Long-term disability (LTD) is of great concern to many people in Nova Scotia. About 30 percent of Nova Scotians have one or more disabilities, but most (62.2 percent) are employable.
An injury or illness may prevent you from returning to work for a significant period of time. LTD benefits can replace up to 70 percent of income through private insurance or government programs.
The problem is that claiming LTD benefits doesn’t guarantee receiving them. Insurance companies may deny a valid claim or delay it for months. During this time, you have medical expenses and other bills mounting.
If you can’t get the relief you need from your insurance company, consult experienced LTD lawyers in Nova Scotia, who can help you navigate the complex legal process of LTD claims.
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What are LTD benefits?
Long Term Disability benefits in Nova Scotia typically replace a portion of a person’s income when they become disabled. Many private life insurance plans may offer disability as a rider.
However, you don’t have to get your own insurance if you’re a regular employee. Most employers in Nova Scotia must provide Workplace Injury Insurance to their employees under the Workers’ Compensation Act.
The disability coverage includes benefits for illnesses or injuries that happened at the workplace, as determined by the Workers’ Compensation Board. However, it won’t provide financial support for non-work-related injuries.
Mandatory insurance for employees typically applies in other provinces in Canada, including Ontario and Quebec. However, the disability rules may differ slightly.
Fortunately, most companies provide workers with group insurance that includes a long-term disability plan. The terms of coverage vary widely across insurance providers, but the Insurance Act provides some uniformity.
One is the initial disability period, which is in item 11 of the Schedule to Part V Statutory Conditions. The insurer must provide initial benefits for loss of time within 30 days of receiving a long-term disability claim. The initial benefits period is usually 30 days, after which the elimination period will begin.
The elimination period is typically 120 consecutive days of disability when you won’t get any insurance money. The length of the wait time is inversely proportionate to the premiums, which means that the more you pay for insurance, the shorter the qualifying time.
The insurance company will take this time to determine if you qualify for LTD benefits. While you wait, you can avail other benefits, such as employer-based sick leave, short-term disability benefits, or Employment Insurance (EI) sickness benefits.
After the elimination period, the insurer will accept or deny your claim for LTD benefits. In many cases, insurers will pay LTD benefits according to the insurance plan, provided you have proof of continued disability.
If the insurer denies your claim despite submitting valid medical evidence, consult LTD lawyers in Nova Scotia to discuss the appeals process and explore other legal options. If the insurance company unreasonably delays payments, you might get a lump-sum payment for the time you should have been covered.
How much is LTD benefits in Nova Scotia?
Long-term disability benefits in Nova Scotia will depend on the disability policy. Typically, it replaces up to 70 percent of your gross income pre-disability.
For example, if you earned $3,500 a month before sustaining severe injuries in a car accident, and you’re not able to work, you can claim LTD benefits with your insurer. If approved, you’ll get $2,450 a month after the elimination period.
Long-term disability lawyers in Nova Scotia can make sure that you get the compensation you deserve under your insurance policy. However, LTD benefits will only partially replace your lost income, meaning you rarely get back everything you lost.
If you sustained injuries because of someone else’s negligence, you can seek compensation from the at-fault party for lost income and other losses. It’s best to retain a personal injury lawyer in Nova Scotia to help you through the process.
What qualifies as a long-term disability in Nova Scotia?
To get LTD benefits in Nova Scotia, you must be unable to return to work because of an illness or injury. This means that you must have been gainfully employed at the onset of the debilitating condition. This also means that you don’t qualify for LTD benefits if you were unemployed when you got sick or injured.
Illness
Many medical conditions, such as heart disease, cancer, and work-related medical conditions, can be a qualifying factor for LTD claims. If the illness resulted from a pre-existing condition, you may still qualify, provided you were employed for 12 or more months before the illness rendered you unable to work.
Injuries
Severe accidental injuries, such as traumatic brain injuries or multiple fractures, that make an otherwise healthy person unable to work may also qualify for LTD benefits. You may claim LTD benefits from your group policy, private insurance, or worker’s compensation.
Duration of Long-Term Disability Benefits in Nova Scotia
LTD benefits in Nova Scotia typically continue until you can return to work, reach 65, or die. The assumption with LTD is that the individual won’t be able to return to work for a long time, perhaps permanently. However, the insurer will require periodic evaluations of the claimant’s condition to determine if they’re still disabled.
If the insurer determines that the claimant no longer meets the definition of disability, the benefit payments will stop. If you think that the insurer prematurely stopped paying benefits or denied your claim altogether, you should consult a Canadian long-term disability lawyer.
In most cases, LTD benefits cover up to two years of being unable to work in the claimant’s own occupation. After two years, LTD benefits continue if the claimant can’t work in any occupation.
The distinction between “own” and “any” occupation is critical for continued access to LTD benefits. Own occupation refers to your work at the onset of the disabling illness or injury. For example, if you were a nurse when you lost your legs in a car accident, you’ll be off work as a nurse, so you can claim LTD benefits for two years.
After extensive rehabilitation, you may be able to re-enter the labour market doing other work, such as medical transcription. This might disqualify you from additional LTD benefits.
There may, however, be circumstances that might prevent you from transitioning to other work. Get legal advice from a long-term disability lawyer if you believe you qualify for continuous LTD benefits in Nova Scotia.
Effects of Canada Pension Plan Disability Benefits
Most long-term disability insurance policies require claimants to apply for Canada Pension Plan Disability (CPPD) benefits. CPPD is a disability support program for employees ($1,538.67 per month to a maximum of $1,546.05 in December 2023) who meet the following eligibility requirements:
- Under 65
- Has a severe, prolonged disability that prevents them from working
- Made enough contributions to CPP (various scenarios)
However, you can’t get more than what the insurer determines or CPP disability benefit maximum per month, whichever is higher. Suppose you make a successful claim for CPPD benefits and LTD benefits from your insurer. The insurer will deduct any amount you receive from CPPD from the LTD benefits.
For example, if your insurer approves $2,800 per month for your LTD claim, and your CPPD benefits are $1,000, your LTD payout from your insurer will be reduced to $1,800.
Hire Long-Term Disability Lawyers in Nova Scotia
A long-term disability can change your life forever. Whether from an injury or illness, LTD benefits can mitigate your losses. In most cases, you won’t need a lawyer to file an LTD claim.
However, if you think that your insurance company isn’t dealing with you fairly, you should consult LTD lawyers at Diamond & Diamond Nova Scotia. Our lawyers have years of experience and handle a variety of insurance claims and personal injury cases. After a lawyer evaluates your case, they can tell you about your legal options.
If you want to know more about LTD and how to get financial support, call us toll-free at 1-800-547-HURT. You can also schedule a free consultation with one of our LTD lawyers in Nova Scotia.
FAQs on Long-Term Disability Lawyers in Nova Scotia
Are LTD benefits taxable?
The Canada Revenue Agency considers most long-term disability benefits as income, so you must report it in your annual tax returns. However, that’s not always the case, and tax credits may also reduce any tax liability you may have. The circumstances of your case will determine if you need to put money aside for taxes and how much.
Can you go on vacation while receiving LTD benefits?
Generally, there’s no bar to you going on vacation while receiving LTD benefits. You can still meet the definition of disability and engage in leisure activities. However, these activities should be consistent with your disability claim. For example, if your medical report says that you have a serious back injury, then you shouldn’t be playing golf or basketball.
Will CPPD benefits end if you start working again?
Not necessarily. You may continue receiving CPPD benefits until age 65 if your gross income is less than $6,600 annually. However, you must inform Service Canada when you start working again.
CPP also provides a three-month work trial where you can start working and still receive CPPD payments. CPP will take this time to evaluate your condition, and if they determine that you can return to work, the payments will stop.
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