When the COVID-19 pandemic brought the world to a halt in early 2020, few could have anticipated its far-reaching consequences and impacts. Throughout the world, and all over Canada, people are still coming to terms with this dreadful period and the implications it has for our future.
One thing is clear: the pandemic took a massive toll on the physical and mental health of Canadians. But it remains unclear how insurance companies will handle the anticipated deluge of disability claims stemming from the pandemic.
Who Qualifies for Disability Benefits?
In principle, you should be eligible to claim disability insurance benefits if an injury or illness prevents you from carrying out your regular job duties. The precise definition of a “disability” varies from company to company, but the core idea is that if you have symptoms severe enough to prevent you from performing your job, you should qualify, even without a specific diagnosis.
In practice, however, many people have had the unfortunate experience of having their disability claims denied, even with supporting documentation from their doctors. This happens because the medical staff employed by insurance companies determine eligibility, not the applicant’s personal doctor.
COVID-19 Long Haulers
It is currently believed that at least 10% of people experience long-term COVID-19 symptoms. These so-called covid “long-haulers” suffer from the symptoms of COVID-19, notably fatigue, mental fog or difficulty concentrating, shortness of breath, aches and pains, loss of smell and/or taste, as well as headaches and coughing, for months on end without relief.
Unlike injuries or other medical conditions, the causes of these symptoms are not easily identified through medical imaging, and the best course of treatment remains to be determined. All of which puts long-haulers in a very difficult position when it comes to dealing with their insurance companies.
Frontline Workers & Mental Health
Throughout this pandemic, essential workers, especially those in medical fields, such as doctors, nurses and emergency medical technicians, bore a tremendous psychological burden by trying to perform their duties in the face of so much risk and uncertainty.
Their display of bravery and determination has been inspirational, but it has led to the development of a range of mental health issues, including chronic stress, burnout, anxiety, addiction, insomnia and post-traumatic stress disorder.
Now that it appears as though the pandemic is winding down, the number of short-term and long-term disability claims for mental health reasons is expected to skyrocket.
Disability Insurance & the COVID-19 Pandemic
Both short and long-term disability benefits are intended to protect employees from wage losses related to either physical or mental illness. In short, any condition that prevents you from returning to your employment should be covered.
Although travel insurance policies were quickly amended during the early phase of the pandemic with COVID-19 exclusions, such exclusions do not apply to long or short-term disability policies.
If you have been unable to return to work for a lengthy period of time because of long-term COVID-19 symptoms, or by a mental health issue, that either began during or was exacerbated by, the pandemic, you could have a valid long-term disability claim.
Filing a Long-Term Disability Claim
All too often, people who have their disability claims denied by their insurance companies suffer unnecessary financial hardship and mental anguish. Insurers have significant resources at their disposal, which is why people with legitimate claims often feel powerless and do not contest unfair decisions.
At DWA LAW, we believe that anyone who is unable to work due to physical or mental illness should receive the benefits they are entitled to. When push comes to shove and claimants retain a long-term disability lawyer, insurance companies are usually quick to engage in settlement negotiations. Our legal team can help you achieve a positive resolution to disputed disability claims.
The Application Process
Long-term disability applications usually require three forms: the employer statement, the employee statement and the attending physician’s statement.
Employer Statement
This document, provided by the employer, lists the pertinent employment information related to your job and your claim, including your wages or salary, term of employment and the last day you worked prior to your disability. Also, it should include your job description, including the physical or mental demands of your duties, in order to establish that your illness or injury prevents you from performing them.
Employee Statement
This form, completed by the claimant, should provide your personal information, as well as your account of how your condition developed and why you are unable to work because of it. Your insurance company might contact you to discuss the information you present in this document.
Attending Physician’s Statement
This document, completed by your primary healthcare provider, should provide as much information as possible about your condition, including any supporting documentation, such as medical test results or specialist consultations.
Your healthcare provider should also include as much detail as possible about your ongoing limitations in order to demonstrate how and why they prevent you from working. This information is especially important for claims related to mental health reasons, as they cannot be supported by medical imaging or other tangible tests.
Has Your Claim Been Denied?
If you are in the unfortunate position of having had a legitimate disability claim denied, DWA LAW is here to help.
For denied claims, you have the option of either going through your insurance company’s appeal process, which could entail multiple requests for new information and assessments. Many people understandably find this time-consuming and frustrating process quite discouraging.
Alternatively, you have the option to initiate legal proceedings. By going this route, you can have an experienced disability lawyer argue on your behalf and greatly increase your chances of a positive resolution to your situation.
