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Short-Term and Long-Term Disability Benefits*

If you are employed, the company you are working for may offer extended health insurance as part of your benefit package. Health insurance benefits may include hospital room coverage, medication coverage, dental and vision coverage, life insurance, and professional services such as podiatry, massage therapy, chiropractic care and psychotherapy. Wage protection through short- and-long term disability income programs is another common benefit of health insurance packages.

Short-term disability programs (STD) provide coverage if you need to be away from work for medical reasons for a relatively short period of time, usually up to a maximum of six months. During this time period, your employer will hold your job for you as you are expected to return to work.

You will need to contact your Human Resource or Personnel Department to find out what steps you must follow to apply for STD. In any case, your doctor will need to provide some basic information to your employer and more detailed medical information to the benefits/insurance company.

The exact amount that you may be eligible for under short-term disability benefits is based on the contract negotiated between your employer and the benefits/insurance company. Generally STD programs will cover up to 26 weeks away from work, paying between 60% and 100% of your current wage. Some plans start immediately; others have a waiting period. Some plans may start after you have used up all of your sick days and vacation time, others start after you have used your sickness benefits from Employment Insurance (EI), while others will provide coverage in place of EI benefits or top-up your EI benefit amount to that of your current wage.

You should review your employee handbook to learn about the specific details of your STD program. A copy of the handbook can be obtained from your Human Resource or Personnel Department. If your company does not have such a handbook, make an appointment with the person in charge of benefits/personnel to find out about what you are entitled to. If there is a union in your workplace, the union steward could be helpful as well.

The insurance company will have a claims adjudicator or liaison employee who can also be contacted for information. Use discretion when giving personal information - you need to keep in control of both your medical information and any decisions about a potential leave from work.

If it is going to take a while to receive your STD benefits, you may have to apply for Employment Insurance (EI) sickness benefits. For details, see the earlier section entitled Employment Insurance Benefits. Long-Term Disability Programs (LTD) cover employees who have a severe illness or disability that prevents an individual from doing their job/or any other job. The definition of disability used by LTD programs tends to be similar to that of the Canada Pension Plan, but not necessarily identical.

To determine eligibility you will have to complete an extensive application, which you will submit to the insurance company. A detailed medical report completed by your doctor will also be required.

LTD benefits are also based on the contract between the employer and the insurance company. Generally LTD starts between six and twelve months after leaving work due to illness and pay between 50% and 90% of your pre-disability wage. LTD usually requires you to use up any pre-LTD sources of income, such as short-term disability or EI sickness benefits, before you will qualify.

Your LTD provider will want you to apply to any other source of income you may be eligible for such as CPP-Disability, Workers Compensation Pension, etc. Amounts received from any of these sources will be deducted dollar for dollar from your total LTD benefit. Your LTD plan will want to evaluate your work potential based on own occupation/any occupation criteria. In your first two years on LTD, you will be evaluated based on your ability to do your own job, after that you will be evaluated against your ability to do any job (occupation) for which you are reasonably suited based on your training, education and experience.

LTD benefits are taxable income, unless you paid a tax premium for a LTD benefit, in which case your LTD will be a tax-free income.

You are still an employee of the company while you are on LTD and may be eligible for some of the other extended health benefits offered. Some plans may require you to pay some of the premium costs for the extended health benefit or life insurance in order to keep this coverage. As with STD, you can find out specific details on LTD from your employee handbook, the person in charge of benefits, a union steward or the insurance company, but again, use discretion about what information you give out.

Private Short-Term and Long-Term Disability Plan

Some individuals, usually self-employed, contract or seasonal workers, purchase their own private STD and LTD through insurance companies, alumni associations, interest or business groups or with an investment company. Most of the points mentioned earlier about employer-based STD/LTD plans apply to private plans, except that rather than your employer negotiating the contract, either you did it yourself or the association negotiated it on behalf of its members.

As with the employer-based STD/LTD plans, review your documents and policy to learn about your benefits. Consider contacting the claims adjudicator or insurance provider to answer any questions you may have. Use discretion in disclosing your medical circumstances without supporting documentation from your doctor.