agreement. For the purposes of calculating years of service your leave counts as being continuously employed. Leave doesn’t guarantee a disability insurance payment, but the federal and provincial leave laws do help protect your job while you do. You can take up to 16 weeks of leave each calendar year by providing a medical certificate that states the estimated duration of your leave. You must do this before the leave begins in order to protect your job. You must provide one week’s written notice of the date you intend to return to work unless there is an agreement otherwise.
In reality, they often do, claiming that the employment contract has “become frustrated” due to your absence on the job.
This means that they have determined that your return to work is improbable, or that you cannot fulfill the terms of the contract.
If they do this, they will owe you severance and pay in-lieu of notice. In some cases, they may have to continue paying your disability benefits. You may also be eligible for public disability benefits, such as CPP or AISH.
What Benefits Are You Entitled to If You Fall ill or Have an Accident?
Benefits can come from a number of sources, depending on whether you were injured or fell in on the job or off the job, on what insurance policies you have available to you, on whether your injury or illness was part of a personal injury case, and more.
Usually you will get 65% to 85% of your net pay on a weekly or biweekly basis. Other insurance policies, such as your medical insurance policy, may cover your medical bills.
If you were disabled on the job then WCB will cover both your medical expenses and a weekly disability award until you are able to return to work. They may also offer a lump-sum payment in cases where you become permanently disabled.
How Do You Apply for Disability Benefits?
There will usually be a claims application to fill out, or an online form.
When you apply, your number one goal is going to be to reduce the number of reasons an adjuster might have for denying your claim.
Fill out the form fully, completely, and accurately. Stick solely to the facts.
In some cases, your employer, your doctor, or a specialist physician will have to fill out paperwork of their own. Follow up with them to make sure they are submitting the claim in a timely fashion. For example, a short-term disability claim form usually consists of the Notice of Claim, the Employer’s Report, and the Attending Doctor’s Report.
You may also need to include copies of your driver’s license and birth certificate.
Do You Need a Lawyer to Handle Your Disability Claim?
If your insurer cuts off benefits before the process is complete or denies your benefits altogether then you might need the help of a disability lawyer. If you’ve provided all the evidence you know to provide and are getting the run-around, a disability lawyer may be able to get your claim back on track.
Need Help with a Disability Claim?
When you’ve been disabled, our team of Red Deer personal injury lawyers is here to help you put your life back together.
Most of our lawyers have over 20 years of experience with personal injury and disability law. We’re known for being some of Alberta’s toughest negotiators and savviest litigators. We’re responsive and caring. Calling us is absolutely risk-free: we’ll evaluate your case without a retainer and without charging an exorbitant hourly rate. We don’t get paid unless we bring your case to a satisfactory conclusion.
Don’t struggle through the process of making a disability claim alone. Don’t let insurance companies take advantage of you. Call (403) 269-7777 to claim a case evaluation today.