Sometimes, the most painful injuries are the ones that others can’t see. Mental health conditions are one of the leading causes of disability in Canada. However, we have observed that long-term disability benefits for mental health and other so-called “invisible” conditions, such as chronic pain, are more likely to be denied and more likely to be terminated sooner. These statistics are likely due to several factors, including increased claims in this area, difficulty in proving the existence of an injury, and ignorance regarding the nature of mental health conditions or chronic pain.  

What Are Long-Term Disability Benefits? 

Long-term disability benefits (also known as “LTD benefits”) provide the recipient with income when they cannot work due to illness or injury. They are intended to replace a percentage of lost income if a person cannot work for more than six months. For the period before the start of LTD benefits, the recipient would use sick leave and short-term disablity benefits to supplement their lost income. 

To claim long-term disability benefits, an applicant will generally be required to prove that they are “totally disabled”. Applicants are entitled to stay on long-term disability benefits if they continue to meet the definition of “totally disabled”. This means their injuries are such that ordinary care and prudence require the person to stop working to bring about a cure to their condition (see Paul Revere Life Insurance Co. v. Sucharov). 

Why Long-Term Disability Benefits for Mental Health Conditions or Chronic Pain Are Denied or Terminated

Many individuals who suffer from “invisible” injuries, such as mental health conditions or chronic pain, face barriers when attempting to file for long-term disability benefits. The rate at which these types of claims are being filed has increased over time, with the Mental Health Commission of Canada reporting they account for nearly 30% of all claims. Since these claims represent a major portion of costs to insurers, they are eager to find reasons to deny the claims.

Furthermore, proving an invisible injury can be more difficult than, say, having a doctor provide the patient’s insurer with an x-ray of a broken bone. There is no single diagnostic tool to verify a mental health claim or chronic pain. Instead, the evidence will likely come from what you report experiencing and what you tell your doctor. Finally, the sad truth is that those who suffer from mental health conditions or chronic pain continue to face societal stigma. Many people do not understand how these diseases work and the extent to which they affect their victims on a day-to-day basis. 

Ironically, having your long-term disability claim denied or terminated can also negatively impact their mental health. A denied applicant may develop financial stress, depression and/or anxiety, or question the severity of the symptoms they are experiencing. These feelings, in turn, can exacerbate or add to an existing condition. 

Tips for Managing Your Long-Term Disability Claim for a Mental Health Condition or Chronic Pain

The most important thing is to take care of yourself, first and foremost. If you are suffering from a mental health condition, chronic pain, or other invisible condition, you should book an appointment with your doctor as soon as possible. Visit your doctor on a regular basis to ensure your condition is being documented, and follow their recommendations. Ask your doctor whether a referral to a psychologist, psychiatrist or another specialist would be appropriate.

The above steps will help you get on the right path to treat your condition and ensure that your condition is documented thoroughly should you need to make a disability claim. 

In addition, consult a disability lawyer as early as possible if your long-term disability claim is denied, to ensure that you remain in compliance with all requirements to effectively challenge the denial.

Experienced Long-Term Disability Lawyers Serving Eastern Ontario and North Bay 

Society has come a long way in understanding and accepting mental illness and other issues like chronic pain. However, the frequent denial of long-term disability benefits for these conditions shows that we haven’t come far enough in supporting people who suffer from invisible illnesses. Fighting an invisible battle with a mental health condition or chronic pain is difficult, and being denied long-term disability benefits when you are struggling can make you feel completely lost. 

No one should have to suffer from an invisible illness or have their long-term disability benefits denied while they are struggling. If you are in this situation, speak with one of our experienced disability lawyers today for more information on your rights and entitlement to long-term disability benefits. 

At Tierney Stauffer LLP, we have been representing clients to reinstate or have their long-term disability claims approved for over thirty years. Our lawyers understand the hardships you may be facing if your insurer denies your claim and our disability team will take swift and effective action to see that your benefits are approved as soon as possible. Call us at 1-888-799-8057 or contact us online to set up a consultation with a member of our team.


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