How COVID-19 Is Impacting Long-Term Disability Claims

COVID-19 has left many people confused – medically, financially and professionally.

While the pandemic has been difficult for everyone, its consequences can be especially challenging if you’re unable to work on medical grounds.

In this post, we address common questions about dealing with your long-term disability insurance claim amid this global pandemic.

How to Navigate Your Long-Term Disability Insurance Claim Amid COVID-19

Read about how coronavirus may affect a long-term disability claim.

What is long-term disability coverage?

This is an insurance policy that pays benefits to workers who become disabled on the job. Under most policies, you qualify for benefits by showing that you’re unable to work due to a medical condition. The disability can be physical, cognitive, emotional, psychological or some amalgamation of the above.

How will my long-term disability claim be affected by COVID-19?

Each long-term disability policy is unique, but most only pay benefits when employees can show they have a disability that prevents them from working. During your first couple of years of eligibility, policies generally pay benefits if your occupation is what disabled you. Beyond that, the insurance provider wants to see if you’re disqualified from a range of occupations for which you’re otherwise qualified.

In some cases, an employee obviously qualifies for the benefit. Say a construction worker loses a limb at work. No one can argue that he is able to return to his job. This would qualify him to receive benefits for at least two years under any long-term disability policy.

Receiving benefits becomes harder, however, when it involves mental health. For instance, a growing number of people are being diagnosed with anxiety and depression, among other mental health issues. But it can be difficult to understand the extent of the illness as some people may have mild cases while others suffer more severely. This may result in the former continuing to work and the latter being unable to manage their symptoms while working. Since mental health can’t be diagnosed in a blood sample or an X-ray, it can make claiming the benefit especially difficult.

In instances where someone is dealing with an emotional, cognitive or psychological condition or a combination of these, what counts is not the diagnosis. Instead, it’s the opinion of your doctor that counts, along with the impact the condition has had on you.

The same is currently applicable to COVID-19 patients. More than your diagnosis, your doctor will be able to tell you if a positive diagnosis will prevent you from working.

Along with consulting a doctor, it’s a good idea to hire a disability lawyer to guide you through the process. They can help navigate the claim while avoiding loopholes in the policy that may prevent you from claiming your benefits.

What do I do if I have an existing health condition that puts me at a higher risk of contracting coronavirus?

Because of COVID-19, many businesses have either transitioned to remote work or had to close altogether.

But certain essential businesses can’t operate remotely. If you need to show up to work every day but have a pre-existing health condition, you may be more at risk of infection than others. However, this also means you may be eligible to file a disability claim.

To figure this out, thoroughly read your company’s disability policy. It will determine the coverage you’re likely to receive and outline the criteria you need to meet. Keep in mind that certain policies may exclude health risks as a basis of disability if you’re capable of going to work. Also, certain policies don’t cover pre-existing conditions, like diabetes, and these omissions can change from policy to policy.

If you think your company’s policy includes your disability claims, you’ll need to submit proof, such as a doctor’s certificate, that states you’re at risk of contracting COVID-19. You’ll also need enough medical records, along with past documentation of your diagnosis, if any.

Regrettably, even if your policy doesn’t entirely exclude these claims and you have the necessary evidence, your claim will be difficult and you should expect your insurance company to respond in an adversarial manner.

A long-term disability claim can be difficult to navigate in the best of times. It’s even more confusing now. Managing COVID-19 is stressful enough without the pressure of having to deal with the legal system. However, the process becomes easier when you hire a disability lawyer. They can also clear up any doubts or questions you may have about how COVID-19 may impact your benefits.

Links to information and help if you are experiencing negative health

https://www.camh.ca/en/health-info/mental-health-and-covid-19

https://www.ontario.ca/page/mental-health-services
https://www.cmho.org/covid19