Toronto Injury Lawyer Blog
The term “long term disability benefits” would lead one to believe that those benefits should last for a long time.
But the term “long” can be misleading and subject to interpretation. Like many things in the practice of the law, the devil’s in the details and you gotta read the fine print.
So while your friends and family may tell you that your “long” term disability benefits will last for a “long” period of time (like your entire life); don’t be mislead.
Different policies of insurance carry different definitions for the duration of those long term disability benefits.
Here are a few examples:
Example #1
Maximum Long Term Disability Benefit Duration: to age 65
Example #2
Maximum Long Term Disability Benefit Duration: 5 years or up to the age of 65, whichever period comes first
Example #3
Maximum Long Term Disability Benefit Duration: 2 years or up to the age of 65, whichever period comes first
In examples 2 and 3, the maximum duration of your long term disability benefits is either 5 years, or just 2 years. Those long term disability benefit periods get even shorter if you reach the age of 65 prior to the 5 year or 2 year marks. Either way you cut it, those duration periods aren’t very “long” as the name “long term disability benefits” would imply.
Knowing how your your long term disability benefits run will give you some sort of peace of mind and will avoid a let down. Here’s an example of a let down situation.
You’re a unionized employee. All of your co-workers talk about your wonderful benefit coverage. Dental, health, long term disability…You think you’re covered. Those long term disability benefits are supposed to last a long time; right up until the age you retire. You’re thinking of retiring at the age of 67; as required by the terms of your collective bargaining agreement.
But here’s the reality. You get injured or really sick and can’t return to work. You apply for long term disability benefits and get approved for the first two years of your disability (great!).
As is common with most long term disability policies, the definition of what it means to be disabled or “disability” changes at the 2 year mark from being able to perform the gainful tasks of your “own occupation” to being able to perform “any occupation” (think parking lot attendant).
You get cut off long term disability benefits. That’s let down #1.
Let down #2 is when your union can’t help you because they don’t have the know how or will power to stand up to the insurance company. Sometimes the union doesn’t have the resources because it’s too small. Other times they tell you that they just don’t do those sort of things. Or your union seems to be on the same side of the insurer!!! You get the feeling that your union is being paid off by the insurer not to challenge their findings. Or that feeling like your Union is in the insurance company’s back pocket and now you have enemies on two fronts. Not a good feeling at all.
Let down #3 is when you find out that your long term disability benefits are maxed out at just 5 years instead of going right up to the age of 65.
Let down #4 is when you planned on working until the age of 67, but your long term disability benefits will only cover you up to the age of 65.
So many let downs! Sorry to paint such a sad picture, but this is the reality which our long term disability lawyers see each month when we hear from our clients and from prospective clients.
Here’s a ray of hope.
If long term disability disputes are not covered in the collective bargaining agreement, you can retain a long term disability lawyer (like the lawyers at Goldfinger Injury Lawyers) to help you with your dispute. Finding out whether or not you can retain a lawyer is sometimes a quick call or conversation with your HR or Union Rep. If you are not a unionized employee, then this is not an issue and you will have no cause for concern in retaining a long term disability lawyer to help you along the way.
One way to avoid the let down is to understand how your long term disability policy works. Don’t trust office gossip about how it works. Instead, take the time to speak with HR, your Union Rep and/or actually reading the policy itself.
I understand that Benefits Booklets and Insurance Polices can be daunting and intimidating documents full of hard to understand English. Here’s a quick pro tip. Most Benefits Booklets and Insurance Policies contain an Index or Table of Contents in the first few pages. Look for the section regarding Long Term Disability Benefits. That’s where you should start and you will likely find your answer to how your benefits work in that section. This will save you the time of flipping through countless pages of fine print on a quest for what you’re looking for.
Once you’ve found the section, it’s ok to use a pencil to underline the portions you believe are relevant, or which point to the answers your looking for. Use a sticky note so that you can reference the page at a later date. Your benefits booklet is an important document, but it’s not a work of art to be left in mint condition for re-sale to a collector down the road. It’s ok to mark it up. At the end if the day, it’s YOUR benefits booklet and it’s there to help you. In all likelihood it won’t be auctioned off at Christie’s years down the road for millions of dollars.
If there is anything which you believe to be alarming in the benefits booklet, it’s best to chat with these concerns to your HR Rep, Union Rep or even a personal injury lawyer. Anticipating any coverage gaps or issues in coverage; and dealing with those coverage issues before they arise will help you handle the situation much better than reacting. Playing catch up will always make you feel like you’re two steps behind.
