When people apply for short-term or long-term disability benefits, it can be as a result of a physical or psychological injury or illness. Many people are unable to continue working as a result of psychological illness such as depression or as a result of a chronic pain disorder. One of these is complex regional pain syndrome (CRPS). Complex regional pain syndrome can interfere with a person’s daily activities and ability to complete the essential duties of his or her job.
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In Parmar v. Teachers Life, Ontario Superior Court Justice Faieta summarily dismissed the plaintiff's claim for disability benefits as limitation-barred.
Claims can take time to win as the insurer has to be satisfied that the applicant’s disability is not only legitimate, but also meets the definition of “disability” contained in the policy of insurance. The tricky thing for adjusters is that every LTD policy is different. They all contain different definitions of disability, different time lines to consider, along with different benefit amounts, such as the following:
A recent case called Cvetkovski v. Canada (Attorney General), involved a 50-year-old man who had applied unsuccessfully for Canada Pension Plan (CPP) benefits. He had a long history of psychological disorders which made it difficult to relate to others, and left him with low energy or motivation to do his job.
Some LTD claims are denied based on the pre-existing exclusion clause. A Pre-Existing Condition depends on the specific wording of the pre-existing clause in your particular disability insurance policy. In group policies (provided usually by an employer), the following type of clause may appear:
Currently, a disabled adult can claim up to $20,000 for the Disability Tax Credit (DTC), and a disabled child (under 18 years old) can claim up to $50,000 for the DTC based on the province that they are in.
The Disability Tax Credit certificate (T2201) is comprised of 2 parts. Part A is what the insured (and a sponsor) complete. Part B is for the qualified practitioner to complete. This bulk of the form is the most important as it can be declined based on what is (or isn’t) written about the disability.
In the case of Cheema v. Khan (2017 BCSC 974) decided June 13, 2017, the court ruled in the manner of assessing damages for a collision which aggravated long-standing pre-existing health complications.
A long-term illness can cause financial strain to an individual, especially when he or she is forced to stay out of work. Statistics show that 30% of the working class from ages 25 and above are prone to accidents or illnesses that may result in long-term leave from work. Most of these occurrences are outside the office; the employee may be considered fully liable. It is during such instances that an employee should get long term disability insurance. Long-term disability (LTD) insurance coverage can cover the loss of income caused by an employee being away from their job to pay for bills and medical expenses.
The plaintiff was not entitled to long-term disability benefits under an insurance policy held by his former employer because the plaintiff did not make his claim until after his employment ceased. This was the ruling in the case of MacIvor v. Pitney Bowes Inc.,  O.J. No. 1161, 2017 ONSC 1550, Ontario Superior Court of Justice, March 7, 2017, A. Pollak J.
Western Medical Assessments (WMA) provides expert medical assessment services to insurance companies, lawyers (both defense and plaintiff) and employers. Our reputation as one of Canada’s most respected disability assessment companies is premised on our trusted network of thousands of clinical experts — mostly specialists — across all medical disciplines (physical and psychological). We’ve been entrusted to complete 63,000 independent medical examinations (IMEs) as our clients appreciate our medical direction, evidence-based medical opinions and complete independence from any ethical conflicts of interest.