To Return or Not to Return – That is the QuestionShould I Return to Work or Claim Long-Term Disability Benefits?

Once you have exhausted your sick days or maximized your short-term disability benefits, you may find yourself wondering whether you have any option other than to return to work.

If you are fortunate to have long-term disability insurance, either through your employer or through a private individual insurance policy, you may wonder whether to submit a claim for long-term disability benefits.

What should I consider in making my decision to return to work after a period of disability?

There are many factors that you will need to consider in reaching your decision; four of the most important considerations are as follows:

1. Are you medically able to return to work;
2. Is your employer willing and able to accommodate you;
3. What if you returned to work prematurely; and
4. What if your long-term disability benefits are denied.

Am I medically able to return to work?

The primary factor in making your decision to return to work should be whether your doctor(s), in consultation with you, are of the opinion that you are functionally able to return to your job and that returning to work will not aggravate your condition.

In discussing your ability to return to your job, it is important for your doctor(s) to consider all of your functional limitations and restrictions. This means that your doctor(s) should consider not only whether you are able to perform the physical demands of your job but also whether you are able to perform the cognitive demands; such as memory, concentration, focus, ability to communicate, regulate emotions and manage stress.

If your doctor(s) are of the opinion that you are medically able to return to work, you may not have sufficient medical support to be successful in your long-term disability claim. In which case, you may choose to return to work.

However, if you feel that you are not able to return, despite your doctor’s opinion, you may still choose to make a claim for long-term disability benefits. Sometimes doctors might not fully understand why you feel you are not able to return to work or understand what information the insurance company needs to approve your claim. Unfortunately, without written support of your doctor(s), your long-term disability claim is likely to be denied.

With our assistance and expertise, we may be able to obtain the evidence you need to demonstrate to your insurance company that you are totally disabled and entitled to long-term disability benefits. If your claim is denied but you feel that you are not able to return to work due to the symptoms of your disability, you should contact Mulqueen Disability Law LLP.

Is my employer able to accommodate me?

If your doctor(s) agrees that you are ready to return to your job, you may need your employer to make some accommodations, in order for you to be successful in your efforts. If you do require any accommodations, it is important that those be discussed with your employer and supported by your doctor(s), in writing. Depending on the extent and nature of accommodations recommended by your doctor, you may instead choose to forego a return to work attempt and apply for long-term disability benefits.

What kind of accommodations can I ask my employer for?

In terms of accommodations, your doctor may recommend a gradual return to work; meaning you would return to your job at a reduced work schedule and gradually increase your hours and days to full-time over the course of days, weeks or months. Your doctor might also recommend that you not perform certain duties of your job for a period of time or ever again; that you be allowed frequent breaks; or that changes be made to your workspace to accommodate your ongoing restrictions/limitations. Your doctor might even suggest that you return to work at a different location or at a completely different job with your employer or elsewhere.

It is important to understand that employers are not permitted to discriminate against you based on your disability. Employers have a duty to accommodate under Ontario’s Human Rights Code, but only to the point of ‘undue hardship’. Your employer’s accommodations must be reasonable, not perfect, and they are not legally required to compensate you for time or work that you have not done.

If it is too difficult for your employer to accommodate you and your employer believes your limitations and restrictions are permanent, your employer may or may not be able to accomodate you and may even choose to terminate your employment. In some cases, depending on the extent and nature of accomodations recommended by your doctor, a better decision may be to forego a return to work and apply for long-term disability benefits, instead.

If your employer tells you they are not able to accomodate you or terminates your employment or if you feel that the accommodations offered do not adequately address your limitations and restrictions, you should contact Mulqueen Disability Lawyers LLP to discuss your options, with respect to claiming long-term disability benefits and/or taking action against your employer.

What if I return to work before I am ready?

The consequences of returning to work before you are ready, whether with or without your doctor’s support or with or without accommodations, can have serious consequences for your future long-term disability claim and also for your employment.

How would my disability strain my relationship with my employer?

If you return to work before you are ready, you could strain your relationship with your employer. Remember, your employer is required to accomodate you, but only to the point of undue hardship. If you are not able to perform what is expected of you or if you are taking significant time off work due to your ongoing condition, your employer may struggle to continue to employ you.

Interpersonal and business relationships at work might also be strained, depending on the nature of your ongoing limitations and restrictions. For example, you may have difficulty managing stress or your emotions, leaving your managers, co-workers and customers, unhappy with your performance. Workplace issues and the inability of your employer to continue to accomodate you are only two potential fallouts from returning to work before you are ready, however there could be many others.

How could returning to work before I am ready affect a future long-term disability claim?

With respect to your long-term disability benefits, if you return to work before you are ready, you could compromise the success of any future long-term disability claim.

Most insurance policies require you demonstrate that you are continuously disabled through an initial period during which no LTD benefits are paid (this may be the short-term disability period). Returning to work could interrupt a period of continuous disability and either provide the insurance company with a basis for denying your long-term disability claim or delaying the payment of benefits, if your claim is approved.

How could working in an accommodated role affect my long-term disability claim?

If you become disabled from working in an accommodated role (performing “easier” duties, perhaps for reduced income), it is important to understand that the insurance company will assess your long-term disability claim based on the job and income you were receiving as of your last day worked. This means that your claim will be assessed based on the duties and income of your accommodated role and not the job/income from before you went off work to begin with.

As a result, it may be more difficult for you to prove that you are disabled from this “easier” job and if your claim is approved, your disability benefit amount will also be reduced to reflect a reduced income from your accommodated role. In many ways, you may find yourself in a worse position than you would have been, had you not returned to work in an accommodated role and simply applied for long-term disability benefits at the end of the short-term disability period.

What are the longer term effects on my LTD claim if I return to work prematurely?

In addition to risking a reduced long-term disability benefit payments for the entire period of your claim, returning to work before you are ready could also make it much more difficult for you to stay “on claim” and to continue to satisfy the insurance company that you are disabled and entitled to benefits.

Most group disability insurance policies have a “change of definition” provision, which makes it more difficult to qualify for benefits beyond a certain date (usually 24 months). Simply, the definition of disability changes such that you must prove not only that you are disabled from your “own occupation” but that you are also disabled from “any occupation”.

At this point, it will be much more difficult for you to prove that you are not able to earn a commensurate income (an income which is a fraction of the already reduced income you were earning when you stopped working) doing any type of job you are reasonably qualified to do. If you are not able to satisfy the new definition of disability, your claim will be terminated and you should contact Mulqueen Disability Lawy LLP, immediately.

What if my long-term disability claim is denied?

If you do decide to submit a claim for long-term disability benefits and your claim is denied you can then decide if you will return to work, appeal the decision or commence a Court Action. If you would like to discuss your options, we encourage you to contact us. Not all cases are the same and what may be the right decision for one person might not be the right decision for you.

What if I am still not sure whether to return to work or apply for long-term disability?

If you are not sure if you are able to return to work after a period of disability (irrespective of your doctor’s opinion or the accommodations offered by your employer), it is important that you consider your options carefully, as returning to work before you are ready could have serious and long-term consequences for your employment, your finances and a future long-term disability claim.

If you would like to discuss whether you should return to work after a period of disability or whether you should apply for long-term disability, instead, we encourage you to contact us. We offer confidential and complimentary consultations and we would be pleased to assist you with information to allow you to make a well-informed decision.

Contact Us to Discuss Your Long Term Disability Claim

If you would like to discuss your Long-Term Disability claim with a lawyer, Mulqueen Disability Law LLP are experienced lawyers dedicated exclusively to the practice of LTD litigation. We have represented disabled clients in various professions against all major life/health insurance companies in Canada. We would be happy to provide you with a free consultation.

The preceding is not intended to be legal advice. This blog is made available for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog, you understand that there is no solicitor client relationship between you and the blog publisher. The blog should not be used as a substitute for competent legal advice from a licensed lawyer in your jurisdiction. If your disability claim has been denied and you require legal advice, contact a lawyer specializing in disability law.