Short Term Disability and Long Term Disability Benefits for Canada Post Employees

Most Canada Post employees are entitled to receive short term disability (STD) and long term disability (LTD) benefit payments if they are unable to work due to illness or injury.  It is important to understand your rights when applying for disability benefits, both to increase the chances of your claim being approved, and so you know your options if the claim is denied.

Short Term Disability for Canada Post Employees

The Canada Post short term disability plan provides income replacement coverage to employees who cannot work for more than seven days due to injury or illness.  Work related injuries are not covered.

Canada Post pays the benefit, but because employers are generally not entitled to employee’s medical records, Canada Life administers claims, including gathering medical evidence and assessing eligibility.

Submitting A Short Term Disability Claim

There are a number of steps Canada Post employees should follow when submitting a short term disability claim:

• If possible, discuss your inability to work with your doctor before starting your claim

• Report your absence to your team leader and to your union steward

• Obtain a short term disability plan application from Itrapost, your team leader, or at canadapost.ca. There are two forms to be completed: the Attending Physician’s Statement and the Employee Statement

• See your primary care provider to complete the Attending Physician’s Statement

• Complete the Employee Statement carefully and without exaggeration

• Submit the Attending Physician’s Statement and Employee Statement to Canada Life at LTDclaims@canadalife.com

 

It is important to complete these steps as soon as possible.  For management employees, the documents must be submitted within 7 days of the start of your absence.  For other unionized employees, the forms must be submitted within 16 days.  If you are late submitting your claim, Canada Life might still approve it, but you will likely need an explanation for the late submission.

How Much Does Short Term Disability Pay?

Canada Post employees can receive 70% of their pre-disability salary if short term disability is approved.

How Long Does Short Term Disability Pay?

Canada Post employees can receive short term disability benefits for up to 30 weeks. 

If the medical evidence indicates you can return to work within 30 weeks, your STD payments will end.

You should expect Canada Life to encourage a return to work before the short term disability coverage ends.  If you and your doctor agree a return to work is appropriate, you should at least attempt to return.  If accommodations are required (for example reduced hours or no heavy lifting), Canada Post is legally required to accommodate your medical restrictions and limitations.  Your union can assist with this.

If you are not able to return to work during the short term disability period, but Canada Life refuses to continue payment of STD benefits, contact your union representative right away.

Long Term Disability Benefits

If your disability lasts more than 30 weeks, you may be eligible for long term disability benefits.

There is a waiting period, or elimination period, before Canada Post employees can receive long term disability benefits.  This is usually 30 weeks, which coincides with the end of the short term disability period.  But if STD coverage is denied, then you may be able to receive long term disability benefits starting 13 weeks after your date of disability.

Applying for Long Term Disability Benefits

In most situations, Canada Life will already be administering the short term disability claim, so the application process for LTD is less formal.  There is usually no requirement to provide a second Attending Physician’s Statement form when transitioning to long term disability benefits.  Instead, Canada Life will review the medical information it already has, and may ask for updated medical information.

Canada Life will also probably require a detailed telephone interview.  You will be asked about your medical conditions, your treatment, what activities you can and cannot do, and anything else that is relevant to your claim. It is important to be honest with the insurance company.  Any discrepancies could lead to claim denial.

How Much Does Long Term Disability Pay?

The Canada Life policy issued to Canada Post pays employees 70% of their pre-disability salary.  The benefit is adjusted annually for cost of living increases, up to 3% per year.  The benefits are fully taxable as income.

How Long Does Long Term Disability Pay?

Canada Post employees are eligible to receive long term disability benefits until retirement or age 65, so long as you remain disabled and meet the other requirements of the policy, such as participating in appropriate treatment.

Two Tests of Disability For Long Term Disability Benefits

To qualify for long term disability benefits, Canada Post employees must be “totally disabled”.  This does not mean you have to be incapable of doing basic activities of daily living.   Total disability means your doctor supports your inability to work.

Own Occupation Test

For the first two years, the test of disability is whether you can do your own job, or your own occupation; that is, the specific job you had before disability.  For example, if you are a letter carrier and cannot walk for long periods, you would be disabled from your own occupation, even if you could work in a sedentary office job.  Similarly, if you work in an office and cannot continue working due to high stress, you are disabled from your own job even if you could work as a letter carrier.

Gainful Employment Test

To receive LTD benefits for more than two years, you must be totally disabled from gainful employment.  This is defined in the insurance policy as follows:

You are considered disabled if, disease or injury prevents you from being gainfully employed. Gainful employment means work:

1. you are medically able to do;

2. for which you have at least the minimum qualifications;

3. that provides income of at least 60% of your monthly earnings; and

4. that exists either in the province or territory where you worked when you became disabled or where you currently live.

Why Are Long Term Disability Benefits Denied?

There are many reasons why long term disability claims are denied.  Canada Life will often state there is insufficient medical evidence of restrictions and limitations that are totally disabling.  What does that mean?  It means the insurer doesn’t think there is enough medical information supporting your inability to work.  It is therefore important to seek regular medical treatment, not only to aide in your recovery, but also to document your symptoms, restrictions, and limitations.

Claims for medical conditions that are not objective are also more likely to be denied, including:

• Chronic pain

• Fibromyalgia

• Chronic fatigue

• Anxiety

• Depression

 

Of course these and other subjective medical conditions can be totally disabling, but they are also harder to verify and more likely to be denied.

Long term disability claims are also often denied at the two year change of definition, from own occupation to gainful employment.  Canada Life frequently gets the change of definition analysis wrong though.  The legal definition is not as simple as: if you can work in any job you no longer quality. But some insurance adjusters look at it that way.  

If you have been denied long term disability benefits for any reason, you should immediately contact a long term disability lawyer.  It costs you nothing, since LTD lawyers offer free initial consultations.

What To Do If Long Term Disability Benefits Are Denied

If long term disability benefits are denied, and you are not capable of returning to work, there are three things you should do before anything else:

• First, book an appointment to see your doctor.  If your doctor does not agree with Canada Life’s decision, your doctor’s support will be very helpful. Try to get a report from your physician that not only says you continue to be disabled, but also provides specific restrictions and limitations.

• Second, don’t argue or try to fight with Canada Life on your own.  You may inadvertently say something that hurts your case.

• Third, contact a long term disability lawyer.  It is important you understand your rights, how much time you have to dispute the denial, and whether it makes more sense to appeal or take legal action.  Do not appeal without first seeking legal advice!

How Can A Long Term Disability Lawyer Help?

A long term disability lawyer’s primary job is to secure the benefits you are entitled to.  Your lawyer will explain your options, including whether it makes sense to proceed with an appeal or not.  Legal action may be required, but that does not mean you are going to court.  Lawsuits are used to level the playing field between you and the insurer, and are very effective: about 99% of long term disability lawsuits settle outside the courtroom.  There are no legal fees unless and until you are successful. 

How To Choose A Long Term Disability Lawyer

There are many lawyers and law firms claiming to be long term disability lawyers.  Some are highly specialized and are very good.  Some are not. 

The lawyer you choose will have a significant impact on the outcome of your claim, including how much money you recover and how fast your case resolves.  Consider these points before retaining a long term disability lawyer: 

• Does the lawyer truly specialize in long term disability?  Personal injury and employment lawyers may not fully understand the complexities of long term disability law, and the unique Canada Post plan in particular.

• Is the lawyer ranked by Lexpert in long term disability law?  Lexpert is an independent third party rating agency.  There are very few Lexpert ranked long term disability lawyers.

• Can you speak directly with a lawyer when you initiate contact? Or will you have to go though an intake process with a legal assistant or law clerk first?  Only lawyers can give legal advice.

• Will the LTD lawyer you speak with personally handle your claim, or will you be referred to someone else in the firm?   You need an expert, not someone with limited experience.

• Has the lawyer represented other Canada Post employees?

• Can the lawyer advise you on the unique aspects of the Canada Post plan, including how the plan interacts with your pension and retirement options?

• Does the lawyer offer a reasonable contingency fee?  Does the fee structure change if there is a full and final settlement versus reinstatement? Will you be responsible for payment of disbursements if the case is not successful?

 

Conclusion

The Canada Post long term disability benefits plan insured by Canada Life is complex.  If your long term disability claim has been denied, you will need help from an experienced long term disability lawyer familiar with the Canada Post policy.

Michael Jordan is a long term disability lawyer who has helped many Canada Post employees successfully resolve denied claims  

You are welcome to contact Michael for a free consultation anytime.  All calls and form submissions go directly to him, and response time is usually immediate.