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Understanding Short-Term Disability

Why Short-Term Disability Insurance Matters

Short-term disability insurance provides crucial financial protection for individuals who are unable to work due to a disabling injury or illness for an extended period. It offers a source of income replacement when a person's ability to earn a living is compromised by a disabling condition. This coverage serves as a vital safety net, ensuring that you and your loved ones are shielded from the potentially devastating financial consequences of short-term disability. With the assurance of income replacement, you can focus on your recovery without the added stress of financial uncertainty. Whether as standalone coverage or as part of a comprehensive financial plan, short-term disability insurance offers invaluable peace of mind for an unpredictable future.

Eligibility Criteria and Types of Disability Covered

Eligibility Criteria

Eligibility criteria for short-term disability (STD) insurance in Canada will vary depending on the insurance provider and the wording in the specific policy. At first blush, this would seem to create individually complex and varied thresholds for eligibility for disability benefits throughout Canada. However, the SCC has ruled that eligibility for long term disability is supposed to be based on a reasonableness standard and not legal minutia. The principle comes from the Sucharov decision, wherein the Supreme Court of Canada held that a person meets the definition of disabled in their policy insurance if a reasonable person in their circumstances would have desisted from work in order to effectuate a cure or minimize symptomology.

Some common short term disability insurance eligibility requirements include:

• Employment Status: You typically need to be employed and have an active STD insurance policy through your employer or a private insurer.
• Medical Condition: You must have a medical condition that prevents you from performing your job duties. This condition should be long-term and expected to last for an extended period.
• Waiting Period: There is usually a waiting period (often 90 to 180 days) during which you must be continuously disabled before benefits begin.
• Medical Documentation: You need to provide medical documentation from a healthcare professional confirming your disability.
• Coverage Terms: The specific terms of your coverage, such as the definition of disability and the percentage of income replacement, will be outlined in your policy.

It’s important to review your specific policy details and consult with a knowledgeable disability insurance lawyer to best understand the exact criteria and process for applying and appealing a claim for STD benefits.

Types of Disabilities Covered

An individual can become disabled from working by many causes. Some are looked at more skeptically by insurance companies, simply because current scientific or medical evidence cannot provide definitive answers or tests. This leads to an array of common types of disabilities that most often lead to improperly denied claims by insurance companies, including fatigue syndrome, fibromyalgia or chronic pain, and various psychiatric illnesses.

Short-term disability insurance is intended to cover a wide range of disabilities, including but not limited to:

1. Physical Injuries: This includes injuries resulting from accidents, such as spinal cord injuries, amputations, traumatic brain injuries, and musculoskeletal disorders.
2. Chronic Illnesses: Conditions such as cancer, heart disease, diabetes, multiple sclerosis, and autoimmune disorders may qualify as long-term disabilities if they significantly impair the individual's ability to work.
3. Mental Health and Psychological Illnesses: such as depression, anxiety disorders, bipolar disorder, schizophrenia, and post-traumatic stress disorder (PTSD).
4. Neurological Disorders: Conditions affecting the nervous system, such as epilepsy, Parkinson's disease, Alzheimer's disease, and stroke, may also qualify for short-term disability benefits.
5. Other Disabilities: Long-term disability insurance policies may cover a variety of other disabling conditions, including vision or hearing loss, respiratory disorders, and digestive disorders.

It's important to review the specific terms and conditions of your short-term disability policy to understand what disabilities are covered and the eligibility requirements for benefits. If you have questions about your eligibility or need assistance with a claim, our experienced legal team is here to help.

Our team at Weir Bowen LLP is knowledgeable in Disability Law and is here to assist you when you are in need. Contact us for personalized guidance and support throughout the claims process.