Long Term Disability

What is Long Term Disability?

Employees across several industries can find themselves physically or mentally unable to perform their usual job duties for a prolonged period of time. This could result in a loss of income which may cause a significant financial strain. An employee who has a long-term disability policy either through their employment or privately can access this benefit. Overall, long-term disability is considered a safety net for those individuals who are unable to return to work, this benefit offers them a portion of their income that could go towards covering basic expenses. The goal of this benefit is to reduce the hardship an employee may suffer as a result of not being able to return to work due to a medical condition.


What is a long-term disability?

Long-term disability (LTD) is a type of income replacement benefit which provides employees with a percentage of their base income if they are ill or injured for an extended period of time. LTD is a type of insurance some employers offer to their employees as a “group benefit”. Keep in mind that employers are not required to offer long-term disability to their employees, and in the event that they do they can offer to pay it in full, part of it, or the employee may cover the full cost of this benefit.  Individuals have the option to purchase their own long-term disability policy if their employer does not offer this benefit, to do this, they should contact a licensed insurance advisor for all the information they will need. 

Long-term disability provides employees with a portion of their income in the event they suffer a disability that does now allow them to work for generally 6 months or more. 


What is long-term disability insurance?

Long-term disability insurance (LTDI) is a type of income protection offered to all plan members in the event they are unable to return to work for a long period of time. This could be caused due to an injury, illness, or accident. Depending on the policy, most LTD plans will pay monthly benefits until the age of 65. LTDI can be sold as a group insurance policy or may be purchased individually. 


What types of long-term disabilities in Ontario are there?

There are several types of long-term disability benefits across Ontario. Some of these benefits are offered by the Provincial Government and others are offered by the Federal Government and private insurance companies. They are the following: 

Each of these disability plans represents a different type of income replacement which means these plans are all different regarding their eligibility criteria and the benefits you are able to receive.


How much do long-term benefits pay in Ontario?

Generally speaking, long-term disability plans cover between 60-80 percent of an employee’s base salary up to a specific maximum annual salary which is stipulated in your policy. 


What are some examples of total disability?

Some examples of totally disabled include but are not limited to the following:

  • Brain injuries
  • Cancer
  • Chronic illnesses
  • Chronic pain
  • Neurological diseases
  • Orthopaedic injuries
  • Psychological conditions like depression and anxiety 


How Long Does Long-term Disability Last?

Long-term disability lasts until an individual is well enough to resume his job or until the end of the coverage period stated in the policy, which is usually at age 65, whichever comes first. To remain eligible for LTD benefits, the individual must meet the criteria of “totally disabled”. Most LTD policies offer these benefits for the first 2 years when the individual is unable to return to his or her “own occupation” which would be the position they had before the illness or accident occurred. Once the 2 years have elapsed, long-term benefits are usually only paid if the individual is unable to return to “any occupation” which means your disability must not allow you to perform any other job. 


What is the difference between “own occupation” and “any occupation”?

  • Own occupation: is the usual occupation or chosen employment field
  • Any occupation is any other position that the individual is suited for based on their education, training, or experience.

In a policy where 2 years have elapsed, and the individual wishes to continue receiving such benefits, they must prove they are still eligible. The individual must go through the insurance company again and prove how they are unable to work in any occupation. Generally, at this stage, the insurance company will arrange a more in-depth assessment with an independent physician. 


Who is Eligible for long-term disability benefits?

The first thing to determine who is eligible for long-term disability benefits, an individual must have an LTD policy through their employer or individually. The second requirement is that the employee must be “totally disabled” to receive such benefits. The exact definition of “totally disabled” will vary depending on the individual’s policy. Generally, the definition of “totally disabled” in LTD policies is when “the employee is unable to perform all their essential and material job duties, they are said to be totally disabled”.


Long-term disability benefits are very helpful for individuals who have been forced in a way to not return to work due to a physical or psychological illness or due to an accident.  Employees seeking to go on long-term disability should carefully review their policy. They should make sure they understand the important terms of their insurer’s LTD policy. Employees with questions about long-term disability benefits or looking to appeal an insurer’s decision should contact an employment and disability lawyer as every case differs from another. 


Contact Us

If you are an employee who has questions about their long-term disability entitlements or are seeking advice about appealing an insurer’s decision regarding their long-term disability benefits, our team of experienced workplace lawyers at Achkar Law can help. so, Contact us by phone toll-free at  +1 (866) 508-2548  or email us at [email protected] and we would be happy to assist.