Everyone’s healing journey is unique. When you’re on long-term disability, your journey is likely not linear. Despite this, insurance companies may try to rush you to return to work so they can stop providing benefits. Additionally, your employer may want you to return to your position before you’re ready. Only you know when it’s the right time to return, and if anything, you’re doctor should be the one to have an opinion, not the insurance company or your employer.
In this blog, we’ll help you better understand your rights when returning to work after long-term disability leave, including LTD coverage, next steps for returning to work, accommodations, and extending coverage.
Understanding Long-Term Disability (LTD) in Canada
The Long-Term Disability (LTD) insurance benefit under the Public Service Management Insurance Plan in Canada is an income replacement support to help Canadians with their finances if they are disabled and cannot work. This benefit’s requirements are for employees who have worked for six months or more.
What LTD Covers
The LTD benefit covers a monthly benefit that lasts, depending on your policy, either when you reach 65 or a predetermined number of years (5 to 10 years). This benefit generally provides around 70% of your total monthly income prior to your injury.
The benefit may adjust the monthly amount depending on any other disability benefits you may have, such as the Canada Pension Plan (CPP). Typically, LTD starts when short-term disability or EI sickness benefits end.
The “Own Occupation” vs. “Any Occupation” Rule
To be eligible for long-term disability insurance, you need to be unable to perform the duties of your regular employment, also known as your “own occupation.” However, after two years on the benefit, to continue to be eligible, you have to be unable to perform the duties of “any occupation.”
“Any occupation” is any other gainful employment you’re reasonably qualified for. Insurance companies will have an easier time denying coverage for this reason, as it’s harder to prove you can’t perform the duties of “any occupation” rather than just your “own occupation.”
To better understand these differences and continue receiving insurance coverage after two years, consider contacting a lawyer for assistance in ensuring continued financial support.
The Role of Medical Clearance
There are many aspects to consider when returning to work following LTD leave. One of which is proper medical clearance from a doctor.
Your Doctor’s Authority
Your doctor is the expert on your health and thus deciding whether you are able to return to work. They have the knowledge if you’re improving; they can provide expert medical advice on any next steps.
With proper medical documentation, it can streamline the preparations to return to work if you require any accommodations, modifications or assistive devices to perform your tasks.
Risks of Returning Without Clearance
It’s crucial to ensure you’re ready to return to work and that your doctor agrees with you. Returning without their clearance could result in complications. Including:
- Worsening of physical or mental health
- Inability to properly perform the work
- Possible termination of LTD benefits
Legal Rights While on LTD
If you’re on LTD benefits, and the two-year period is nearly up, you’ll need to start to consider whether you are ready to return to work. During this period, protecting your rights is critical. Here are some factors to consider:
Ready to Return: Duty to Accommodate
When returning to work from an LTD, your employer must accommodate your return, which could include various supports, including:
- Working part-time rather than full-time until you can reintegrate, and your insurance can make partial payments until you return full-time.
- Requesting adjustments, which could include working remotely, flexible hours, or changes to physical workspaces.
- Addressing discrimination by reporting it to the HR department. Everyone is entitled to a work environment that is accommodating and respectful.
Not Ready to Return: How to Protect Yourself
If you decide not to return, or have decided to return but realize it was not the best decision, you need to know the best ways to prepare for what comes next.
Recurrent Disability Clause
If you returned to work but would like to go back on LTD benefits, your work insurance plan may have a recurrent disability clause. This means that, depending on the policy and requirements, you may be able to have your benefits reinstated.
The recurrent disability clause can streamline the process of reinstating your benefits without a waiting period. Whether your symptoms return or a new accident were to occur, this could help give you the chance to return to work to know if you’re ready.
Update Your Medical Evidence
However, if you’ve decided not to return and you’re starting to face mounting pressure from your insurance and employer, there are steps you can take to protect yourself.
If you need to extend your coverage, detailed medical records are crucial. Now you’ll have to prove that you can’t fulfill the tasks for any occupation, as mentioned above. Your doctor can perform a thorough assessment of your condition, provided you are unable to return to work.
When to Consult a Long-term Disability Lawyer
Returning to work after a long-term disability is a decision that should not be taken lightly. If you feel pressure to return from your insurance or employer, you can protect your mental and physical health by working with a long-term disability lawyer.
If you need help navigating insurance claims, extending coverage, or dealing with termination of employment or benefits, our professional team at Van Dyke Law are here to help. Book a free consultation with Frank Van Dyke today.