7 Steps to Apply for Long-term Disability Benefits in Canada

Hi there, David Brannan, disability lawyer. In this video, I'm going to take you through my seven step process to apply for long-term disability benefits. These are going to be seven easy steps you can follow in almost any situation. Let's dive into it. Step number one, before you can apply for long-term disability benefits, you need to figure out what your waiting period is. Long-term disability is a little different in that you can't apply for it as soon as you go off on a sick leave. There's usually a period anywhere from 17 weeks up to as 52 weeks, which is called a waiting period. You have to be continuously unable to work over that period of time before you can even qualify to apply. You need to figure out when does your waiting period end so you know when to put your application in. You don't want to wait until the waiting period is over to get your application in because as soon as the waiting period ends, that's your first date that you could be eligible to be paid for benefits. You want to figure out when your waiting period ends, get the application started several weeks before so that you get it in plenty of time for them to make a decision and figure out your waiting period. Step number two, before you're thinking of making a long-term disability claim, even if you're already off on short-term disability, figure out if you have your doctor's support. That is number two. Do you have your doctor's support? It is hard enough to win a disability claim when your doctor is 100% behind you. If you don't have support of your own doctor, it's pretty much very hard to be almost impossible. The insurance company will be all over that. So here's the thing. Some doctors, they're just different in how they handle the situation and you just have to work with the doctor that you have. It's not easy to switch doctors and shop around for doctors that can also be worse. So here's the deal. Some doctors will be very comfortable with their patients being on a short-term disability leave but for the doctors, how they view long-term disability, maybe they're going to think they don't want you to do that. They don't see you as that disabled. They have their own vision of what that means and so they would be reluctant to be on your side for it. In that situation, you may need to just work with your doctor. Maybe you will try a return to work even though you're not confident it's going to work but you've got to work with your doctor so that they're going to be understanding that you've tried enough so they'll come around and support you. Sometimes you can work with a firm like ours and we can reach out to the doctor to explain. Maybe the doctor has some misconceptions and myths about this. One of the myths that doctors have is if someone goes on long-term disability, that's it. They're going to be done. They're never going to try to work again. We could explain to your doctor that at least our law firm takes the approach that we encourage people to go back to work just because someone's applying for disability. There are deadlines to do it. It doesn't mean you can't still also try a return to work in the near future. The whole point of long-term disability is to give people two years of time to recuperate and try to get back into their own job so that going on long-term disability is to further your ability to access rehabilitation benefits and other things. Once a doctor hears all that, they're like, oh okay, so you're not just going to try to go off and never do anything again. That may be important to explain to your doctor. Number three, you have to tell the insurance company that you want to apply. It's a different process in different situations. Once you know you got your doctor's support, your waiting period's figured out, you need to get the forms to apply and you need to tell the insurance company or sometimes your employer is going to give you the forms. You're going to want to get these forms and get them ready to be filled out. That takes me to number four is filling out these forms. Again, your situation will be different. If you're already on a short-term disability claim with the same insurance company, you may not have to fill out any more forms. You would have already filled out a bunch of forms. They're getting updates as you go along. Sometimes it's just a seamless transition into long-term disability and there's not much to do. If it's a different insurance company, you're going to have to go through the whole process of forms, reports from your doctor, etc., getting them information. That takes some time. You're going to want to get those forms, get all the information, get up your benefits booklet, and work at getting that all done. There are three forms that you do need to fill out in most claims, at least at some point. There's going to be a form you fill out with information about your situation. There's a form your doctor fills out and a form your employer fills out. Unless you're self-employed, it's going to be filled out by your employer. You're going to need to arrange. It's on you to arrange to get all these forms done and sent in. Usually your doctor and employer are going to send the forms directly to the insurance. It won't come through you. It's not ideal because you really want to see what's on those forms, so you may ask the insurance company to send you back a copy once they get them. Number five. Once you get everything done, you're going to want to send a package of information in to the insurance company. You don't have to send everything at once. What I would, in fact, encourage you to do is get your form filled out and in right away. That puts the insurance company on notice that you're making a claim and that more stuff's going to follow. Then you can follow up with your doctor to make sure they get their stuff in, your employer to make sure they get their stuff in, and if there's any other things you want to send in, other supporting medical information, you can get that in later as well. But don't wait around. Some people wait around and hold off and hold off, waiting to get all the other stuff. That's not a good idea. You can sometimes wait too long and miss the technical deadline to apply. Better to get the things started, get them on notice as soon as possible, and sometimes the insurance companies either chase down your doctor or your employer to get the other forms in. It can help you. Next one. Cooperate with reasonable requests from the insurance company. This is not the time to play games or to try to give them as little information as possible. Now, I've told you in other videos, dealing with insurance companies is sort of like the police. You have to be very careful what you say. But it's also different from the police because with the police, you have a right to remain silent. With insurance companies, you actually have a duty to give them information they need to approve your claim. So you really don't want to throw up artificial barriers or put limits on information. If they want to do a phone interview with you, if they want to ask for medical records beyond the forms, they may want to ask your doctor specific questions to put in writing. These are all things that you should be encouraging and facilitating to happen. It's reasonable to do it and sometimes it may feel awkward to you. Like, why do they want all these notes and information? They need all that information because quite frankly, they have behind-the-scenes doctors who want to review everything to get a better picture of what's going on. That's really what's going on here. So you want to facilitate that process. Get all the information in. Certainly when we represent a client, we are on the side of we get them whatever they want because I want to be able to tell the judge at the end of the day if this ever gets down the road. Not all cases do that, but if it does, you want to be able to tell the judge that my client gave all the information. They were cooperative. The insurance company has been the bad actor the whole way along here. What you don't want is this Jerry Springer back and forth where you're kind of a tit-for-tat being nasty to them as they are to you. That just doesn't go over well and it always ends up worse for you. You want to really be the person to be seen to rise above and to have been helpful. The more you do that, the more likely it is your claim is going to be approved. So you're cooperating with reasonable requests from the insurance. The last thing is you just have to wait. You just have to wait for them to make a decision. Again, there's no typical time. It can take 30 days, 60 days. It really starts counting from when they have all the forms in, but they want this specific other information from your doctor or they want your doctor to answer certain questions. If the doctor takes another three months to get that to them, you're waiting three months. They will usually wait to get this information before making a decision. If you want to pressure them, they'll make a decision early and just deny it. So what you'll want to do is when they're trying to get other information from your doctors or others, you'll want to follow up with your doctors to try to make sure that happens as fast as possible. Be patient. Some doctors are very overwhelmed, especially in the current times that are going on of the shooting of this video. So don't be too hard on your doctors, but try to politely try to get them to get whatever information they need. Also, once a decision comes in, the decision is either going to be an approval, a denial, or what I call a conditional approval. So an approval is one where your benefits are approved, there's no conditions on it, and you're just moving forward. They'll reassess it as they go. A conditional approval is where you've got to really watch out for this one. They've approved it, but it's conditional on your doctor getting this information into them by next month, or it's conditional on you doing this or some other thing. There's a condition there that means that it's an approval, but it's a very tenuous approval and it could end very quickly. If you see that kind of thing, be very aware of it. You may want to reach out for legal help. If you get a denial, they'll deny the benefits. Many people get denied to have claims approved later on. I think that's obvious. Maybe not obvious, but it does happen a lot. So don't despair if it gets denied. These things can be turned around quite quickly. I did statistics last year and I think it was a quarter of all the people we represent in long-term disability claims, a quarter of those people, we got approved before lawsuits by doing these internal appeals. I don't know what it is. I haven't redone the statistics, so I'm not sure what it is at this point. But that's the last time I checked. It's a quarter of the one. That's just the people we're working with. So you can be approved on these appeals. You don't always have to go to a lawsuit. Keep that in mind. So those are seven steps. Obviously, I'm not going into great detail, but it gives you an overview and a framework that you can follow. If you have any questions, don't hesitate to reach out to us. You can use the links on this page, or if you're watching us on YouTube, go down to the video description and there'll be a link to our website. You can request a free consultation and I'll see you back here next time.