Can I Get Short- or Long-Term Disability Benefits After a WSIB Claim?
I’ve been injured at work and filed a claim with the WSIB, can I also apply for short or long-term disability benefits?
Lawyers love to answer questions with “it depends.” Refreshingly, I can give a definitive “yes” to this one.
In a previous post I’ve mentioned that the insurance regime is usually designed to avoid “double recovery.” In other words, to prevent you being paid two benefits at the same time for the same loss. This general rule applies to the above question, as most short/long-term disability benefit policies reduce the amount they pay by any WSIB loss of earnings benefits you receive.
The WSIB calculates your benefits as 85% of your net-average earnings (post-deductions). Most LTD carriers are from 60-70% of your gross wage. These benefits usually work out to about the same amount, meaning that one is almost equal to the other.
However, this does not prevent a person from applying to both benefits simultaneously. The reality is, while likely only one will be payable, it’s quite possible to qualify for both at the same time. A person off work for a workplace injury due to their limitations is also going to meet the criteria for disability benefits (i.e. a disability from work).
Many employers’ HR departments are unaware of this, and sometimes give poor advice to injured workers that they should not apply for short/long-term disability benefits if they believe their injury is work related. I’ve often counselled people to disregard this advice.
One of the reasons for this is that, particularly with complex claims, the WSIB may take a number of weeks, or sometimes even months, to adjudicate if your injury/illness “arose out of and in the course of employment.” In short/long-term disability claims, the cause of your condition is irrelevant, all that matters is the severity of the impairments and whether they prevent a person from working.
As a result, in some cases, disability benefits can provide income security while awaiting a WSIB decision. If the WSIB subsequently approves the claim, no problem, they will pay back the other insurer from the benefits they owe you, and in the meantime, you received support.
In other cases, the WSIB might move quickly on your matter, but subsequently terminate your benefits as they believe you’ve sufficiently recovered from the “work-related” medical condition. However, the disability insurer has to consider the limitations from all of your medical conditions, whether they arose from work-related causes or not. Thus your matter would simply switch to a disability claim upon WSIB termination, providing you with additional income security. I find this to be particularly useful in cases where a client is experiencing both physical and psychological impairments, and we’re struggling to have the WSIB recognize the latter as related to the workplace injury.
Does this all sound a tad complex? It can be. If you find yourself in a situation where you’re asking the above questions, you don’t need to navigate that alone, or rely upon blind faith in Google AI. We offer free consultations for people navigating car accident claims, slip and fall injuries, disability insurance disputes and WSIB claims. Please don’t hesitate to contact us.
