What to expect when submitting an LTD claim during COVID-19

COVID-19 has affected all Canadians in some way, shape or form. Whether they’ve lost their job, become sick with the virus, or suffered from other COVID-19-related issues; this pandemic has impacted the lives of millions, and some worse than others. Complications, anxiety, depression, chronic fatigue, and burn-out are just some of the ways that COVID-19 has affected the long-term health of many individuals. As a result, there are many concerns surrounding how and if you can make long-term disability claims. What happens if you can no longer work or are incapable of returning to work in the foreseeable future?

Long-term disability claims vs short-term 

If you have disability insurance, it is there to provide you with income support should you become disabled and unable to work. Disabilities include illnesses, phycological disorders, and physical injuries. There are two types of disability claims you can submit; short-term disability (STD) and long-term disability (LTD).

If you have taken sick leave from work, STD comes in to play once your sick leave has run out. Coverage can typically last for six months up to a year and covers approximately 70% of your salary. Sometimes employers will rely on employment insurance (EI) benefits instead of offering STD coverage. If you are still incapable of returning to work after your STD or EI has run out, LTD is the next step. You can remain on LTD for up to two years if you are unable to work at your regular job. You could also receive LTD coverage up until the age of 65 if your disability prevents you from working altogether, in any occupation.

Not all coverage is the same and is dependant on your policy. If you are considering submitting short-term or long-term disability claims, make sure to read up on all of the details in your policy to make sure you qualify.

Submitting long-term disability claims related to COVID-19

Firstly, even if you have been laid-off or terminated by your employer, in most cases, you are eligible to receive benefits from them. The amount of time your coverage can be extended can vary and is determined on a case-by-case basis.

If a medical professional has advised you that you can not return to work because of COVID-19 reasons, you may be eligible for LTD. First, you must apply for STD or EI before you can submit long-term disability claims. Make sure that your policy’s definition of “disability” refers to your specific situation. If you already have a pre-existing disability claim, it will not affect a COVID-19-related disability claim.

Disclaimer: submitting long-term disability claims isn’t always easy

Under normal circumstances, filing long-term disability claims is not an easy feat. It is also exceptionally challenging when the disability falls under the category of mental health disorders simply because they are ‘harder to prove.’ Some reasons as to why long-term disability claims may get denied include:

– Not meeting your policy’s definition of disabled (again, it is essential to check your policy’s qualifications if you’re submitting a claim for COVID-19 reasons)

– Having a pre-existing medical condition before becoming insured 

– An inability to provide sufficient documentation that proves your disability (common with mental health claims) 

– Your insurance company conducts an independent investigation with their own medical professional. Their doctor may disagree with your physician’s recommendations. 

To prevent COVID-19 long-term disability claims from getting denied you should ensure that you:

– Seek help from a medical professional and receive treatment as soon as possible.

– Keep all of your disability-related documents, reports, and prescriptions.

– Read your policy document thoroughly

– Submit a claim that is backed by a medical professional (e.g., not based on self-reported symptoms)

– Fill out your application accurately and include all necessary documentation to prevent errors.

When long-term disability claims get denied, it is best not to appeal the denial unless you have additional documents and proof that you can provide the insurer. If you feel your claim has been wrongfully denied, it would be wise to onboard a lawyer to handle your case. Insurance companies are trying to make money, not pay it, so they can be notoriously difficult to deal with unless you pursue legal actions.

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Daniel Badre Founder, Partner
Daniel Badre is a distinguished personal injury lawyer based in Ottawa, renowned for his unwavering commitment to justice and advocacy for those who have suffered from accidents or negligence. With a legal career spanning over two decades, Badre has established himself as a compassionate and tenacious advocate for his clients.
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