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Short-Term and Long-Term Disability Benefits

Program Overview:

Many employers, both large and small, offer employee benefits as an incentive to attract and maintain employees. Two potential benefits include Short-Term (STD) and Long-Term Disability (LTD). These are offered as wage-loss protection programs for employees who require time away from work due to illness or injury. Most STD and LTD plans are offered through employment, although some people purchase their own private plans through an insurance company, alumni association, or business group.

Qualifying Criteria:

Your STD and LTD benefit is a specific and unique contract between your employer and the insurance company, and you will need to review your employee handbook or the contract to learn about the details and program eligibility criteria. You will want to learn: what forms have to be completed and when; what will your physician need to do; is there a waiting period; how long is the benefit paid and how much will you be paid; are monies from other sources deducted. One of the most important parts of your application for benefits will be your medical condition. This will include your past, present and future treatments, objective and subjective medical issues, and prognosis. Have a conversation with your physician – do they support your application, and do they have enough medical information.

Definition of Disability:

For Short-Term Disability, you are usually required to provide a medical indicating your condition and your expected date of return. The definition of disability for Long-Term Disability tends to mirror the definition for Canada Pension Plan-Disability Benefits. Most plans consider someone disabled if in the first two years they are unable to perform their own occupation, and any occupation (total disability) they are reasonably qualified to do if they are off work longer than two years. You will be required to submit medical information completed by your physician(s), and you may be asked to see an independent medical examiner at the cost of the insurance company in order to verify your disability both initially and on an on-going basis.

Waiting Period:

Your waiting period will depend on the benefits your employer is able to offer. Some plans start STD immediately, some after other benefits such as sick time have been exhausted. Many people utilize EI Sickness Benefits after completing STD but prior to LTD benefits starting. Most STD benefits last between 6 months and 1 year. Most LTD benefits start 120 days after leaving employment (since EI Sickness Benefits are 15 weeks plus 2 weeks waiting period = 119 days). Your LTD benefit may be for only a specific length of time (ie 2 years) or may last until retirement.

Payment Amount:

Most STD benefits pay 60%-100% of your pre-illness income. Most LTD benefits pay 50%-70% of your previous income. Most do not have indexing for the rate of inflation. If during employment you paid 100% of the LTD premium cost, then your LTD income is not taxable, otherwise your LTD is a taxable income. Most contracts also have a provision that money from other sources such as CPP-D are deducted dollar-for-dollar from your LTD income.

Other Benefits:

The main benefit offered with STD and LTD is vocational rehabilitation. The emphasis will be on trying to help you return to either your previous employment, a modified position, or new employment that meets your abilities and limitations. While you are on LTD you are still an employee of the company, however some employers have terminated extended health benefits or asked the employee to pay for these benefits. The decision through some court challenges is that health benefits are seen as a benefit related to active employment, and may not have to be offered indefinitely to employees on LTD.

How/Why the Benefit might end:
  • Your STD or LTD benefits have run out
  • You have regained the capacity to work, you are earning income, or have been terminated by the Insurance Company for other reasons
Tips/suggestions:
  • Keep copies of all the information you have submitted to the Insurance Company
  • Keep your physician informed about your benefits, forms that may need to be completed, and your health in general (subjective medical information can be very important in receiving and maintaining your benefits).
Contact information/Resources:

 

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