According to a study released by the Mental Health Commission of Canada, 1 in 5 Canadians go through mental illness in any given year. In related research, over 20% of the workforce aged 18 to 64 have a form of work disability.
One solution for workers and employers with mental illness is applying for long-term disability benefits.
This article looks to address concerns on the intersection of mental illnesses, including depression, with one’s long-term disability benefits, and how lawyers can help with these concerns.
What are long-term disability benefits in Canada?
Long-term disability benefits (LTD benefits) are benefits for eligible employees, offered by private insurance companies and by the government through its programs.
It's separate from other types of programs such as short-term disability benefits. In LTD benefits, only diseases, illnesses, or disabilities that persist for a longer period are allowed.
Specific assistances under LTD benefits may include:
- salary or wage replacement
- medical benefits
- housekeeping and transportation benefits
Each insurance company or government program will have its own set of policies for eligibility, its computations for the benefits it gives, and other conditions.
Is depression considered a long-term disability in Canada?
Yes, depression is considered a long-term disability in Canada. Mental illnesses are long-term disabilities, taken as a group of medical conditions.
When a mental illness such as depression affects your normal functions or daily routines, it becomes a long-term disability that needs medical attention. You can file a claim for long-term disability for depression in Canada, as allowed by your policy or by the government program you are part of.
How to get long-term disability benefits for depression
There are two main sources of long-term disability benefits for depression in Canada:
- insurance policies: either through an employer’s group benefits plan or with a private insurance company
- government programs: with the Canada Pension Plan (CPP); provincial or territorial Workers’ Compensation Boards (WCB); and other provincial or territorial programs
This video explains how CPP disability treats long-term disability for depression:
Read our explainer on long-term disability for an overall look at what it is how it works.
How to prove depression for LTD benefits
You must first satisfy certain requirements to be eligible for long-term disability for depression in Canada. These requirements are stated in your insurance policy or in the policy of the government program you’re applying for.
While these may differ for every insurance policy or government program, there are certain common requirements among them:
- medical diagnosis: you must first seek medical attention and have a medical diagnosis from your doctor (and/or from the doctor stated in your policy)
- medical treatment: your diagnosis must state that you need medical treatment; or, you must have already undergone, or are currently undergoing, medical treatment
- proof of work interference: you must be able to show that your mental illness affects your ability to work and do normal functions
There must be a connection between your medical diagnosis and how it interferes with your work.
Here are some documentary evidence that you can use when applying for long-term disability for depression in Canada:
- doctor’s official records proving diagnosis of depression
- documents showing the medical treatment plan prescribed by your doctor
- proof of treatment or regular check-ups, including follow-ups
- prescription for anti-depressants and other medications
- accounts from your doctor, employer, family, or friends that depression has been interfering with your work
Follow your policy on how to prove disabilities when applying for LTD benefits. This will ensure that your application for these benefits is approved or that there’s minimal chance that it will be denied.
How long is long-term disability for depression
The time that you can be on long-term disability for depression will depend on your policy or program.
LTD benefits usually start after six months of short-term disability benefits. When the disability is medically determined to last longer than 6 months, your short-term benefits are then converted into LTD benefits.
In other policies, this six-month period coincides with the waiting period for approval for LTD benefits.
A long-term disability for depression in Canada, or for any other disease or illness, will usually last for 2 years or more.
If your condition continues beyond 2 years, and it permanently affects your ability to work for any occupation, your long-term disability for depression may be extended. You may have to submit additional proof and undergo a separate process to be eligible for extension after the initial 2 years.
You must show proof that your depression has become chronic to qualify for long-term disability for depression beyond the initial 2 years.
Can claims for long-term disability for depression be denied?
There are grounds that your insurer or the government program you’re applying for may deny your claim for long-term disability for depression.
They may also prematurely cut it off when the policy or its specific conditions have been breached midway through.
While the specific grounds may also be stated in your policy, here are some examples of these grounds for denying a claim for long-term disability for depression in Canada:
- medical attention was not sought as the symptom of depression arises
- lack of medical evidence that a person is suffering from depression
- medical treatment was not followed when the LTD benefit is approved
- inconsistent records or statements
- fraud on using depression as a disability for LTD benefits
Seek advice from a long-term disability lawyer if your claim is denied without any legal justification. Some legal options: you can dispute your claim with your provider or file a case in court.
If you’re looking for long-term disability lawyers in your area, contact one of the best long-term disability lawyers in Canada as ranked by Lexpert.