An accident victim’s need to live with a disability does not always guarantee that same victim’s ability to acquire disability insurance. In Ontario, the standards applied to disabled employees have complicated the task of obtaining long term disability benefits.
Each insured disability in Ontario gets measured by 2 standards.
The language that defines the 2 standards has been included in the long-term disability insurance policy.
Both standards do not get applied at the same time. Each standard needs to be satisfied at a specific stage of the period during which the benefits get delivered to the disabled employee.
At what stage do the standards need to be satisfied?
One standard must be satisfied during the first 2 years of the delivery of long-term insurance benefits. A second standard needs to be satisfied during the period of time from the end of those 2 years to the date for the return of the disabled employee to the workplace, or the date for the start of the retirement of that same disabled employee.
What is the standard at each stage?
During the first 2 years, the standard’s focus is on the insured’s former occupation. The insured qualifies for benefits if he or she proves incapable of performing his or her former job responsibilities. If necessary, a medical test gets used, in order to determine the extent to which the insured’s body can handle the demands of a former occupation.
During the next stage, the injury lawyer in Cornwall knows that the standard’s focus is on the insured’s capabilities. Can he or she carry-out the job responsibilities in any occupation? It takes longer to carry-out all the testing that is needed, for assessing a policy holder’s ability to take-on any occupation. Sometimes the insured and disabled employee must work with a vocational therapist.
Employees working with a vocational therapist do not enjoy the delivery of benefits. Indeed, each of them faces a gap in the delivery of benefits. The existence of that gap explains the basis for the question at the head of the next section.
How does a disabled employee take care of the gap in insurance coverage?
Following the termination of 2 years of coverage, the disabled employee must wait for initiation of the next stage of benefits distribution. During that gap in coverage, a disabled worker living in Ontario can rely on 2 other sources of support.
One of those is the Canada Pension Plan, which covers those employees that have paid into the Plan. The other is the Ontario Disability Support Program. That can offer financial support to a disabled employee that needs to set aside time for visiting a vocational therapist, and cannot be performing the tasks associated with a paying job.