Ontario Disability Helpline
Ontario Disability
Helpline
Free Disability Claim Reviews
Free Disability Claim Reviews
Contact Us:
(416) 931-2555
Ontario Disability Helpline
Free Disability Claim Reviews
Short Term Disability Claim Denied?
Call for a free short term disability claim review:
(416) 931-2555
Short Term Disability Claim Denied?
Call for a free short term disability claim review:
(416) 931-2555
Our Short Term Disability Lawyers are available to answer your questions.
No obligations – we offer phone, zoom, or in-person consultations.
Free Consultation
Disability Lawyers – Frequently asked questions
What is a Short Term Disability claim?
These benefits are usually administered by an insurance company (like Sun Life, Manulife, Canada Life, or Industrial Alliance) or third party administrator (like Morneu Shepell, or Oncidium) whose job it is to determine whether the employee qualifies for short term disability benefits (ie. to approve or deny the short term disability claim).
If approved, Short Term Disability benefit may be paid by the insurer, or by the employer themselves (depending on the type of policy in place). Not all employers provide Short Term Disability insurance to their employees.
How do I apply for Short Term Disability benefits?
The application will usually consist of three parts: a form for you to fill out (often called the Member’s Statement), a form for your employer to fill out (often called the Sponsor’s Statement) and a form for your doctor to fill out (often call a Physician’s Statement).
These forms are usually not tailored to your specific illness and can be difficult to answer precisely. For example, in a case of depression or anxiety it may be difficult to pin-point the first time you experienced symptoms because you may not remember or you may not be certain of the exact start date. If you have any questions about filling out your forms, call to speak with one of our short term disability lawyers for a free review.
What illnesses qualify for short term disability benefits?
In most cases, any kind of illness that is severe enough that it prevents you from working (though some exceptions exist) will qualify. There is usually no list of specific illnesses or injuries that qualify for short term disability. Rather, the focus of the application process is to determine whether or not the restrictions / limitations arising from your disability are sufficiently disabling to prevent you from working (regardless of the specific nature of the disability or illness).
The most common kinds of short term disability claims that we handle are psychological in nature (these include Depression, Anxiety, Bipolar, and Panic Disorders), or pain related (such as Chronic Pain or Fibromyalgia).
How long will my short term disability benefits last?
Some employers provide STD benefits for as long as a year, others for 6 months, some for only a few weeks, and some employers provide none at all. If you’re uncertain as to how long your specific policy covers you for, you can check with your employer or give us a call.
How much will I get for short term disability benefits?
Some short term disability insurance policies also vary depending on your length of service, providing a higher percentage payment of your income for longer serving employees (so an employee that has worked with an employer for 1 year may receive a lower percentage of their pay than an employee that had worked there for 10 years).
Almost all Short Term Disability benefits will, however, be calculated as a percentage of your income. To determine exactly how much you will get you will need to review your policy, or have one of our short term disability lawyers help review it for you (there is no fee for this service).
How can I get approved for Short Term Disability
What do I do if my Short Term Disability claim is denied?
There are advantages to both of these options, and they should be considered carefully before deciding how to proceed. If your claim for short term disability benefits has been denied, we recommend immediately calling to speak with one of our short term disability lawyers for a free short term disability case review.
The Most Common Reasons for Short Term Disability Denials
A) Do not meet criteria for “Total Disability”
The single most common reason for a short term disability denial is not meeting criteria for “Total Disability”
This is somewhat of a catch-all term, as “Total Disability” really describes the basic eligibility criteria for Short Term Disability benefits in the first place. Ultimately, this is just another way of stating that the applicant has not proven that they are “totally disabled” or unable to perform the essential tasks of their occupation.
There are often other reasons given for the denial in addition to this, including the following reasons below.
B) Insufficient Medical Evidence
Insufficient medical evidence would be the next most commonly cited issue. This the adjudicator’s way of stating that the applicant has not “proven” that they are totally disabled.
This can be extremely frustrating. If your own doctors confirmed you cannot work, having an insurance company say otherwise is upsetting to say the least.
Another reason this can be upsetting is that for claims for mental health or chronic pain, there is no x-ray or MRI result that can demonstrate the illness.
Diagnosing mental health or chronic pain illnesses are largely based on self-reports, and so there are almost no cases where an insurer cannot claim that “insufficient medical evidence” has been provided (even the most severe cases).
Do not simply accept this result. Call to speak to one of our short term disability lawyers immediately if the std insurer tells you this to learn about how to deal with your short term disability claim denial.
C) Workplace stress / Workplace issues
Although there are many other possible reasons for a denial, the third and final reason we are including here is workplace stress and/or workplace issues.
This is often included as an “extra” issue in an STD denial letter (in addition to the two described above). It is extremely common for workplace stress or other problems to trigger a worsening of a mental health condition, or for mental health, depression, or anxiety to impact one’s workplace. For this reason, workplace issue are likely involved in a majority of these cases.
The involvement of a workplace dispute does not mean that you are not entitled to term disability benefits. If the workplace issue was the only reason for your absence (and not for medical reasons), it could be grounds for non-payment of short term disability benefits. However, if your absence is due to medical restrictions that would prevent you from working (even if those workplace issued were now resolved), it should not prevent you from successfully pursuing your STD benefits. Call us today to discuss the details of your case.
How Can Our Short Term Disability Lawyers Help You:
It all starts with a free review of your short term disability claim. Whether you want to speak for 15 minutes, or want to have a complete in-depth review of your full disability claim, call us today. We do not charge any fees for our case reviews.
Our Short Term Disability Lawyers can help with
- Free Case Reviews
- Free Short Term Disability Appeals
- Or explaining your rights and the process involved, helping you make an informed decision as to what is right for your unique situation.
No matter what you decide, our short term disability lawyers will make sure you understand the options available to you, to help you arrive at the best decision for your specific case.
Workplace Issues
We also help you manage any workplace issues. Call us if your employer is:
- demanding that you return to work (but your doctor says you cannot)
- threatening to terminate your job
- asking you to resign
- claiming you have abandoned your job.
You are not alone, and don’t be bullied into any action before knowing your options and what decision is best for you and your family.