The Balance Between Worker Needs And Employee Needs
When an employee goes on long term disability, both the employee and the employer understand that the worker will not be able to come back to work for some time. The employee may want their job held so that they can return if there is any hope of coming back to work.
The employer, on the other hand, may need to fill that position to continue to operate. If long term disability benefits are coming from the employer, there is also an interest in stopping those payments as soon as possible as well.
To ensure that there is a balance between these two concerns, Canada law has developed in a way that attempts to make these competing interests as fair as possible.
After Approval Of Long
You still have to deal with the insurance company after they approve you for long-term disability. They will continue to monitor your condition and treatment. They may ask you to see a doctor. Or, they might enrol you in a treatment program. Ultimately, its your responsibility to follow the rules laid out by your provider.
So, to keep your benefits, you must carefully manage your relationship with the insurance company. You will need to do what they ask, even if you disagree with it. The following are common issues that happen after claim approval.
Effects Of Leave Without Pay On Benefits And Employment
Your leave without pay will have an impact on:
Once the Pay Centre receives the necessary documentation from your departmental human resources team, it will provide you with a benefit letter outlining the impact your period of leave without pay will have on your benefits.
The Pay Centre will also explain:
- how your sick leave benefits are impacted
- how to complete and submit disability and long term disability insurance forms
Recommended Reading: How Much Is A Disability Check For Autism
What Can I Do To Maximize My Chances Of Success In Filing A Disability Insurance Claim
When filing a disability claim it is important that you go to a doctor or a specialist who has an expertise in the medical condition that you are coping with. This way they have the ability to more accurately detail your prognosis and required treatment. It is also important that you discuss with them your job duties and responsibilities and how your condition may affect your ability to do these tasks. Consider the physical and mental demands that are required and what limitations you will face. This is important when evaluating whether you can fulfill the essentials of your own job as determined in the Own Occupation test.
How Can An Employer Terminate An Employee On Long Term Disability
The onus is very much on employers to show that they have adequately considered all options to support a disabled employee. However, there are some requirements that can be inferred from cases that have been decided:
- Employers must show efforts to modify the workplace to accommodate the employee
- The position must be kept vacant to allow the employee to return
- The employees duties must be modified, if required, to permit them to return this includes allowing a gradual return to work
- Employees must be shown to be incapable of engaging in any work with the employer they are reasonably suited for.
If all such efforts have failed, the employer must:
- Independently verify the prognosis of the health of the employee
- Review the employees circumstances and accommodations that have been made/are possible
- If there is a possibility that the employee can return to employment in the future
- Determine if undue hardship has been caused to the employer due to accommodation
- The effect of termination on the employee
These are subjective legal points and must be assessed in consultation with experienced employment lawyers in Toronto.
Terminating an employee on short term disability or long term disability benefits is not an easy decision for employers not just for the legal exposure but because they are aware of what it means for the employee. It is why the law lays down a high standard for employers to cross before disabled employees can be terminated.
About The Author: Rahul Soni
Recommended Reading: How To Get Disability Sign For Car
Termination Of Employment May Impact Your Long Term Disability Claim
Many employees dealing with a disability also face the risk of unemployment because they are unable to continue fulfilling the requirements of their jobs. If you are considering accepting a severance package from your employer, but have a significant and debilitating health condition, you should first review your companys long term disability policy before making the decision to accept a severance package. If you terminate employment, you may be prevented from receiving disability benefits from your former companys policy.
This is what happened to the plaintiff in the matter of Perez-Jones v. Liberty Life Assn Co. of Boston, No. 14-55455, __F.Appx___, 2016 WL 1320516 . The Ninth Circuit Court of Appeals affirmed the district courts determination that the plaintiff waived her right to receive long term disability benefits by signing a severance agreement and accepting a severance package provided by her then-employer. The court affirmed the district courts decision on the basis that the plaintiff was not a participant in the long term disability plan entitled to bring an ERISA claim. This is because the plaintiff no longer worked for the long term disability plans sponsor at the time she sought long term disability benefits since she had already signed a severance agreement and terminated her employment. The court found that she was not a Covered Person under the terms of the plan entitled to claim benefits.
What Type Of Disability Allows Me To Qualify For Long Term Disability Benefits
Most long term disability policies cover you regardless of the severity or type of illness or injury you are suffering from that prevents you from working. However, some policies exclude certain illnesses, and others may exclude injuries or illnesses which are compensable under a Workplace Safety Insurance Board claim, if it is available through your workplace.
Generally, if you are not able to do all or substantially all of the tasks required by your current job then you will qualify for long term disability benefits. Essentially, the threshold is that your disability prevents you from being able to work. However, depending on your policy it may state that in order to qualify for disability benefits you must prove that it is not only your own job that you are unable to do, but any job that you may be qualified to do in consideration of your education, training or experience. Refer to your policy to see what applies to you.
Also Check: Are Long Term Disability Insurance Payments Taxable
Employment Termination And Long
Can I be fired while I am on long-term disability? We get this question all the time.
Unfortunately, the short answer is yes. Generally speaking, employers can fire employees at any time. They cant just fire you because of your disability that would be a human rights violation. Legally, they have to provide termination or severance pay.
So, in some cases you may have a legal claim against your employer. For instance, if you are terminated without severance pay. You would also have a case if you believe it was because of your medical condition or disability. In these cases, you can win compensation in court.
Most employers wont terminate you if youre on long-term disability because they know it looks bad. They want to avoid lawsuits and human rights claims. Therefore, cautious employers will allow you to be on sick leave for up to two years.
But, after two years, your employer may have the option to terminate you for cause. This means they would only have to pay the minimum severance allowed under provincial laws. This type of termination is based on the frustration of employment. This is a complicated area of law. If this is your situation, I urge you to get specific legal advice.
Consider The Impact Of Termination On Your Health Insurance
Although employees who are unable to work because of their medical conditions may be able to continue collecting long-term disability benefits payments even after their employment has been terminated, losing their jobs may prevent them from accessing their regular health and dental insurance coverage.
As long as you remain employed, you may be able to continue using your companys group health and dental insurance coverage.
Recommended Reading: How To Check On Disability Claim
What Should You Do If You Have Been Terminated
If you have been terminated from employment while on long-term disability, make sure you continue to see your medical providers for treatment of your disability. The most important factor to consider regarding termination of employment long-term disability is whether the employer has considered enough evidence before making the decision. An employer should obtainproper medical evidence and an opinion from a doctor regarding the employees ability to return to work.
If an employer fails to obtain sufficient medical evidence before terminating the employment of a worker on long-term disability, they may be required to continue to pay the employee. The employer may also be on the hook for the employees legal costs.
Many long-term disability benefits lawyers offer a free initial consultation that can help you learn about your options and determine if you need further legal assistance. If you decide to hire a lawyer to help with your termination of employment long-term disability claim, your lawyer will review your insurance policy, your medical records, your employment contract, and any other important information to determine how to proceed. Lawyers will fight on your behalf to help you get the benefits you deserve.
In most cases, lawyers who handle long-term disability cases will work on contingency. That means they will not get paid unless you win your case.
Employment Rights And Disability Benefits
When taking a sick leave to apply for disability benefits, it is important to understand your employment rights and obligations. You have a relationship with your employer that is separate from the disability insurance company. You and your employer have rights and obligations that operate apart from your disability claim. Your employment rights come from the common law, employment standards laws, and human rights laws.
You May Like: What Is The Disability Rating For Hearing Loss
Can Your Benefits Be Terminated While On Long
Long-term disability claims can be challenging and time-consuming. Unfortunately, even once your long-term disability claim is approved, your benefits can still be terminated. There are many reasons why the insurance company may terminate your long-term disability benefits. Your claim may be terminated if you no longer meet the definition of disability. In many policies, the definition of disability changes after 2448 months and will then consider whether you are disabled from any occupation, not just your own occupation. There can also be other limitations in your policy that could result in termination. Below, we discuss some of the reasons why your long-term disability claim may be terminated. But you should read your policy carefully to understand the definition of disability and the other factors and provisions that may affect your ability to continue receiving long-term disability benefits.
Protections For People With Disabilities
The ADA also protects workers from discrimination based on their health history. Take for instance if a person has a history of heart disease.
If your leg is injured and your injury doesnt impair your ability to walk, it is discriminatory if your boss thinks you cant do a job that requires you to walk. This is perception is discriminatory.
If you can do the essential responsibilities of your job with reasonable accommodations, it is illegal for your boss to fire you because of your disability. As a result, terminating an employee with a disability for discriminatory reasons is not a valid cause for termination.
You May Like: How To Get Disability In Nc
When I Sue The Insurance Company For Disability Benefits What Do I Actually Sue For
In long term disability actions you are suing for the payment of the disability benefits to which you are entitled. If you and your lawyer decide that the insurance company acted unfairly when they denied your claim you may also sue for bad faith. Your lawyer will also make a claim for pre- and post-judgment interest on the amounts claimed along with a financial contribution from the defendants which will go towards your legal fees.
How Long Do I Have To Wait To Collect Long Term Disability Benefits
Once you have made a claim how long you have to wait in order to collect your disability benefits depends on your policy as your claim must be evaluated, approved and a mandatory waiting period must be completed. If your employer has a Short Term Disability plan the waiting period to access the benefits under your plan is usually within 5 days.For long term disability benefits, you will need to be off of work for several months before you can collect benefits. This waiting period is called an elimination or qualifying period and it can range from 90 to 180 days. Consult your policy and your employer for clarification.
There are alternatives if you do not have access to a short term disability plan. Instead you may qualify for Employment Insurance or Sickness Benefits through the Government of Canada. This can provide up to 15 weeks of sick benefits.
Also Check: Can You Get Disability For Gout
Do I Need A Lawyer To Handle My Long Term Disability Insurance Claim
It is a personal choice in deciding whether or not you would like a disability insurance lawyer to represent you and handle your claim. It is important to be aware of your rights and stay in control of your situation. When a person negotiates directly with an insurance company, he or she needs to understand that insurance companies have hundreds of years of experience in how to manage and settle losses. As private companies, they are always working for the benefit of its shareholders. If your claim is denied you may wish to consult with a lawyer who has the experience and knowledge necessary for advancing your claim.
Are My Benefits Taxable
Generally, if you, the employee, have an individual disability insurance policy where you pay the premiums then any payments you receive are not taxable. If the employer pays the premiums for the employees disability insurance policy then when the benefit payments are received by the disabled employee they are taxable.
You May Like: How To Apply For Disability Benefits In Utah
Can I Apply For Long
If you are wondering whether you can apply for Long-Term Disability benefits under your previous employers insurance policy, even though you are no longer employed by them, you are not alone. This is a question that we have been asked countless times by hundreds of people, over the past 20 years of us practicing LTD insurance law.
As you may have anticipated, the answer is not as simple as yes or no. As with most answers to legal questions, the answer to this question starts with it depends.
In this article, we will attempt to answer whether you may be eligible for LTD benefits under your former employers insurance policy by exploring some of the most common ways in which this issue arises and ultimately, plays out in litigation.
To help you understand this complex issue, we will go through some real case examples with the hope that you may see your set of circumstances in this article and gain a better understanding of whether you may be eligible to apply for LTD benefits after your employment has terminated.
That said, all cases are different and one subtle difference might alter the outcome in your particular case. Therefore, it is always best to discuss the specific details of your claim with an experienced LTD insurance lawyer, rather than rely on information you might find online. We offer for that very purpose and we encourage you to contact us if you have any questions regarding LTD benefits or anything you read in this article.
Disclaimer: Changes In Your Work Or Life Situation
The information on this page applies to departments and agencies served by the Pay Centre. If your department or agency is not served by the Pay Centre, contact your departmental compensation unit.
Please request additional guidance from your manager, departmental human resources and finance, as pay-related information and processes are subject to change.
Don’t Miss: How Do Disability Lawyers Get Paid
What If I Am Ready To Return To Work And My Job Is Gone
A key aspect of FMLA leave is job protection. If a worker is ready to return to work after their FMLA leave is complete, they should expect to return to their same position. If that position has been reassigned, the employer needs to offer a job that is nearly identical, meaning it offers equivalent pay and benefits.
How The Americans With Disabilities Act Can Protect Your Job
Although most employees in the United States work on an “at-will” basis, which means they can be terminated for virtually any reason, the Americans with Disabilities Act makes it illegal to fire an employee due to disability. This law protects those who meet the ADA’s definition of disability, which includes many individuals on disability leave and some who have previously received benefits and returned to work.
Under the ADA, disability is defined as “a physical or mental impairment that substantially limits a major life activity.” Employers covered by the ADA must offer to make reasonable accommodations of your disability as long as it will not cause them “undue hardship.” The burden is, however, on the employee to inform their boss of their disability so that accommodations can be provided.
Accommodations can include restructuring a person’s job duties or schedule, installing Braille signage, modifying desks, making the workplace more wheelchair accessible, and many others. Even granting additional unpaid leave can be a reasonable accommodation. Whether any of these accommodations constitute a hardship for the employer depends on many factors, including the size of the company and the cost of the changes. If there aren’t any reasonable accommodations an employer can make that will allow a disabled employee to perform all the essential functions of the position, the worker may be legally terminated.
Don’t Miss: What Percentage Of Disability Appeals Are Approved