Disability benefits through employer insurance are available to many full-time workers. It can be difficult to know what to expect if your benefits have been revoked. Long-term disability plans offered by employers can be confusing, but you have the right to know exactly what you are entitled to and a lawyer can help you decipher your policy. Here is what to know about LTD benefits and reasons why your benefits may have been revoked.

What is Employer Insurance? 

In Canada, disability insurance through employers is common. Disability benefits are either received through the government plan or through a person’s employer. Many businesses offer employer insurance to employees. Employer disability insurance benefits cover individuals who cannot work due to sickness or injury. Getting employer disability benefits means having income while you are out of work. 

Businesses can choose to offer employer insurance to workers who cannot work due to an injury or illness that prevents them from doing their jobs. Injuries or illnesses do not have to be work-related for a person to be entitled to disability insurance through their employer. Disability insurance through employers can provide either long-term or short-term benefits. Employer insurance laws may state that certain employers must participate in disability benefit programs.

What are LTD Benefits?

Unlike short-term disability benefits, which last for a maximum of 26 weeks, long-term disability benefits kick in after short-term benefits are up. Long-term disability benefits are for employees who cannot work for long periods of time due to injuries or illnesses. Usually, LTD benefits are for six months or longer periods of time.

LTD disability benefits usually give an employee 50% or 60% of their pay when qualified. Depending on the employee’s age, the long-term disability benefits can provide income for a specific amount of time or continue into the person’s retirement age, if they are near retirement when they become disabled. Most long-term disability benefits are paid up until age 65. The disability insurance benefits are calculated as a percentage of the person’s usual compensation while they were working. In most policies, there is a maximum compensation amount.

Long-term disability insurance defines disabilities in two ways. The first way means the disabled person cannot perform the tasks required of them in their occupation. The second way in determining that the disabled person cannot perform the tasks of any job, not just the one they left. Many times, long-term disability insurance policies use both. First, they will determine a person cannot work their job, and then after some time, they will be determined to be able to work other jobs, so the LTD benefits will stop. 

How Do Employer Disability Insurance Benefits Work?

Before getting on a long term employer disability plan, many employers offer sick leave benefits and then short term disability insurance. Many people use these benefits before long term employer insurance kicks in. Long term employer insurance usually covers about 60% of your income. 

Disability plans vary. Some employer insurance policies will cover benefits for two years if you are not able to perform your job. 

After two years of receiving benefits, employer insurance plans will continue only if you have proven you are still unable to do your job or you cannot do another job. Sometimes, disability insurance will terminate after two years if it is determined you are able to work another job. Sometimes you may be deemed unable to work your regular job but you could start another job that does not have the same demands. This depends on your specific illness or injury. Employees do not have to have a permanent disability to obtain employer insurance benefits. 

What are the Employer Disability Insurance Requirements?

Employer disability insurance requires you to be employed and your weekly pay to be reduced by over 40% due to your illness or injury. You must have accumulated 600 hours of insurable employment at your job and your doctor must authorize that you are medically unable to work.

Employer disability insurance requirements include being a regular, full-time employee for at least a year to be qualified to receive benefits. To be qualified, you must no longer be eligible for employer sick pay or short term disability. 

Applying for employer disability insurance can be done online. The application process includes filling out a form, a medical certificate from your doctor that authorizes how long you will be out of work, and a Record of Employment from your place of work. 

Why Were Your Employer Insurance LTD Benefits Revoked?

Employer insurance can be revoked for a number of reasons. Sometimes, there is a simple reason why the benefits have been terminated and a document or form can reactivate your benefits. 

Another reason for the termination of benefits is if you have not been given an examination by a doctor who is approved by the insurance company. Or, you may have exceeded the time limitation and did not submit your claim on time.

If your application for benefits had a mistake in it that could be another reason for evoked benefits. If you have left something out of your claim or misrepresented your disability and you have been under surveillance by an insurance company then your benefits could be cut off. Insurance companies have the legal right to surveil you and collect contradictory evidence of your claim. 

The failure to have your doctor properly document your condition could result in termination. Or, if you have not kept up with treatment, insurance companies can cancel your benefits.

Commonly, benefits are revoked after a two year period. It can be deemed that you are able to work a job, if not your usual job then another job with less demanding conditions. To continue receiving benefits, you may have to take an “any occupation” test to determine if you are able to work. Sometimes, insurance companies will claim you are only partially disabled and you will lose your long term benefits. A LTD lawyer can help you fight for the benefits you’re entitled to. Long-term disability lawyers are often well-versed on the reasons insurance companies revoke benefits and can help you through the process. 

How Can You Get Help?

Applying for or navigating employer insurance disability benefits can be daunting. If your employer insurance benefits have been denied or revoked, you may need additional help. Dealing with an insurance company alone can be tedious or stressful. In most cases, getting help is the easiest way to deal with long-term disability benefits. 

There are lawyers who devote their practice solely to long-term disability benefits. Long-term disability lawyers are equipped with the knowledge to deal with insurance companies if you have been denied benefits or your benefits have been terminated. Seeking representation from a qualified lawyer is often the easiest solution to obtaining or reestablishing employer disability benefits.