Many individuals, through their workplace group benefits plans, CPP, or other insurance policies receive benefits, including long-term disability insurance. Disability insurance provides “peace of mind” coverage for a portion of your lost income if you become disabled from work as a result of illness or injury.
In this Part One of our four-part Practice Profile, we look at the definitions that are common to disability insurance contracts. The insurance contract or policy itself will set out the definition of “total disability” and the onus is on you to establish that you are disabled within that definition. Typically, you will qualify for benefits if your illness or injury prevents you from performing the essential duties of your own current occupation. This is often referred to as the “own occupation” definition. After a certain time frame, many policies will often change the definition of “total disability” to that of being disabled from “any occupation”. In other words, after a certain time period you then have to prove that you are not only disabled from working the essential duties of your own occupation, but you are also disabled from working any occupation.
In order to establish that you are disabled within the meaning under the contract or policy, you will be required to provide medical evidence documenting your illness or injury and how it prevents you from performing the essential duties of your own occupation. You will likely also be required to show that you have been receiving ongoing care and treatment from a physician for that injury or illness.