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How to Submit a Long-Term Disability Claim

A long-term disability (LTD) claim is essential for those unable to work due to a debilitating medical condition or injury. If you cannot work because of a medical condition or injury, it may be possible to secure LTD benefits. Today, let’s examine how to submit a long-term disability claim in more detail. In addition, we’ll cover what happens if you are denied including next steps.

Make the Most of the Elimination Period

Among your responsibilities is the need for a firm understanding of your elimination period. This is otherwise known as the waiting period – the amount of time you must be disabled for prior to applying. Submitting your claim too early is sometimes a risk, as you may be turned down for not proving beyond a reasonable doubt your inability to work. Most of the time, however, early applicants will simply be required to wait. While waiting for the elimination period to end, you should instead gather as much medical documentation in support of your claim as possible. We also recommend consulting your employer’s policy booklet to ensure all their terms and conditions are met. The more thorough and complete your claim and supporting documentation is, the better the chances you’ll have of getting accepted – all while reducing the risk of delays.

The “Big Three”

When submitting a long-term disability claim, there are normally three important statements you must include with it. Sometimes only two are needed – one from yourself and a doctor – but this depends on the employer in question. The so-called “big three” are as follows:

Employee Statement

Your first-hand statement needs to be clear and concise about your physical and/or mental limitations and/or restrictions. For instance, if you are diagnosed with depression, list the specific conditions and symptoms that prevent you from working. You should also detail why you cannot work in your field of expertise – do not hold back on any critical factors and remain as accurate as possible. And don’t worry if you run out of room – a second sheet can be attached without voiding your application. 

Employer Statement

In most cases, the employer in question must provide equally clear, concise and thorough documentation of your situation. This usually includes a complete list of the duties within your role, and whether it would be feasible to alter your role. 

Practitioner (Doctor) Statement

We’ve noticed that doctor’s statements can often be incomplete or difficult to interpret. That’s why our legal team is happy to resolve any conflicts by acting as a liaison between you and your doctor prior to submitting your claim. Doctors may have busier jobs than ever, but they still must provide ample detail on your symptoms, diagnosis, recommended treatments and whether you’ve undertaken them, and why you cannot perform your duties. All relevant medical documentation – treatment programs, visitation records and otherwise – must be attached with this statement. This statement is the most heavily scrutinized by claim analyzers for accuracy and legitimacy. Remember, LTD insurers are known to even monitor social media behaviour by the applicant to verify their honesty.

What if I’m Turned Down?

Sometimes a rejection can be remedied by providing more complete information or addressing any red flags. The clearer the picture for the individual analyzing the claim, the better. Usually, you won’t be denied and instead will receive a request for more medical evidence. Alternatively, if you aren’t following treatment recommendations by your doctor you may be denied LTD benefits. We’ve covered the main reasons why you would be denied in this blog post – give it a read to learn more. 

Need Help with Your LTD Claim, ASAP? Contact RavenLaw Today!

At RavenLaw, our legal professionals can help you with unbiased, expert feedback on your LTD application, statements and attached documentation. If anything is unclear, missing or otherwise, we can work with you on resolving any grey areas. Reach out to us to get started!

RavenLaw Hosts Fall Long-Term Disability Conference

On September 24, 2020, RavenLaw hosted its fall LTD conference via video conference. The conference focused on long-term disability claims in the context of post-concussion syndrome and brain injuries.

The conference was attended by many union representatives of several federal public sector unions and by non-unionized employees. A neurological physiotherapist, Amaal Mirani of Lifemark Physiotherapy, provided a medical view on the fundamentals of concussions and post-concussion syndrome, their effects on the brain, and available treatments. Two guest speakers also shared their personal stories about dealing with post-concussion syndrome in both private and public sector employment, as well as their experiences pursuing claims against their insurance companies for long-term disability benefits.

Finally, James Cameron, Kim Patenaude, and Anna Lichty of RavenLaw provided a legal perspective on litigating long-term disability claims for clients with post-concussion syndrome and other brain injuries.

Bargaining in a COVID Economy. Get Informed – It’s Your Right

For unions, another round of negotiations has often meant getting back into a familiar pattern: deliver notice to bargain, prepare proposals, have a series of sometimes constructive, sometimes frustrating discussions across the bargaining table, perhaps resort to strike or face a lockout, then arrive at a collective agreement.

We are living in a different world.  Do not assume same-old is the same old.

A union may have a right to a range of information that is relevant to collective bargaining. Unions have a right to receive information about changes an employer is considering that may have a major impact on the bargaining unit.  That is particularly true in response to certain employer positions like a declaration of an inability to pay. They have that right even if they don’t ask, as the obligation to disclose is part of the duty to bargain in good faith.  If they ask, the obligation is probably even more extensive. You can look at a decision called PSAC v. Forintek Canada Corp. for details about how the Ontario Labour Relations Board applied this principle several decades ago.  It is still good law.

Employers may be thinking about a variety of options as COVID-19 remains one of the central features of the economy – from local markets to international trade.  A Union and its members are entitled to know what decisions have been made and what decisions are being considered. To be in the best position to prepare demands, to negotiate for appropriate contract terms and to speak with members about whether a tentative collective agreement is reasonable, it is more important than ever to create a comprehensive request for information and disclosure.

Each request will be different and will depend on the sector of the economy, local conditions, and the relationship between the Union and the employer.  Whatever the circumstances, no union should go into bargaining (or if already there, sign a tentative agreement) without making the request.

The information may be significant, or there may not be much.  It may be that the employer is forthcoming, or it may be necessary to extract it like you were doing dentistry.  In any event, it is much better to have made the request than to be surprised two months after signing the agreement with a reorganization, or a series of layoffs, or some other change that had been in the works for a considerable period of time.

This is one of the obligations the parties have in bargaining. It is more important than ever to make sure the other side lives up to its obligations.

Supreme Court Finds RCMP Pension Scheme Discriminates Against Women

On October 16, 2020, the Supreme Court of Canada upheld a Charter challenge to portions of the RCMP pension plan, which had been applied to prevent employees from buying back periods of service during which they had temporarily reduced hours of work for childcare reasons.

In its decision, the majority of the Supreme Court concluded that the pension law had a disproportionate, negative impact on women due to their sex. Particularly, the majority noted that the evidence demonstrated both that the Appellants themselves had been negatively impacted by the pension scheme due to childcare responsibilities and that, more broadly, women as a group face disadvantages related to balancing work and childcare obligations. The majority also accepted that the specific negative impact in this case perpetuated historical gender biases in pension plans. The majority concluded that the pension law therefore breached the equality rights of women, contrary to section 15 of the Charter.

As the Government could not provide a pressing or substantial reason to justify the negative impact on women, the Court directed the Government to design remedial measures to address the negative impacts on the pensions of the Appellants and others in the same position.

Andrew Astritis and Morgan Rowe from RavenLaw appeared on behalf of the intervener, the Public Service Alliance of Canada, to support the Appellants in their arguments that the pension law discriminates against women and other parents because of their childcare obligations.

Is there recourse for COVID-19 discrimination?

Ravenlaw gratefully acknowledges the contribution of this post by articling student Simcha Walfish.

As the Centre for Addiction and Mental Health (CAMH) has noted, the “COVID-19 pandemic has sparked a rise in stigma and discrimination against people who have the virus; people from countries where the virus originated or are considered hot zones; people who have travelled recently; or even those who it is believed have come in contact with someone who has the virus.”

When people face discrimination because of this stigma, what recourse can they hope for in Ontario’s human rights law? The Ontario Human Rights Commission has taken the position that the “Code ground of disability is engaged in relation to COVID-19, as it covers medical conditions or perceived medical conditions that carry significant social stigma.” This means that an employer who fires an employee because the employee is diagnosed with COVID-19 may be held responsible for human rights violations. Further, under the Code, discrimination based on perception of disability is prohibited. So, if an employer believes the employee may have COVID-19, they may also be held responsible for human rights violations.

These grounds for discrimination will hold true for all areas covered by the Code. For example, a landlord that evicts a tenant because the tenant has, or is perceived to have, COVID-19 could be found liable for the discrimination.

In a case working its way through the British Columbia Human Rights Tribunal, a harm reduction worker in the Vancouver Downtown Eastside and Surrey was evicted due to her landlord’s concern that she had been exposed to COVID-19 because of her work. The landlord argued that her claim should be dismissed because COVID-19 is not a physical disability under the Code and the claim therefore had no prospect of success.

The Tribunal refused to dismiss the complaint because the stigma of COVID-19 is such that even being perceived to have it should be protected under the ground of physical disability. The Tribunal reasoned that “this aspect of the complaint is about the alleged stigma that attaches to Covid-19, quite apart from the virus’ effects on a person who has it. In my view, the issue raised by this aspect of the complaint falls squarely within the ambit of perceived physical disability.”

Once a complainant establishes that they have been the subject of discrimination due to having, or being perceived to have, COVID-19, the burden will shift to respondents to justify the conduct for legitimate health and safety reasons and to show why they could not accommodate the complainant. General concerns about the virus will not be enough to justify discrimination. In the BC case, the Tribunal found the landlord’s arguments regarding his “genuine worries” about health to be insufficient without detailed information about his specific vulnerabilities, his understanding about COVID-19 at the time, his genuine concerns, what information he sought from the tenant, and what options he considered before eviction.

It remains to be seen how much latitude human rights tribunals will grant those who discriminate based on “genuine worries” about the virus. But, if the case from BC is any indication, those who have faced discrimination based on COVID-19 stigma need not assume that concerns related to the virus will always prevail over the right to be free from discrimination.

If you have questions or concerns about the implications of COVID-19 on your employment, please call 613-567-2901 or email info@ravenlaw.com. If you are a member of a union, please contact them directly for assistance in dealing with your workplace issue.

 

Bargaining Unit Positions May Be Tied to Work Location, Trigger Job Posting and Seniority Rights

In a recent grievance decision between the Limestone District School Board and CUPE Local 1480, Arbitrator Jesse Nyman found that changing a bargaining unit member’s work location may eliminate a position and create a vacancy, triggering the mandatory posting provisions of a collective agreement.

In 2013, the Employer decided to close two of its secondary schools in Kingston, Ontario and to construct a new secondary school. The grievance began when the Employer announced its intention to unilaterally transfer staff from one of the old schools to the new school when it opened.

At arbitration, the Union argued that, when an old school closes, the positions at that school cease to exist and when the new school opens, vacancies will be created that must be posted and filled in accordance with the posting and seniority provisions of the parties’ collective agreements. The Employer defended its intention to simply transfer staff from one school to another by arguing that there were no vacancies created, only a change in work location, and therefore no provisions of the collective agreements applied.

In his decision, the Arbitrator agreed with the Union’s position that the shutting down of the old schools and opening of the new school was a “school closure” within the meaning of the collective agreement. The Arbitrator also accepted the Union’s argument that the collective agreements prohibited the Employer from unilaterally transferring employees from one work location to another when a school closes. Rather, the posting provisions must be applied. The Arbitrator found that this interpretation was supported by the plain language of the agreements and the parties’ past practice regarding school-to-school transfers. The grievance was therefore allowed and the Board was ordered to post the new positions in accordance with the terms of the collective agreements.

This win for the Union highlights that a change of work location, depending on the language of the collective agreement, may trigger a vacancy that requires a position to be posted. This reinforces the importance of seniority rights for workers, which are almost always a key determinant in filling vacant positions.

The Union was represented by Julia Williams of RavenLaw.

Alison McEwen to Present at Labour and Human Rights Conference

On December 8, 2020, Alison McEwen will be speaking as part of Lancaster House’s annual “Bargaining in the Broader Public Sector” conference. Alison will present as part of a panel on bargaining and negotiation priorities in the post-COVID-19 world. The panel will discuss how the pandemic has caused broader policy shifts and how these shifts are likely to affect bargaining in the public sector.

Wassim Garzouzi Appointed President of Canadian Association of Labour Lawyers

RavenLaw is pleased to announce that one of its partners, Wassim Garzouzi, has been unanimously appointed as the President of the Canadian Association of Labour Lawyers (CALL) as of July 30, 2020. CALL is a voluntary organization comprised of approximately 600 lawyers who represent the labour movement across Canada. The Association endeavours to protect and advance the interests of workers in the forums where labour law is made and administered. Wassim’s presidency marks the first time that a Black, Indigenous, or Person of Colour has been named to the CALL executive since its founding in the late 1980s.

Wassim, who was previously elected to the role Regional Vice-President (Ontario), has been a member of CALL Council since 2016.

Congratulations to Wassim on his historic appointment!