Navigating the rules and regulations surrounding long-term disability (LTD) benefits in Ontario, Canada, when considering returning to work can indeed be complex. It's crucial to understand your specific LTD policy and its terms to make informed decisions. Here's some information to help clarify the situation:
Long-Term Disability Benefits in Ontario, Canada
If you're currently receiving long-term disability benefits and you decide to return to full-time work, your LTD benefits may be at risk. The insurance provider may view your return to work as evidence that you are no longer disabled, particularly if your new income is comparable to what you were earning before becoming disabled. Even if your new income isn't quite as high as your pre-disability salary, it could still jeopardize your LTD status.
The terms of your policy will determine whether you can maintain your full disability benefits when returning to work. In Ontario, there are two main types of LTD policies that impact your ability to work:
- Own Occupation Policy:
Under an Own Occupation LTD policy, disability is defined as the inability to perform the essential duties of the job you had before your disability began. This means that if your new job involves different duties than your previous one, your partial or total disability benefits are unlikely to be disrupted. However, if your earnings from the new job reach a certain level, you may lose your disability status or be required to repay some of the benefits you received.
Own Occupation LTD benefits come with limitations, such as:
- If your wages exceed 70% of your pre-disability income, you may no longer meet the definition of disability.
- There may be reduced benefits if your combined wages and monthly disability benefit exceed 100% of your pre-disability income.
It's crucial to carefully review your policy to ensure you don't inadvertently violate its terms regarding eligibility for partial disability payments.
- Any Occupation Policy:
An Any Occupation LTD policy provides benefits only to individuals who cannot work in any job, not just jobs that match their previous duties and capabilities. Many Canadian LTD policies have an Own Occupation period of 24 months, after which the coverage may shift to Any Occupation. At this point, your monthly disability benefit may cease, as you may be considered no longer disabled or permanently disabled. Again, carefully read your policy to understand the impact of returning to work. For example, many policies stipulate that the more you earn from your new job, the fewer benefits you will receive. However, if your wages from the new job are less than 20% of your pre-disability earnings, your LTD income will likely remain unaffected.
Partial Disability Benefits and Rehabilitation Incentives:
Many Any Occupation policies allow for partial disability benefits if you are capable of part-time work. If your policy permits this, you can work part-time and still maintain some of your benefits. However, if your part-time income falls between 20% and 80% of your pre-disability earnings, your long-term disability benefits will be reduced proportionally, and you may need to provide proof of hours worked and wages earned to maintain your benefits.
Some Any Occupation policies may offer rehabilitation incentives for individuals receiving short-term disability benefits. These programs can help you return to part-time work or a different job than before and may provide vocational rehabilitation training and additional incentives on top of your regular LTD income without any clawback. Given the complexity of LTD policies and their impact on your ability to work and receive benefits, consulting with a legal professional experienced in disability law, such as the team at VC lawyers, can be invaluable. They can provide clear guidance and help you make informed decisions regarding your long-term disability benefits and returning to work.
If you're facing challenges in receiving your full disability benefits or navigating the rules around working while on disability, VC Lawyers, specializing in personal injury and disability claims, can assist. We can appeal your denied disability insurance claims or clarify your policy to ensure you meet the criteria to maintain eligibility for long-term disability benefits. Contact VC LAWYERS today at 1-(855) 932-4929 for a complimentary consultation!