How to Transition from Short-Term to Long-Term Disability in Canada?
If you’re unable to work due to illness or injury, understanding how to apply for short-term disability (STD) and transition to long-term disability (LTD) can make all the difference. Whether you’re just starting the application process or your STD benefits are ending, knowing what steps to take, and when, can help protect your income and avoid costly mistakes. In this blog, we break down the short-term disability claim process, how to prepare for a transition from STD to LTD, and what to do if your long-term disability claim is denied. At Whitten & Lublin, we help employees navigate the complex disability insurance process so you can focus on your recovery, not red tape.
What is Disability Insurance and How Does It Work?
Disability insurance is a policy of insurance that is income replacement should you become unable to work due to a medical injury or illness for a short or long period of time. Typically, they are part of your benefits package with your employer. These benefits are referred to as short term disability (“STD”) or long-term disability (“LTD”). Regardless, whether you believe you will need coverage for a limited time or longer, the inception of a claim begins by submitting an application for short-term disability coverage.
How to Apply for Short-Term Disability Benefits?
Submitting a claim is straightforward and requires three applications, which you can request from your employer’s human resources representative or head of the benefits department.
What forms do I need to submit?
The application consists of 3 forms:
- Plan Member Statement – you are responsible for completing this form
- Attending Physician Statement – you will need to ask your doctor to fill out the form to submit to the insurance company
- Plan Sponsor Statement – your employer is responsible for completing this form regarding the details of your employment
Once these forms are submitted to your insurer, you’ve applied for STD and can await further directions from your insurer.
If you are approved, STD coverage will cover you for a limited period. It if finite in nature, hence why it is referred to as “short” (term coverage). Typically, STD will cover you between 4 and 6 months, but its important to check your policy to understand the timeframe that applies to your situation.
What Happens when Your Short-Term Disability is Ending?
If you are nearing the end of your STD coverage and still cannot return to work, you should apply for long term disability. At this point, there are two potential scenarios:
If Your STD and LTD Insurer are the Same:
If your STD insurer is the same as your LTD insurer, your case manager should transition your benefits from STD to LTD. This means they would not require you to fill out another application and can use the information submitted during the STD period in evaluating your LTD claim.
Take note, if you were approved for STD does not automatically mean you will qualify for LTD. The policy definitions between your STD policy and your LTD policy are different and operate differently. The department handling your STD vs LTD claim is also different.
If Your STD and LTD Insurer are Different:
If you have different insurers for your STD and LTD coverage, you’ll need to submit an LTD application. The forms will be the same as mentioned earlier under “How Do I Submit a Claim for STD?”. Ensure you complete the forms before your LTD benefit start date. The LTD insurer will likely take some time in deciding on your claim so you want to ensure there is enough time between your STD period ending and before your LTD benefits begin.
Knowing your Filing Deadlines for LTD Claims
It’s important to know the application and filing deadlines in your insurance policy. For example, your LTD policy might indicate that an LTD application must be submitted within 90 days of your date of disability. Consider the following example to illustrate this:
Date of Disability (day you have gone off work): January 1, 2025
STD period: 12 weeks
LTD Benefit start date: April 1, 2025
If your policy requires you to submit an LTD application within 90 days of your date of disability, you’d have to submit your LTD application by April 1, 2025 to make the filing deadline. If you miss this deadline, you risk getting denied by the insurer on a technicality i.e.: non-compliance with a policy requirement.
The early bird gets the worm. The same principle should be applied to your LTD application if you are considering applying for LTD.
If you get denied on a contractual basis, there are legal principles to help potentially overcome the imperfect compliance with the policy, but these are determined on a case-by-case basis, and you will need the help of an experienced disability lawyer to help evaluate the situation.
How to Ensure A Smooth Transition from STD to LTD
Here are three important tips to help ensure a smooth transition if you’re going from STD benefits to LTD.
- Communicate Early with Your Insurer. Keep your insurer informed and express your intent to apply for LTD. The earlier you let your insurance company know, the better.
- Coordinate with Your Doctor. Take steps to coordinate with your doctor by getting a doctor’s appointment ready and inform your insurer of your intention of completing the Attending Physician Statement.
- Keep a Record of All your Interactions. Keep your own notes. It’s helpful to keep a chronology of who you spoke to and when. Who your case manager is (or who it is being changed to), when you saw your doctor, what did you discuss and notes from your calls with your case manager.
Case managers add their own notes on your file after a discussion, so it is best to keep your own log of the conversation as well.
Why should you speak to a disability lawyer?
STD, LTD, different case managers, your employer, your doctors and your health – the “disability web”. If you find yourself caught in the many moving parts of the disability web, you need to consult an experienced disability lawyer who can help you untangle it.
At Whitten & Lublin, we offer a free consultation for short-term and long-term disability matters. If you have questions about transitioning from STD to LTD or if your STD or LTD claim has been denied, contact us online or call 416 640 2667. We can help you take back control.
Author – Aman Chaggar