Depression Long-term Disability Benefits in Canada

In this video, I'm going to give you an overview of long-term disability benefits for depression in Canada. I'll cover three areas. I'll start by talking about is depression of long-term disability in Canada to start with. Number two, I'll go through the sources and types of benefits that you can get for depression for long-term disability. And finally, I'll go through some tips on how you can improve your chances of being approved for long-term disability benefits Let's dive on in. First of all, is depression a long-term disability in Canada? I think I'm not going to bury the lead here. It absolutely is. Being diagnosed with depression is not enough to get you approved by the various long-term disability programs. You will still need to prove the amount of impairment that you have from your specific symptoms of depression. It's important to understand that depression is actually the most common reason for people to apply for and be approved for long-term disability benefits. Mental illness as a group of conditions is the largest group for people applying for long-term disability and depression is the biggest category within that group. It far exceeds any other single diagnosis or source of long-term disability in Canada. So much so that insurance companies have targeted depression to disability claims as something of concern to them because these claims are rising and they're overtaking all other types they're basically making more claims than ever for insurance companies and it seems like it's going up every year. So insurance companies are taking a careful look at this and they will really vet these claims before approving them. All right, let's move into these sources and types of benefits for long-term disability for depression in Canada. There are three sources of where you're going to get these benefits. First, you can get them from insurance plans or policies. Second, you can get benefits from your provincial government. And third, you can get benefits from the federal government. Let's go through these now starting with insurance companies. So insurance companies provide benefits across Canada and these plans will usually cover depression. Now it's important to know that there are plans out there for group insurance plans and individual plans that exclude coverage for depression. Yes, believe it or not, this is actually fairly common in the United States. It's much less frequently seen here in Canada but I am aware of some group plans and certainly private individual disability plans that exclude claims for depression. For example, I know for a fact there's at least one teacher's union plan that excludes claims for mental illness. So the first thing you need to know is if you are going to be applying through an insurance plan, does that plan exclude any claims for depression? It probably won't but it is something you need know about. If you purchased an individual plan, the only way it would really exclude claims for depression is if you had a history of depression or any type of mental illness or those type of symptoms before you applied for that and that insurance company was aware of it and excluded it from the policy. Okay, number two is you are going to be able to get benefits for depression through the provincial government. Now each province has two programs that they run. They're different but they're the same. So they're the same types of programs but the specifics of how they run and the details are going to be very different. Those two programs are each province has a workers' compensation plan program and each province has a what I will just call the provincial disability or income support benefits for people with disabilities. Now if we look at workers' comp first, it is not easy to have a successful workers' compensation claim based on depression. That is because you have to prove that your depression is caused by an injury at work. So some incident at work or something to do with your work caused the depression rather than you just developing this condition for other reasons. This is why it's very difficult and in some provinces almost impossible to have a successful depression claim for workers' compensation. Now it doesn't mean that it can't happen but you are going to if you feel like your work contributed or is the major factor in your depression that is something you want to look into but be very careful about that because if you pin you try to pin it on your work and you're unsuccessful it can hurt claims that you make with insurance and other providers who won't cover you if it is work related. So you have to be very careful around that. Now the second one for provinces is called these provincial disability benefits. There's different names across Canada in Ontario for example it's ODSP, BC it's called PWD, H in Alberta etc. Now the thing to know here is certainly depression is covered by these plans. Again they will look at the seriousness of your depression to make sure that you reach the level of disability. Your depression basically would need to keep you from doing any type of work. Now in addition to that the problem with these provincial programs is that they are capped in terms of your family income. So if your family income is at a certain level from other family members and things then you won't qualify for these benefits because you earn you have too much money according to them. So keep that in mind these these benefits are there but they're not available to everyone if you have someone else in the family working and that kind of thing it can be very disappointing. Next one on our list here is federal programs. So there are two real programs out there that will cover people with depression actually three. Let's go through the first one. The first one is the one that's most widely known Canada pension disability benefits that will absolutely cover people with depression as long as you can prove that the depression keeps you from you have to prove two things. Number one the depression prevents you from regularly working in any type of occupation. You can earn a little bit of money but if you have the ability to earn over around nine thousand a year and certainly once you get up to earning into the to the sixteen seventeen thousand dollar range that's going to be too much ability to earn money to qualify for CPP disability. So number one it has to be disabling to the point where you really can't work on a regular basis. Number two and this is where many depression claims don't win with CPP disability is that you have to show that it is permanent. Depression is very treatable and there's very high functioning people who have bouts of depression and then rebound and go through great periods where there's no problems as long as you follow the medication and things like that. CPP knows that and they will many claims are going to get denied on the basis that you haven't proven that it's going to be permanent and that you're not going to get better in a few years. That's a big challenge with these claims with CPP disability you're going to need to take special care when doing that type of claim. Next from the federal government there is EI sickness benefits. These are a short-term benefit available through the employment insurance plan. They only cover 15 weeks but certainly if you're out for depression especially if you're out for a short period this is going to be the perfect type of benefit. They approve them automatically as long as your doctor certifies you're not able to work so there's no investigation like with the other claims so that's an easy one. Now the third one it's not really a benefit that gets paid out monthly like these other ones it is called the You can be approved for that with depression. Now it has to be quite severe depression but you can get approved and if you do you're entitled to a tax credit on taxes that you pay into the federal government. This benefit's only good if you're actually paying in taxes and can get a refund. Either you or someone else in your immediate family who's supporting you financially they could use if you get approved for the disability tax credit they can apply it to their taxes. It doesn't pay out a monthly benefit but you can get a refund at the end of the year based on the credit amount. How to prove a depression disability claim. This is an interesting area because all long-term disability claims are not the same. Some claims have certain challenges and depression has a lot of challenges to it. Now it's not insurmountable or it's not impossible to win one of these cases but you do need to keep these things in mind in order to be successful. First of all I already mentioned at the beginning of this video that there's kind of a target on your back if you're making a claim for depression because of what a big deal this is becoming for the insurance industry and they're being overwhelmed with these claims and so they're really scrutinizing them. So it's going to be more important than ever that you make sure that your claim is very tight and you've checked off all the boxes that they need in order to approve your claim. So the first thing is you absolutely need an official appropriate medical diagnosis of depression. Where I see people go wrong here is sometimes there's a reluctance especially if this is your first time experiencing these symptoms. Some doctors don't want to slap on a diagnosis of depression right away. They will soften the blow by just saying that it's burnout, that you maybe are just stressed out and they put you off work on a stress leave or for burnout, that kind of thing. That type of diagnosis is not going to fly with insurance companies. They will automatically deny those types of claims. They're going to say it's not serious, it's not a serious diagnosis and so if you actually have depression and it's going to be a long-term issue that you're dealing with then you need to actually have that diagnosis. Diagnosis of burnout and stress and that kind of thing is just not going to work. Now often you're going to see depression coexist with other diagnoses like fibromyalgia, chronic pain, chronic fatigue syndrome. There's all these things that kind of co-mingle. Sometimes that actually can be helpful because there's other things to focus on in other instances but sometimes the insurance company will sort of say well this you don't have fibromyalgia you have depression. So it kind of all gets mingled up here. The important thing is that you have an official diagnosis and that you can present that to the insurance company. Number two, the number one way that you will not get approved for a depression claim is if you are not getting what is considered a reasonable treatment. I don't know why I'm stumbling over that. If you're not getting reasonable treatment, appropriate treatment, the insurance company is not going to approve your claim. What is reasonable and appropriate treatment? There is some debate over that depending on your situation. It's not a cookie cutter approach but at least from the point of view of getting your long-term disability claim approved it's going to be whatever the insurance says it is. So if the insurance feels like you should be taking medications, you should be getting psychology and that's usually what they insist on. If you're not doing those things they will deem you not to be getting appropriate treatment and therefore deny your claim. They're allowed to deny claims especially under insurance policies but also with government programs if you're not following appropriate treatment. Now there again there can be some debate over what is appropriate but at the end of the day their definition is going to win out at least initially because they will just refuse to pay if you're not doing what they said. So it's very important if you are going to have a long-term disability claim for depression that your doctor be following best practices, that your treatment's well documented, and that you're progressing through the treatment. The next one is if you're going to be on a long-term depression claim. Like I said, depression is one of these things where very high functioning people have depression. It can be episodic. You may have it for a few months and then you're fine. But if you're into a chronic depressive state, which does happen and I've had many clients in that situation, you have to show them that you have tried everything. You can't be in a chronic depressive state and feel like and think that you're going to get long-term disability benefits if you have not tried everything in terms of treatment. So that means if that one medication didn't work you have to try the other one. You can't just say well medications don't work because I tried that one it didn't work. I don't want to go through that nightmare again because it is a to try out these various medications. But unfortunately you have to do it. You have to show that you've tried all the different types of recommended medications and that they did not, they were not successful in regulating your mood. You have to show if it's been recommended that psychology or counseling. You have to do it. If you can't afford to do it, you have to show that you've used every effort to look for ways to get it paid for or free through the government or out patients or something. You can't just say oh I had no money so I didn't do it. No well did you call around? Did you check this program? So you have to show that you have tried everything possible and that despite everything you are still chronically depressed. If you don't have that your claim is going to be denied and if you come to a lawyer like me you're going to hear the story well look you can do your case but you are going to have to go and try these treatments or it's all for naught. A judge will not approve this case at the end of the day if you haven't pulled out all the stops and tried everything to overcome this illness. Now you may feel you've tried everything but objectively looking at it from outsiders they will say well you should have tried this other medication. You should have definitely gone for psychology because there was funding available. This type of thing that's going to be critical. Now in addition to exhausting all treatment you the next one is going to be you have to have evidence of work-related limitations. Again it's not the diagnosis of depression that's going to get you approved or for your claim. It's going to be you drawing a link between the seriousness of your symptoms and those symptoms and limitations making you incapable of doing your own job or any other job in some situations. So how do you prove that? It's very hard to prove. Depression is invisible. It can't be really measured easily. So the best way to prove these things are to have your doctor document it over time that these are the parts of the work that you're struggling with. You can have your work kind of it's good to have a job description of all your duties so you can see the type of duties where you're going to be struggling with and have your doctor speak to why depression would prevent you from carrying out these functions in your work. Sometimes it's obvious but you do need to make that link directly from your symptoms their severity and how it prevents you from doing your doing your work. Also sometimes employment records can be helpful because they can show that you have tried to do modifications in the work maybe cutting back on certain duties doing other things to try to keep you in the workforce and those things weren't successful. You may also have to just try a return to work if everybody feels like well maybe you should try this it could work then you you do have to give it a try even if it only lasts a day a week or whatever that's fine it shows that you tried if your doctor is supportive and at least you try if your doctor is supportive and at least you're trying to see if it could work and you don't do it game over okay you have to at least go try or engage the process. Sometimes what will happen is they will ask you to work with a rehabilitation person all this thing you don't think it's going to work but you still should engage the process because it shows that you are actually trying a little bit here okay. Last one here is in some ways most important is to protect your credibility it's an invisible illness you either are going to be believed or not believed. In theory people can fake or exaggerate symptoms of depression it's certainly possible to do and insurance companies are aware of this the insurance companies know this so what they're always going to do one of ways to beat you is to make you look like a not believable person so that the judge will be less likely to believe that you are telling the truth or think that you might be exaggerating your symptoms. So how do you protect your credibility? Well there's certain things you need to avoid for example you need to avoid saying things that contradict the information in your medical records or contradicting things that you said before without really a good explanation of why what you're saying has changed. You have to avoid and this is a big one making excuses or blaming others well you stopped that treatment because you didn't like that person the doctor didn't know what they were doing that's why you didn't do that you can't get into the situation where all your reasons for why you're not doing things is blaming other people that will be seen very negatively by the courts. Another one is and this doesn't come up so much necessarily with people with depression but generally speaking if you're having fights with your doctors filing complaints against them to the medical regulators or other professionals if you're at war with your own treatment providers very bad for your credibility even if you're in the right. I tell people like hold off on that like do that war after your disability claims over you're better off to take the higher road and just seek other treatment providers if you're if you're not agreeable with these ones don't get into fights and wars with your own treatment providers it kills your credibility and it will not help you win your case. Again you want to be seen as the reasonable person who is trying their best so you need to avoid things like being confrontational with the insurance company taking sarcastic tones saying nasty things to them that can be easy to do with depression because sometimes you're to the breaking point and you can have an outburst but if you do have those outbursts make sure you apologize you can't be coming off as seen as a hot head who is causing trouble for the insurance company you don't want them being sympathetic in any way and they can be sometimes if you are the one being abusive to the the people you're dealing with at the insurance company and certainly seen that and I've also seen the back and forth which is just as bad you're better to be the one taking the high road and that protects your credibility. Finally acting like a medical expert will always ruin your credibility medical recommendations have to come from credential providers I know with the internet and with with information available you can learn a lot in some cases you may know in certain situations as much about your condition as anyone else and the treatment available and that kind of thing you still can't present yourself as an expert you have to get your doctors on board and other treatment providers. All right I am out of breath we're at the end of this video I hope you enjoyed it if you did please go ahead and subscribe hit the like make sure this video gets pushed out to more people and go to our website and if you're not already there go to our websites subscribe to our email list and you will get information and tips on all types of disability claims. I'll see you back here next time. I'm disability lawyer David Brannan. Take care.