{"id":1980,"date":"2025-03-05T17:39:58","date_gmt":"2025-03-05T22:39:58","guid":{"rendered":"https:\/\/johnstonesbenefits.com\/clients\/ila\/?p=1980"},"modified":"2025-03-05T17:39:58","modified_gmt":"2025-03-05T22:39:58","slug":"long-term-disability-its-a-process","status":"publish","type":"post","link":"https:\/\/johnstonesbenefits.com\/clients\/ila\/long-term-disability-its-a-process\/","title":{"rendered":"LONG TERM DISABILITY \u2013 IT\u2019S A PROCESS!"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_heading-2d9bbcf79d50a3601923aa8844f713a6\">\n#top .av-special-heading.av-av_heading-2d9bbcf79d50a3601923aa8844f713a6{\npadding-bottom:10px;\nfont-size:4vw;\n}\nbody .av-special-heading.av-av_heading-2d9bbcf79d50a3601923aa8844f713a6 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n#top #wrap_all .av-special-heading.av-av_heading-2d9bbcf79d50a3601923aa8844f713a6 .av-special-heading-tag{\nfont-size:4vw;\n}\n.av-special-heading.av-av_heading-2d9bbcf79d50a3601923aa8844f713a6 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-av_heading-2d9bbcf79d50a3601923aa8844f713a6 av-special-heading-h2 blockquote modern-quote  avia-builder-el-0  el_before_av_hr  avia-builder-el-first  av-inherit-size'><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >The Journal<\/h2><div class='av-subheading av-subheading_below'><p>Solid Group Plans Made Simple<\/p>\n<\/div><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n<div  class='hr av-av_hr-f04ef840c2b66cff6c43fead44ee8d66 hr-default  avia-builder-el-1  el_after_av_heading  el_before_av_heading '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-m7wi2h76-5bead3030ca2a7439034e4b48ef40a52\">\n#top .av-special-heading.av-m7wi2h76-5bead3030ca2a7439034e4b48ef40a52{\npadding-bottom:10px;\ncolor:#c4a106;\nfont-size:3vw;\n}\nbody .av-special-heading.av-m7wi2h76-5bead3030ca2a7439034e4b48ef40a52 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n#top #wrap_all .av-special-heading.av-m7wi2h76-5bead3030ca2a7439034e4b48ef40a52 .av-special-heading-tag{\nfont-size:3vw;\n}\n.av-special-heading.av-m7wi2h76-5bead3030ca2a7439034e4b48ef40a52 .special-heading-inner-border{\nborder-color:#c4a106;\n}\n.av-special-heading.av-m7wi2h76-5bead3030ca2a7439034e4b48ef40a52 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-m7wi2h76-5bead3030ca2a7439034e4b48ef40a52 av-special-heading-h2 custom-color-heading blockquote modern-quote  avia-builder-el-2  el_after_av_hr  el_before_av_hr  av-inherit-size'><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >LONG TERM DISABILITY \u2013 IT\u2019S A PROCESS!<\/h2><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_hr-8ddc7023771561a08c2d1878cbb01bdc\">\n#top .hr.hr-invisible.av-av_hr-8ddc7023771561a08c2d1878cbb01bdc{\nheight:30px;\n}\n<\/style>\n<div  class='hr av-av_hr-8ddc7023771561a08c2d1878cbb01bdc hr-invisible  avia-builder-el-3  el_after_av_heading  el_before_av_one_full '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_full-7688609b370c0fc22d37f41de2668996\">\n.flex_column.av-av_one_full-7688609b370c0fc22d37f41de2668996{\nborder-radius:0px 0px 0px 0px;\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-av_one_full-7688609b370c0fc22d37f41de2668996 av_one_full  avia-builder-el-4  el_after_av_hr  avia-builder-el-last  first flex_column_div av-zero-column-padding '   ><section  class='av_textblock_section av-m7wi3b0l-acdfada70e2c302bd46a67e726f3f1db'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><a href=\"https:\/\/johnstonesbenefits.com\/clients\/ila\/wp-content\/uploads\/2025\/03\/2025_03-LTD-Claims.pdf\" target=\"_blank\" rel=\"noopener\">Click here to download pdf<\/a><\/p>\n<p>It is not something any of us like to think about but picture your life in the event of a prolonged absence from work due to illness or injury. Long term disability (LTD) benefits provide employees with a percentage of their monthly income (typically between 60 and 70 percent), starting after a waiting period, which is the period of time the employee is receiving sick leave or short-term disability benefits, commonly 17, 26 or 52 weeks. LTD benefits may continue to age 65.<\/p>\n<p><strong>Disability claim process<\/strong><\/p>\n<p>The application process and approval time for disability claims can be lengthy, and then there\u2019s the paperwork! If you have been off work for two or three months and believe it\u2019s unlikely you will be able to return to work before completing the LTD waiting period, we recommend filing an LTD claim application within 90 days of the date you became disabled.<\/p>\n<p>For disability claims, insurers require information from the employee, the employer, and the physician(s). These can be submitted separately, but the insurer won\u2019t start their adjudication process until all three statements are received.<\/p>\n<p>The physician statement is particularly important, so giving your physician plenty of time to provide quality and substantive information about the disability will be crucial in getting the insurer\u2019s approval of your LTD claim. Upon review, the insurer may request additional information to assess the claim and may also ask for an independent medical exam (IME), which may take several weeks to arrange, complete and receive the resulting report.<\/p>\n<p><strong>Definition of total disability<\/strong><\/p>\n<p>\u201cTotal disability\u201d is specifically defined in the LTD contract. One common definition is \u201cunable to perform the essential duties in the employee\u2019s own occupation for a period of two years, and for any occupation thereafter\u201d. This definition creates a re-assessment of the employee\u2019s eligibility for disability before continuing benefits beyond the first two years.<\/p>\n<p><strong>Definition of monthly earnings<\/strong><\/p>\n<p>The monthly LTD benefit an employee receives when disabled is normally based on a percentage of reported pre-disability earnings. Many LTD contracts define \u201cmonthly earnings\u201d as regular monthly earnings, but it could include commission or other forms of income. Typically bonuses, dividends and overtime are not included in \u201cmonthly earnings\u201d.<\/p>\n<p>For those clients who we provide Third-Party Administrator (TPA) services for group benefits, it\u2019s very important for you to keep us updated with salary changes toensure your LTD insurer has correct information. Because the earnings used for the LTD claim are established at the pre-disability level, the salary\/wage cannot be adjusted until the employee has returned to work. Only then will the new earnings level be used.<\/p>\n<p><strong>Disability plan offsets<\/strong><\/p>\n<p>Almost all LTD policies allow the insurer to deduct (or \u201coffset\u201d) other benefits from their insurer payout amount.\u00a0Many LTD claimants do not realize they cannot stack various types of benefits<\/p>\n<p>Insurers applying offsets will define them as \u201cprimary\u201d and\/or \u201csecondary\u201d offsets. Typical \u201cprimary\u201d offsets include<\/p>\n<ul>\n<li>Benefits payable from any Workers\u2019 Compensation plan<\/li>\n<li>Disability benefits received under any other government program such as, Canadian Pension Plan disability, provincial Disability Support Program (ifapplicable), Employment Insurance Sickness Benefits, etc.<\/li>\n<li>Income from the Criminal Injuries Compensation Act<\/li>\n<li>Wages or remuneration payable from, any employer, including any statutory or common-law termination and\/or severance pay<\/li>\n<\/ul>\n<p>Most LTD policies require the employee to apply for the CPP disability benefit (if eligible) and then allow for the deduction of the original CPP disability benefit, not an indexed or adjusted benefit.<\/p>\n<p>Depending on the LTD policy, the insurer may also deduct spouse or children\u2019s CPP benefits, known as \u201csecondary\u201d offsets, although this is not as common as \u201cprimary\u201d offsets.<\/p>\n<p>Generally, insurers will pay Workers\u2019 Compensation benefits before LTD benefits, while CPP disability benefits are deducted from monthly LTD payments (note: this applies to both group and individual LTD plans). If there are offsets, we can help you understand how to keep a potential future LTD claim viable.<\/p>\n<p><strong>Partial vs. residual disability <\/strong><\/p>\n<p>Some insurers offer beneficial definitions of disability in their group policies; the fundamental difference being how the employee is able to satisfy the Elimination Period.<\/p>\n<p>Under the \u201cpartial\u201d definition, the employee must be unable to perform any of the material and substantial duties of their occupation. Under the \u201cresidual\u201d definition, the employee does not have to be totally disabled during the elimination period \u2013 rather they must be \u201climited from performing the material and substantial duties of their regular occupation\u201d. Under both definitions, the employee must have 20% or more loss of indexed monthly earnings due to the same illness or injury.<\/p>\n<p><strong>Non-evidence maximum (NEM)<\/strong><\/p>\n<p>The insurer sets the amount of coverage an employee is eligible to receive, without having to provide the insurer with evidence of good health, based on the size and make-up of the employee group. To qualify for amounts above the NEM, an employee is required to complete an \u201cevidence of insurability\u201d form. Johnstone\u2019s Benefits provides notification annually and whenever we are advised of a salary increase which results in a benefit over the NEM or an increase more than 10%.<\/p>\n<p><strong>Notes<\/strong><\/p>\n<p>In Canada, Employment Insurance (EI) sickness benefits can last\u00a0up to 26 weeks\u00a0in 2025. The length of benefits depends on how long you are unable to work due to a medical condition.<\/p>\n<p>You could receive up to 55% of your earnings, up to a maximum of $695 per week. The exact amount you receive depends on your insurable earnings before taxes in the past 52 weeks and the max changes each year.<\/p>\n<p>If you are eligible for LTD benefits after 17 weeks of disability, the EI sickness benefit will be used as an offset between the 17 week and 26 week eligibility period of the EI sickness benefit.<\/p>\n<\/div><\/section><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-1980","post","type-post","status-publish","format-standard","hentry","category-news"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\r\n<title>LONG TERM DISABILITY \u2013 IT\u2019S A PROCESS! - Johnstone&#039;s Benefits<\/title>\r\n<meta name=\"description\" content=\"Johnstone&#039;s Benefits provides simple employee insurance benefit programs for large and small business.\" \/>\r\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\r\n<link rel=\"canonical\" href=\"https:\/\/johnstonesbenefits.com\/clients\/ila\/long-term-disability-its-a-process\/\" \/>\r\n<meta property=\"og:locale\" content=\"en_US\" \/>\r\n<meta property=\"og:type\" content=\"article\" \/>\r\n<meta property=\"og:title\" content=\"LONG TERM DISABILITY \u2013 IT\u2019S A PROCESS! 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