Schizophrenia & Long-Term Disability Benefits

Schizophrenia and Denied Long - Term Disability Benefits

By Matt Lalande, Esq

Schizophrenia is an incredibly complex mental disorder that generally affects a claimant’s perception of reality, making it difficult for that disability claimant to understand and experience the world around them. Psychosis is a common component of schizophrenia, which often leads to hallucinations, delusions, and confusion.

Have you been unreasonably denied or cut-off your long-term disability benefits?

Current statistics indicate that schizophrenia affects approximately 300,000 Canadians. This is approximately 1% of the overall population of the country. Symptoms generally begin appearing between the ages of 18 and 30, often appearing earlier in men than in women.

There is no specific cause outlined for the disease, as each individual case is unique and dependent on a variety of factors. Researchers have outlined individual brain chemistry, genetics, and environmental factors as some of these contributing elements. However, this research is not conclusive due to the complexity of schizophrenia.

Common Symptoms of Schizophrenia

The symptoms of schizophrenia are generally divided into two main categories: positive and negative. Positive symptoms are classified as those that are added to an individual’s experiences, while negative symptoms are classified as those that reduce or remove something. Essentially, positive symptoms are those that were not present before, and negative symptoms are those that were there and have now been removed.  The most common symptoms of schizophrenia focuses on positive psychotic symptoms such as:

• Hallucinations
• Delusions
• Paranoia
• Confusion
• Movement disorders (such as becoming more jumpy, feeling tingles on the skin)
• Negative symptoms of schizophrenia may include:
• Lack of motivation
• Decreased social function
• Trouble speaking
• Lack of emotions
• Insomnia
• Withdrawal
• Inability to complete daily tasks
• Neglect of personal hygiene

The onset of schizophrenia later in life may lead to difficulty securing employment.

Unfortunately, schizophrenia is a terribly disabling psychiatric illness with severe and long-term consequences for claimants and their families. The onset in early adulthood was clinically, at one point, considered by the medical community to be the main characteristic of schizophrenia.

Although the illness normally happens during a person’s early adulthood  –  it’s been reported that at least 20% of patients have onset after the age of 40 years, which would be the prime of a person’s working career.

Most patients with late-onset schizophrenia have onset of illness during middle age – although there are many reports of persons ages 65 and older that suffer schizophrenic symptoms which are more analogous to “psychosis” type issues, with fewer and less severe positive symptoms than those who are younger. Unfortunately, schizophrenia is associated with recurrent hospitalizations, need for long-term community support, poor social functioning, and high-unemployment rates.  The employment of persons who suffer from schizophrenia is unfortunately often impeded by numerous clinical problems, including symptoms of schizophrenia and poor cognitive functioning.  In fact, medical research has found that more positive psychotic symptoms were predictive of job loss.

Would schizophrenia normally be considered a “Total Disability” under my Long-Term Disability Policy?

There is no cure for schizophrenia, and while recovery is possible, it can often have a significant impact on one’s ability to work. Individuals suffering from schizophrenia may lose their ability to communicate with others and to perform other tasks that are required by their occupation. Some individuals may become significantly ill and are required to spend a large portion of their time seeking treatment in the hospital.

If a schizophrenic individual does not receive proper treatment or medication, their symptoms and experiences may become worse, and they may lose the ability to function within society or to their full personal potential. Often, this treatment is time consuming and may take a long period of time. This can render the individual totally disabled as they are unable to work while they are seeking recovery.

What happens if my long-term disability insurance provider denies or cuts off my benefits?

Yes, schizophrenia can be considered a total disability under almost every Canadian disability policy but remember, most disability policies provide for benefits to be paid in two separate stages.

The first stage is usually for the first 24 months of disability. If you meet the test of total disability, you would qualify to receive long-term disability benefits if you can no longer do the substantial duties of your own job. This is typically called the “own occupation” definition.

The second stage is typically called the “any occupation” definition. The change of definition, after the 24 month mark, changes the definition of total disability from own occupation to any occupation. This means that claimants must not only be disabled from performing the duties of his or her own occupation, but also for any occupation to achieve or she is suited by reason of education training and experience. Therefore, after 24 months, claimants must meet a much stricter definition of entitlement.

Unfortunately for people at suffer from schizophrenia, positive symptoms, if not controlled properly, medically and regularly, will affect a claimant’s participation in employment.  Claimants that suffer the onset of schizophrenia, particularly with positive symptoms, may experience a multitude of psycho-social difficulties that prevent them from actively participating in any type of regular work structure.

Schizophrenia is typically characterized as a disease and severe psychotic disorder, which is normally characterized by chronic and relapsing clinical symptoms that over time and cause substantial functional decline. The disease has a major negative effect upon the quality of life – especially with vocational functioning.

What happens if your disability lawyers get me approved for both CPP and Long-Term Disability?

There will be, in 99% of the cases, an offset in disability benefits. LTD policies will normally state that CPP will be offset (deducted) from your monthly long-term disability payments.

If you suffer from the onset of schizophrenia later in life and can no longer function at work, call our Hamilton disability lawyers. We serve all of Ontario.

Matt Lalande has been practicing disability law since 2003 and has the experience necessary to assist those who cannot work due to a mental illness such as schizophrenia. We are dedicated to helping our  claimants who been unreasonably denied or cut-off their long-term disability benefits.  Contact our Hamilton disability lawyers at 905-333-8888 or by filling out a contact form to request a legal consultation. All consultations are free and confidential, with no obligation to retain our services.