By Matt Lalande in Long-Term Disability on February 10, 2021
According to the World Health Organization’s (WHO’s) definition:
“Mental health is a state of well-being in which an individual can realize his or her own abilities, interact positively with others, cope with the stressors of life and study, work productively and fruitfully, and contribute to his or her family and community.”
Mental Health Disorder is a relatively broad term – but it can be thought of as a diverse group of conditions that primarily impair cognition, emotion, and behavioral control which may appear at any point during an individual’s life. The problem is when these conditions arise during someone’s vocational years, it can place a significant strain on their ability to work.
Mental illness can no doubt adversely impact a person’s ability to work. In fact, mental health disorders are now the most common reason for long-term sickness absence in Canada. Studies have shown that time and time again, individuals suffering from mental illness have an increased risk of employment termination in general as well as both involuntary and voluntary job loss – leading people to long-term disability.
But what happens when long-term disability is denied – or even worse, wrongfully cut off?
According to Health Canada, 1 in 5 Canadians will experience some type of mental illness at some point during their lifetime. Approximately 8% of Canadian adults will experience major depression at one time or another during their lives – while 1% will suffer from bi-polar disorder. In some cases, there may be a determined cause. For example, post-traumatic stress disorder is caused by a traumatic event an individual experiences that continues to trigger vivid flashbacks and negative memories. Other conditions do not have a specific cause associated and can depend on a range of circumstances including family genetics, brain chemistry, environment, social factors, and more.
Mental illness is considered an invisible illness because it is not always physically evident that someone is suffering. Further, mental illness does not discriminate against who it might impact; many conditions affect Canadians regardless of age, income, background, lifestyle, or education level.
There are many types of mental illnesses; there are those that affect mood, personality, and psyche. Some of these mental illnesses, like eating disorders, can be overcome or prevented with the support of loved ones, while others require professional help. There are also critical conditions that require medication, psychiatric counselling and/or therapy.
In 2014, the WHO identified eight major problems that contribute to 75% of the global burden of mental disorders, which were – depression, schizophrenia, psychoses other than schizophrenia, suicide, epilepsy, dementia, alcohol and illegal drugs abuse, and pediatric mental disorders. In Canada, the most common forms of mental health disorders are note to be:
Mental illnesses are not instantly developed; they occur due to a combination of many factors, including personal experiences combined over the course of years or months. Some are easily noticeable with identifiable causes, but others are slow to develop and might only show seemingly harmless symptoms like mild depression. Not only is the whole of the individual an important factor, but his or her surroundings can also determine the character or severity of the mental illness. Climate, culture, and social experiences, especially childhood experiences, are some of the external forces that psychiatrists consider when diagnosing people with mental illness.
Some illnesses are primary effects of traumatic experiences, while others are inherited in genes. Some are transient or temporary, while others are recurring, even chronic. One cannot prevent the occurrence of mental illness in a person since there is more than one factor that helps to develop it. There are different forms of treatment that help cure mental illness. There are also alternative methods for those who prefer natural ways to cure the condition. Depending on the severity and type of mental illness, the afflicted person might undergo medication, psychotherapy, group therapy, or hospitalization. There are existing natural alternatives that claim to help with such illnesses, like meditative strategies ect.
The answer is that each case is dependent on its own facts.
Long Term Disability policies in Ontario do not typically require you to be be completely helpless and incapable of any activity – but – rather the question is whether you are incapable of engaging in the substantial duties of your own occupation for the first 24 months of disability. After 24 months of disability benefit payments have been made, most, if not all disability policies typically switch definitions to a stricter definition, in that to be able to qualify for long-term disability benefits, you must be unable to perform the activities of any occupation for which you are reasonably suited by your education training and experience.
It’s very important to understand these policy definitions. The definition of total disability, for the first 24 months, is normally called the “own occupation” definition. What “own occupation” means is that you will be deemed totally disabled by your insurance carrier (Sunlife, Manulife, Great-West Life ect.) if you are unable to carry on the functions and duties of your own job or own occupation. If you suffer from a serious mental illness and are able to perform only minor functions of your job, you will nonetheless be deemed totally disabled.
After two years, the total disability definition in most, if not all disability policies, changes to an “any occupation” definition of disability. This test is much more strict. This means that in order to be deemed totally disabled, your disability must prevent you from engaging in any occupation or from performing any work for compensation or profit.
In some cases, insurance carriers may wrongfully or cut off long term disability benefits. Many, if not most claimants are unaware that they do not have to take a denial as the final answer. Claimants have the right to hire their own disability lawyer and appeal the denial of their disability benefits. However, the process can become complex and frustrating. It’s highly recommended that you obtain the help of a qualified disability lawyer, who specializes in representing claimants who have been denied their long-term disability benefits. Contact our Hamilton Disability Lawyers as soon as possible to review the details of your claim and help you file an appeal.
Matt Lalande is one of Ontario’s leading disability lawyers who has represented hundreds of clients who have been denied or unreasonably cut off from receiving long-term disability benefits since 2003. He has recovered millions of dollars in lost income benefits for people across Ontario. You don’t have to give up, and our team will make sure you are fairly, passionately, and properly represented against even the biggest insurance carriers in Canada.
If you have been denied your long-term disability benefits, book a free, no-obligation consultation and we will work with you to determine the best course of action for your claim. Call us nationwide at 1-844-525-2633 or local in the Hamilton/GTA at 905-333-8888 to schedule a call back in person or virtually to get in touch.
LALANDE PERSONAL INJURY LAWYERS – HAMILTON OFFICE
1 King Street East, Suite 1705
Hamilton, On L8P 1A4
*The above information was approved by Matt Lalande or another lawyer at Lalande Personal Injury Lawyers. The information comes from legal experience, trial experience, extensive medical research and discussion with medical professionals, medical journal review and updates and/or consultations with fellow friends and colleagues in the legal and medical field.