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Short-Term Disability in Ontario: Your Quick Guide
If you can’t work because of illness or injury, short-term disability (STD) benefits can provide essential income replacement. In Ontario, these benefits often come through employer group insurance plans or private policies, but each plan has its own rules.
This guide explains short-term disability in Ontario, including eligibility, application steps, short-term disability terms, what happens when EI sick benefits run out, and your legal options if a claim is denied.
What Is Short-Term Disability in Ontario?
Short-term disability is designed to replace part of your income if you cannot perform your job because of a medical condition, physical, psychological, cognitive, or emotional, for a limited period.
Common features include:
- Replacing 50%–70% of your regular income (some plans offer up to 100%)
- Coverage for a set number of weeks (often 15–26 weeks, sometimes up to 52 weeks)
- Requirement for medical evidence from a healthcare provider
As Christopher Achkar, lawyer and founder of Achkar Law, explains:
“Short-term disability exists to give employees space to recover without financial ruin. Unfortunately, many claims are denied for reasons that can be challenged and knowing your rights is the first step.”
Who Qualifies for Short-Term Disability in Ontario?
You may qualify if:
- You are covered by a short-term disability plan at the time you become unable to work
- Your condition prevents you from performing your own occupation (not just any job)
- You provide sufficient medical documentation supporting your inability to work
Coverage is usually provided through:
- Employer group benefits
- Private short-term disability insurance
- Certain union agreements
Short-Term Disability Terms You Should Know
Understanding your policy’s language is key. Common short-term disability terms include:
- Elimination Period – Waiting time before benefits start (often covered by sick leave, vacation pay, or EI sickness benefits)
- Own Occupation Test – Proof you can’t perform the essential duties of your current role
- Benefit Duration – Maximum period benefits are payable before transitioning to long-term disability (LTD) or other programs
- Pre-Existing Condition Clause – May limit coverage if your condition existed before your policy began
- Medical Evidence – Detailed reports from your healthcare provider supporting your claim
How to Apply for Short-Term Disability in Ontario
- Check Your Coverage – Review your benefits booklet or policy
- Get Medical Documentation – A detailed statement from your doctor is essential
- Complete the Application Forms – Typically includes:
- Employee Statement
- Attending Physician’s Statement
- Employer Statement
- Submit to the Insurer – Keep copies of everything you submit
- Follow Up – Respond promptly to requests for more information
How Much Do Short-Term Disability Benefits Pay?
Benefit amounts vary by plan. Most pay between 60%–70% of your gross salary, though some offer full income replacement. Payments are typically made weekly or biweekly.
How Long Does Short-Term Disability Last?
Most STD benefits last up to 26 weeks, though some plans offer shorter (15 weeks) or longer (up to 52 weeks) coverage. If you are still unable to work after STD ends, you may transition to long-term disability (LTD), EI sickness benefits, or the Ontario Disability Support Program (ODSP).
What to Do When EI Sick Benefits Run Out
If you’ve been receiving EI sickness benefits and your condition continues:
- Apply for STD benefits if you are covered
- Transition to LTD if your STD benefits are ending
- Consider ODSP for long-term support if you meet eligibility requirements
- Seek legal advice if there are disputes about your entitlement
What If Your Short-Term Disability Claim Is Denied?
Claims can be denied for reasons like:
- Insufficient medical evidence
- Disputes over whether you meet the policy’s definition of disability
- Pre-existing condition exclusions
If denied, you have two main options:
- Appeal with the Insurer – Usually up to 3 internal appeals within strict deadlines (often 90 days)
- Start Legal Action – In many cases, going directly to legal action can be faster and more effective than multiple appeals, especially if you have strong medical support
Christopher Achkar advises:
“Appealing a denial without addressing the insurer’s concerns rarely changes the outcome. A legal review can identify gaps, strengthen your evidence, and put pressure on the insurer to pay.”
STD Employment Protections
While on STD leave:
- Your job is generally protected under the ESA and human rights laws
- Employers cannot terminate you because of your disability
- If terminated for unrelated reasons, proper notice or severance must be provided
- Discriminatory terminations can result in additional compensation
Short-term Disability FAQs
Most plans cover 15–26 weeks, but some extend to 52 weeks.
Not at the same time. If you receive both, you may have to repay EI. You can apply for EI sickness benefits after STD ends, or vice versa.
It’s possible, but not for reasons related to your disability. If it is, this may be a human rights violation.
You can appeal internally or take legal action. Legal advice early on can improve your chances.
You may be able to apply for EI sickness benefits, ODSP, or Canada Pension Plan Disability (CPP-D) depending on your situation.
Conclusion
Short-term disability in Ontario can provide crucial financial support when you can’t work due to illness or injury, but the process is full of fine print. If your claim is denied or you face job issues while on leave, getting legal advice early can make a significant difference.
Toll-free: 1-800-771-7882 | Email [email protected]
The article in this client update provides general information and should not be relied on as legal advice or opinion. This publication is copyrighted by Achkar Law Professional Corporation and may not be photocopied or reproduced in any form, in whole or in part, without the express permission of Achkar Law Professional Corporation. ©
Workplace Law Topic: Long-Term Disability Claims