Mental health problems are a leading cause of disability in Canada. In any given year, 1 in 5 Canadians will experience a mental health issue or illness. About 50% of our population will have or have had a mental illness by age 40. At least 30% of short-term disability and long-term disability claims in Canada are attributable to mental health problems and illnesses.
Mental health issues are very common, yet many people choose to not seek treatment or claim disability for mental illness. Stigma, discrimination, and the fear of getting fired or being labelled “unreliable” or “unproductive” at work can stop a person from getting the support they need.
What are mental health disability benefits?
Claiming disability for mental health concerns shouldn’t be stigmatizing or scary. Mental illness disability benefits are supposed to be there to help you financially when you need them most. Private and group plans include short-term and long-term benefit coverage for disabling mental health conditions. You may be able to claim for mental health issues ranging from workplace stress/burnout, depression, and anxiety to bipolar disorder, eating disorders, substance use disorders, or schizophrenia, for example.
Once disability benefits are approved, you can focus on treatment and recovery.
Who is eligible to apply for mental health disability?
When it comes to eligibility, the question is whether your mental health condition is limiting your ability to work effectively (or at all) for an extended period of time. There are people who experience depression and anxiety, or who have been diagnosed with a personality disorder, for example, who are still able to function at work and be productive in their job. Those people are not disabled for the purpose of disability benefits.
You are eligible to apply for mental health disability benefits if you are experiencing a mental illness or mental health issue that is preventing you from doing the important aspects of your job. “Own Occupation” and “Any Occupation” are the legal tests under which your entitlement to disability benefits will be assessed.
Most long-term disability plans with a period of own occupation, which commonly runs for two years. During this initial period, the “own occupation” test asks whether you are unable to do the essential duties of your own occupation. For long-term disability benefit coverage to continue past the “own occupation” stage, the question becomes whether your mental health condition is so disabling that it leaves you unable to do the essential duties of any occupation.
How to apply for mental health disability benefits
Applying for mental health disability benefits can be very challenging. It’s not enough to have a mental health issue or be diagnosed with a mental illness. You must satisfy the benefit provider that the issue or illness fits into the definition of disability as determined by the insurance policy or plan, and you must prove that the illness is limiting your capacity to work.
Insurance companies are often highly skeptical of mental illness disability claims quick to deny legitimate claims. Unlike physical disabilities, mental health concerns are not visible to the naked eye and can’t be demonstrated with a blood test or X-ray. Many disability claims are denied due to lack of medical evidence, lack of objective evidence to substantiate self-reported functional impairment, and failure to seek or follow the recommended treatment plan.
When applying for mental health disability benefits, your odds of success greatly improve by submitting a supportive medical report from a doctor and/or specialist (e.g., a psychiatrist, psychologist, or counsellor) that details your symptoms and the restrictions or limitation that are preventing you from working. You may also need to provide detailed letters of support from your employer, co-workers, and family.
It’s also essential that you regularly see your doctor or health care professional about your mental health issues and carefully follow the treatment plan prescribed to you. If you don’t follow the treatment plan, you claim will likely be denied. If, after being approved, you stop following the treatment plan, your benefits will be terminated.
What do you if you’re facing a disability claim denial
The stress of a disability benefit claim denial can worsen mental health issues. You should reach out to a mental health benefits disability attorney as soon as possible if your application has been denied. We can help you find out why benefits were denied and help you through the appeal process so you get the benefits you deserve.
Mental health issues and disability claim guidance in Calgary, Alberta, and Saskatchewan
It is highly recommended that you seek legal representation to assist you with the disability claim application process—or the appeals process if your claim has been denied.
Ludwar Law Firm has over 25 years of experience representing clients with disability claims for mental health conditions. Our clients appreciate that we take the time to explain their options, what is required to make a long-term disability claim, and what to expect during the claims process or disability appeal process.
Our legal expertise has helped win even difficult disability claims for mental health conditions. We welcome you to contact us today to schedule your free consultation.
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