What’s the difference between CPP Disability and Long-Term Disability Benefits?

Sickness or injury can happen to anyone at any time —especially when you least expect it. When something like this happens, ensuring that you have adequate financial support is a priority. Thankfully, there are disability benefits available in Canada to help you through this challenging time – such as CPP Disability Benefits and Long-Term Disability Benefits.

We understand that there’s a lot of questions to be asked in terms of CPP and Long-Term Disability Benefits – such as what’s the difference between these two financial benefits? Do I need both? Can I apply for CPP disability on my own? Can I apply for long-term disability on my own? What should I do if I’ve been denied CPP Disability? Can I appeal? How much money can I get from CPP Disability benefits? How to I get long-term disability and what do I do if I’m denied? Can someone work while receiving CPP disability benefits? We try to answer most of these common questions in this article below.

Remember, if you’ve been denied long-term disability, contact our Hamilton Disability Lawyers to learn what options you may have. We can provide the help you need to get the disability benefits you deserve. We have experience in dealing with all types of disability claims and can provide professional representation to ensure that you receive the long-term disability benefits you are entitled to. Contact us today for more information or to schedule an appointment with our firm. Call us today, toll-free, no matter where you are in Ontario at 1-844-LALANDE or local in Southern Ontario at 905-333-8888 or fill in a contact form on our website and we will be happy to get right back to you.

What are CPP Disability Benefits?

CPP Disability Benefits are a form of financial assistance provided by the Canadian government to individuals who have made contributions to the Canada Pension Plan (CPP) and are unable to work due to a severe and prolonged disability.

To qualify for CPP Disability Benefits, an individual must meet the following criteria:

1. Be under the age of 65
2. Have made sufficient contributions to the CPP
3. Have a severe and prolonged disability that prevents them from working at any job on a regular basis

The disability must also be expected to last for at least one year or be terminal.

If an individual meets these requirements, they may be eligible to receive monthly payments from the CPP Disability program. The amount of the payment is based on the individual’s CPP contributions and the amount of time they have contributed to the program.

How much CPP Disability can I receive?

The amount of CPP Disability Benefit you can receive depends on how much you have contributed to the Canada Pension Plan (CPP) during your working years. The average monthly payment for CPP Disability Benefit is $1,080.60, and the maximum monthly payment is $1538.67 as of 2023.

To calculate your CPP Disability Benefit, the government uses a formula that takes into account the amount you have contributed to CPP and the number of years you have contributed. The formula is complex, and the exact amount you receive will depend on your individual situation.

You can check your CPP contributions and estimated CPP Disability Benefit by creating a My Service Canada Account online or by contacting the government directly.

How do I apply for CPP Disability Benefits?

To apply for CPP Disability Benefits, follow these steps:

Check if you are eligible: You must have contributed to the Canada Pension Plan (CPP) for at least four of the last six years, have a severe and prolonged disability that prevents you from working, and be under the age of 65.

Gather documents: You will need to provide a variety of documents including your social insurance number, medical records, work history, and any other relevant information.

Fill out the application: You can apply online, by mail, or in person at a Service Canada office. The application will ask for information about your disability, work history, and other personal information.

Submit your application: Once you have completed the application, you can submit it along with all the required documents. If you have any questions or need help filling out the application, you can contact Service Canada for assistance.

Submit your medical form: You will need to work with your doctor or nurse practitioner to submit 1 of the two following forms that applies to your situation:

• Medical report (ISP-2519) (non-terminal illness)
• Terminal Illness Medical Attestation form (ISP-2530B) (terminal illness only)

After your doctor or nurse practitioner fills in the form for you, you will then have 3 options to submit your document:

• sign in to your MSCA to upload your medical form
• send it by mail, or
• drop it off at a Service Canada office

Wait for a decision: It can take several months for Service Canada to review your application and make a decision. If your application is approved, you will start receiving CPP Disability Benefits. If it is denied, you can appeal the decision.

What happens if I am denied CPP Disability Benefits?

If you have been denied CPP Disability benefits in Canada, there are a few steps you can take:

You can appeal the decision: You have the right to appeal the decision within 90 days of receiving the denial letter. You can do this by filling out a reconsideration request form and providing any additional information that may support your case.

Seek legal advice: Consider speaking to a lawyer, paralegal or a legal aid clinic to help you navigate the appeals process. They can provide advice on the next steps to take and may represent you in the appeal.

Gather additional medical evidence to provide to Service Canada: If you believe that the denial was due to insufficient medical evidence, you can work with your healthcare providers to gather additional documentation to support your case.

Contact Service Canada: You can contact Service Canada to ask for a detailed explanation of the reasons for the denial. This can help you understand the issues with your application and may give you an idea of what evidence you need to provide to strengthen your case.

Consider other financial assistance: If you are struggling financially, consider looking into other financial assistance programs that may be available to you, such as Employment Insurance (EI) sickness benefits or provincial disability benefits.

Remember that the appeals process can take some time, so be patient and persistent in your efforts to obtain CPP Disability benefits.

What are Long-Term Disability Benefits?

Long-term disability is a type of disability insurance coverage that provides income replacement to individuals who are unable to work due to injury or illness. These benefits are typically provided by an employer through an employee group benefits package or purchased by an individual, and are designed to supplement other disability benefits such as income replacement benefits or workers’ compensation benefits.

Long-term disability benefits usually begin after a certain waiting period, typically called the elimination period – which is typically 90 to 120 days, and can continue for several years or until the individual reaches retirement age. The amount of the benefit is typically a percentage of the individual’s pre-disability income (normally 60%) with a maximum monthly benefit amount (normally 85%).

To qualify for long-term disability benefits, you must meet the definition of “total disability” as defined by your disability insurance policy. This typically means that the individual is unable to perform the essential duties of their own occupation for the first two years of disability. Then the definition of total disability changes to that of “any occupation” meaning that the individual must be disabled from any occupation for which he or she may be reasonably qualified by education, training, or experience.

It’s important to note that long-term disability benefits can be a crucial source of financial support for individuals who are unable to work due to a disability. It’s therefore important to carefully review and understand the terms and conditions of any long-term disability insurance policy before purchasing it or relying on it as a source of income.

How long can I receive Long-Term Disability Benefits for?

The length of time that someone can receive long-term disability (LTD) benefits depends on the terms of their policy or plan.

Typically, LTD benefits are designed to provide income replacement for a prolonged period of time, often until retirement age or until the individual is able to return to work. However, the specific duration of LTD benefits can vary widely based on the terms of the policy or plan – but in most cases the maximum payment period is until age 65.

Some policies may provide LTD benefits for a specific number of years, such as five or ten years, while others may provide benefits for as long as the individual remains disabled and unable to work. In some cases, the policy may also have a maximum benefit amount or a cap on the total length of time that benefits can be received.

It is important to carefully review the terms of an LTD policy or plan to understand the specific duration of benefits and any limitations or conditions that may apply.

I’ve been denied Long-Term Disability Benefits, what should I do?

If you are denied long-term disability (LTD) benefits, the first step is to review the denial letter carefully to understand the reasons for the denial. The letter should outline the specific policy provisions or plan requirements that were not met and provide an explanation for the denial.

If you believe that the denial was unjustified or wrongful, you may have the option to appeal the decision. The appeal process can vary depending on the policy or plan, but typically involves submitting additional documentation or evidence to support your claim. In our experience, internal appeals rarely work and most, if not all, are unsuccessful because of the following reasons:

Limited new evidence: during an internal appeal, the insurance company will typically review the same medical records and other evidence that was provided during the initial claim. If there is no new evidence or information to support the claim, the likelihood of a successful appeal may be lower.

Biased review: internal appeals are typically reviewed by the same insurance company that denied the initial claim, which may result in a biased review. The reviewer may be more inclined to uphold the original decision rather than approve the claim.

Stringent policy requirements: the policy or plan may have strict requirements for demonstrating a disability, and if the evidence does not meet these requirements, the appeal may be denied.

Limited time for appeal: internal appeals may have strict deadlines, which can limit the amount of time to gather additional evidence or submit a compelling argument.

It is important to note that while most internal appeals are not successful, it may still be possible to obtain LTD benefits through other means, such as hiring your own disability lawyer and filing a lawsuit. It is also important to seek the guidance of a qualified disability lawyer who specializes in disability claims, as they can provide guidance and support throughout the appeals process.

If I receive Long-Term Disability Benefits, do I need to apply for CPP Disability as well?

Normally in most cases yes, you do. If you are receiving both long-term disability (LTD) benefits and Canada Pension Plan (CPP) Disability benefits, your LTD benefits will (in most cases) be reduced by the amount of CPP Disability benefits you receive. This is because many LTD plans include a provision that allows the insurer to offset the amount of benefits you receive from other sources, including CPP Disability Benefits.

The specific terms of your LTD plan will determine whether your benefits will be reduced by CPP Disability Benefits. Some LTD plans allow for full or partial offset of CPP Disability benefits, while some older disability policy (pre-2010) may in fact not offset any CPP Disability benefits.

It’s important to carefully review the terms of your LTD plan to understand how it interacts with other sources of income, including CPP Disability Benefits. If you are unsure, you can contact your LTD plan administrator or a legal professional for guidance.

Do I need to hire a lawyer if I’ve been denied Long-Term Disability Benefits?

Yes – it is absolutely advisable to hire a disability lawyer if you have been denied long-term disability benefits. This is because the process of appealing a denial of benefits can be complex and difficult to navigate on your own. An experienced long-term disability lawyer can help you understand your legal rights and options, and can guide you through the appeals process.

Additionally, a lawyer can help you gather and present evidence to support your claim for benefits, and can negotiate with the insurance company on your behalf. They can also represent you in court if necessary.

Keep in mind that most long-term disability insurance policies have strict deadlines for appealing a denial of benefits, so it is important to act quickly if you plan to appeal. A Hamilton disability lawyer can help ensure that you meet all deadlines and requirements, and can give you the best chance of obtaining the benefits you deserve.

My Disability Carrier is telling me to file an “Internal Appeal” – should I do this?

We recommend to never file and internal appeal and instead, hire a disability lawyer to help fight for the benefits you deserve.

Think of it this way – there may in fact be a conflict of interest since there is no “independent body” that is reviewing your internal appeal. It is the same company that denied you who will be reviewing your appeal – is this fair?

Remember, your long-term disability carrier is responsible for paying out claims, but they are also a for-profit business. This creates a potential conflict of interest where the carrier may be motivated to deny claims in order to save money. Filing an internal appeal with the same carrier may not be the most effective way to get a fair review of your claim.

How do I hire a Long-Term Disability lawyer?

Hiring a long-term disability lawyer can be a complex process, but the following steps can help guide you through the process:

Determine the type of lawyer you need – look for lawyers who specialize in long-term disability claims. These lawyers are well-versed in the complex legal issues involved in these cases. This is extremely important. Lalande Personal Injury Lawyers have been specializing in representing disability claimants who have been wrongfully denied their long-term disability benefits for over two decades. Do not hesitate to contact us with any disability related questions you may have.

Try to hire local – try to hire a local long-term disability lawyer that you can call and/or visit as often as you like. Although we represent many claimants from across the Province and are happy to do so – we suggest that if you are from the Hamilton or southern Ontario area, the best thing you can do is hire a Hamilton lawyer.

Research potential lawyers – research potential disability lawyers through online searches, referrals from friends or family, or through legal directories.

Evaluate the lawyer’s experience and credentials: Look for lawyers who have experience handling cases similar to yours. Check their credentials, such as their education, bar admissions, and any professional associations they belong to.

Schedule a consultation: Contact the lawyer to schedule a consultation. During the consultation, ask questions about their experience, fees, and the process for handling your case.

Evaluate the lawyer’s communication skills: Look for a lawyer who communicates well and who will keep you informed about the progress of your case. Does the lawyer talk down to you or does the lawyer listen to you and talk to you with comfort and understanding?

Discuss legal fees: Make sure you understand the lawyer’s fee structure and what services are included in the fee. Some lawyers, such as Lalande Personal Injury Lawyers, charge a contingency fee, which means we only get paid if you win your case.

Sign a retainer agreement: If you decide to hire the lawyer, you will need to sign a retainer agreement, which outlines the terms of your representation.

Remember, hiring a long-term disability lawyer can be a significant investment, but having a qualified disability lawyer like Matt Lalande on your side can help ensure that you receive the benefits you are entitled to.

How much does it cost to hire a disability lawyer?

The cost of hiring a disability lawyer can vary depending on several factors such as the complexity of your case, the location of the lawyer, and the fee structure of the lawyer.

While we cannot comment on other Hamilton Disability Lawyers, our disability lawyers work on a contingency fee basis, which means that we NEVER ask for money upfront, under any circumstances. We only get paid if we win your case. Also, unlike many Hamilton lawyers, we will never charge you any of our incurred legal fees or disbursements if we do not recover any money for you or if we are not successful.

Our Hamilton Long-Term Disability Lawyers can help at any stage of the disability benefits process

If a serious injury has left you unable to work, Lalande Personal Injury Lawyers can help. Our team of long-term disability lawyers can help guide you through the complex process of obtaining long-term disability benefits. Since 2003, Hamilton Disability Lawyer Matt Lalande has recovered tens of millions in compensation for disability claimants who are were going through the worst times of their lives. Stop struggling with a faceless insurance company – and call our Hamilton long-term disability lawyers to get your free consultation today.

We represent disability claimants all over Ontario – and our disability lawyers can help you get the compensation deserve you you. Our consultations are 100% free – and if you decide to work with our Hamilton disability lawyers, the fee is free. We do not charge our clients anything unless we win their case. We are happy to provide you the legal advice you need in order for you to make an informed decision about your own particular situation. Call us no matter where you are in Ontario at 1-844-LALANDE or local in the Southern Ontario region at 905-333-8888. Alternatively, you can send us a confidential email through our website – and we would be happy to explain your long-term disability rights and legal options to you, at no cost.

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