Yes, cancer can be considered a “long-term disability” with regard to obtaining income replacement benefits. However, coverage is not automatically granted. Patients will need to meet the eligibility requirements for long-term disability coverage and prove that the cancer symptoms have prevented them from performing their work duties or undergoing training for a new occupation.
What is long-term disability in Canada?
Canadians who are unable to work due to illness or injury may apply for disability coverage through their employers or unions. The self-employed must have purchased an independent long-term disability plan or qualified for group benefits as a member of a professional association.
Claimants need not inform their employers of the particulars, but need only state that they are “unable to perform their regular work duties” and are applying for income replacement benefits. This coverage is designed to help employees pay for medical and rehabilitation expenses, as well as the daily expenses of life. Most plans will cover 60 to 70 percent of your regular pay. There will be a waiting period – usually, a couple of months of inability to work — before you can begin collecting payments (with back pay).
When making a claim, the insurance provider will require details on the medical condition, including a patient statement regarding specific symptoms and reports from the doctor as additional evidence. If approved, short-term disability coverage will kick in for the first 120 days. Then long-term disability will kick in for up to two years if the claimant cannot work his or her own job.
At the two-year mark, if it is determined the claimant is too sick or injured to work ANY job, benefits may be collected until age 65.
Eligibility requirements for long-term disability under your employer’s policy
Eligibility for group disability benefits depends upon two tests:
Due to that second point, Canadians are increasingly purchasing their own private insurance disability policies to supplement their group benefits – which are becoming harder to get and are notoriously inadequate. These policies may be subject to more lenient rules. Seeking legal representation is another way you could successfully fight for your right to compensation.
Cancer symptoms that interfere with work
A cancer diagnosis is stressful, and most people would prefer to stay home and focus on recovery. However, long-term disability policies require cancer patients to prove they cannot work given their inability to perform day-to-day activities, side effects of their planned treatments, or workplace environments that cannot support necessary modifications.
Cancer can be extremely debilitating, depending on the type, stage, and comorbidities. Severe pain and fatigue typically prevent people from performing any type of physical labour. Headaches, nausea, vomiting, dizziness, and the inability to concentrate can further hinder employee performance. Sometimes cancer patients are unable to perform sedentary work, involving sitting for extended periods of time and less than 10 pounds of lifting. Even sedentary work requires certain education, training, people skills, and manual dexterity – which cancer can interfere with considerably.
Do you have a pre-existing condition?
A person’s group disability plan may have a pre-existing condition clause that limits claims when a person had a diagnosed medical condition one to two years prior to enrolling in the plan. Depression and anxiety are commonly excluded conditions, but so is cancer. There have been many cases of Canadians’ LTD claims denied when early detection tests found potential cancer prior to enrollment for insurance.
Do you need a lawyer to help with your LTD claim?
Coping with a cancer diagnosis is burden enough. Contact Preszler Law Firm in British Columbia for expert legal assistance from a personal injury lawyer who is well-versed in disability law. We liaison with insurers for you to fight for fair and full compensation, including back pay.
Denial of benefits can occur for a number of reasons, including “insufficient medical evidence” or the presence of “a pre-existing condition.” Even though there is an appeals process in place, most claims are denied time and time again – unless there is pressure from a long term disability law firm.
Contact us for a free case review to learn how we can resolve your claim as quickly and favourably as possible.