Arthritis Disability Benefits Canada | Comprehensive 2024 Guide

Living with arthritis can be incredibly challenging, often affecting your ability to work and perform everyday tasks comfortably. The pain and stiffness can make even the simplest activities difficult, and trying to balance work with managing your condition can feel overwhelming. If arthritis is impacting your ability to work, know that you don’t have to navigate this journey alone.

At Samfiru Tumarkin LLP, we’re dedicated to helping individuals secure the disability benefits they need to manage their health and maintain financial stability. Our experienced team is here to support you through Canada’s disability benefits system, ensuring you have the resources to focus on your well-being.

1. What is Arthritis?
2. Types of Arthritis
3. Is Arthritis a Disability in Canada?
4. Arthritis Disability Benefits in Canada
7. How to Apply for Arthritis Disability Benefits
8. Common Reasons for Denial of Arthritis Disability Claims
9. What to Do If Your Arthritis Disability Claim is Denied
10. FAQs
11. Expert Support for Your Arthritis Claim

What is Arthritis?

Arthritis is a group of conditions that cause inflammation and pain in the joints, often impacting daily activities and quality of life. This chronic condition can lead to stiffness, swelling, and decreased range of motion, affecting mobility and overall functionality.

Arthritis encompasses over 100 types, each with unique symptoms and challenges. The impact of arthritis can vary widely, with some individuals experiencing mild discomfort and others facing severe pain and joint damage.

Symptoms of Arthritis

Arthritis symptoms can vary based on the type and severity, but early management can help reduce long-term damage. Common symptoms include:

Joint Pain and Stiffness: Persistent pain and stiffness in the joints, often worse in the morning or after long periods of inactivity.
Swelling and Redness: Inflammation in affected joints may cause visible swelling and redness.
Reduced Range of Motion: Limited movement in the joints, impacting daily activities and mobility.
Fatigue: Constant tiredness or feeling drained, which can accompany arthritis flare-ups or chronic inflammation.
Bone Spurs: In some types of arthritis, bone growths or lumps can form around affected joints, causing additional pain and stiffness.

Who Does Arthritis Affect?

Arthritis can affect anyone, but certain factors increase the risk. According to the Arthritis Society of Canada, some groups are more susceptible:

Older Adults: The likelihood of developing arthritis increases with age, particularly in individuals over 50.
Women: Certain types of arthritis, such as rheumatoid arthritis, are more common in women.
Individuals with Family History: Genetics can play a role, especially with osteoarthritis and rheumatoid arthritis.
People with Previous Joint Injuries: Injuries from accidents or sports can increase the risk of arthritis in the affected joint.
Obesity: Extra body weight puts additional strain on joints, particularly in the hips and knees, increasing arthritis risk.

Types of Arthritis

Arthritis has various forms, each with different causes, symptoms, and treatment options. Understanding the types can help in managing symptoms and selecting the most effective care options:

Osteoarthritis: The most common form, resulting from wear-and-tear damage to joint cartilage.
Rheumatoid Arthritis: An autoimmune disorder where the immune system attacks the joints, causing inflammation and joint damage.
Psoriatic Arthritis: A type of arthritis that affects some people with psoriasis, leading to joint pain and skin symptoms.
Gout: A form of arthritis characterized by sudden, severe attacks of pain, swelling, and redness, usually in the big toe.
Ankylosing Spondylitis: A type of arthritis that primarily affects the spine, causing pain and stiffness from the neck down to the lower back.

Is Arthritis a Disability in Canada?

Yes, arthritis is recognized as a disability in Canada under the Canadian Human Rights Act and equivalent provincial human rights laws. When arthritis significantly limits a person’s ability to carry out daily activities or perform their job, they are entitled to protection from workplace discrimination as well as reasonable accommodations to help them perform their job.

Employment Rights

Employers are required to accommodate workers with arthritis, which may include adjustments to work schedules, duties, or environments.

However, eligibility for disability benefits isn’t based solely on having a diagnosis of arthritis. To qualify for specific disability benefits, you must demonstrate that your condition severely impacts your ability to work and meets the criteria outlined in the benefit plan or program.

Arthritis Disability Benefits in Canada

If arthritis symptoms make it difficult or impossible for you to work, you may qualify for various disability benefits, including:

Employment Insurance (EI) Sickness Benefits

EI sickness benefits provide up to 15 weeks of financial assistance if you’re unable to work for medical reasons. You must have worked the required number of insurable hours and provide a medical certificate confirming your inability to work.

Application: Submit an application online or at a Service Canada office as soon as you stop working.

Short-Term Disability (STD) Benefits

STD benefits provide financial support for a temporary period, typically up to 17 weeks, through an employer’s insurance plan.

Application: Obtain forms from your employer or insurer, and submit all required documentation promptly.

Long-Term Disability (LTD) Benefits for Arthritis

LTD benefits provide extended financial support if arthritis prevents you from returning to work after STD or EI benefits expire. These benefits can last for several years – often until age 65 or until you’re able to work again. To qualify, you must meet your insurer’s definition of “totally disabled,” meaning you can’t perform your own job or any other suitable employment based on your education, training, and experience.

Application: Requires detailed medical evidence and may involve assessments by the insurer.

Canada Pension Plan (CPP) Disability Benefits

Those with severe and prolonged arthritis symptoms that prevent them from working may qualify for Canada Pension Plan (CPP) disability benefits. Offered by the federal government, this program provides long-term financial support to Canadians who have contributed to the CPP and are under the age of 65.

Application: Involves a detailed application and medical report submitted to Service Canada.

Disability Tax Credit (DTC)

Arthritis may qualify for the Disability Tax Credit (DTC) in Canada if it severely impacts daily functioning. The DTC is a non-refundable tax credit that reduces the income tax you owe.

Application: Requires Form T2201 to be completed by you and your medical practitioner and submitted to the Canada Revenue Agency.

Provincial Disability Benefits

Each province offers its own disability assistance programs, which are generally based on financial need and the severity of your disability. They can include income support, health benefits, and employment support services.

Application: Process varies by province, typically involving an application form and medical assessment.

How to Apply for Arthritis Disability Benefits

Applying for short-term or long-term disability benefits for arthritis involves several critical steps:

1. Obtain a Formal Diagnosis

See a doctor or other qualified healthcare provider to get an official diagnosis for arthritis. Ensure the assessment covers your medical history, symptom severity, and how symptoms affect your daily life.

2. Document Your Symptoms and Impact on Work

Record how arthritis symptoms affect your ability to perform your job duties, through a journal or diary. Gather all relevant medical documents, including test results, treatment plans, and doctor’s notes.

3. Follow Prescribed Treatment Plans

Engage in all recommended therapies, whether medication, counseling, or behavioral strategies. Keep records of appointments, medications taken, and any side effects experienced.

4. Communicate with Your Employer

Discuss possible workplace accommodations that could help you perform your job. Keep a record of all communications with your employer regarding your condition and any accommodations provided.

5. Complete Application Forms Thoroughly

Provide comprehensive answers to all questions on the application forms. Double-check all information for accuracy before submission.

6. Submit Supporting Documentation

Attach medical records, letters from healthcare providers, and any other evidence that supports your claim. Make it easy for the reviewer to find and understand your documentation.

7. Meet All Deadlines

Be aware of all application deadlines for the specific benefits you’re applying for. Submit your application as soon as possible to avoid delays.

8. Follow Up on Your Application

Check the status of your application periodically. Provide any additional information requested by the benefit provider promptly.

9. Get Legal Advice

If you’re unsure about the process or face challenges, get invaluable professional guidance from our team.

Contact the arthritis disability lawyers at Samfiru Tumarkin LLP for a FREE consultation if your STD or LTD claim is denied by the insurance company.

Our experienced legal team specializes in disability benefits. We can help you navigate the process and improve the chances of your claim for benefits being approved.

Further enhance your long-term disability claim. Watch this short video where we share three effective ways to make your application stronger:

Applying for disability benefits can be overwhelming, but taking it step by step can make the process more manageable. Remember, it’s okay to ask for help along the way.

Common Reasons for Denial of Arthritis Disability Claims

Disability claims for arthritis are often denied for the following reasons:

Insufficient Medical Evidence

Claims are frequently denied due to a lack of comprehensive medical documentation.

Solution: Provide detailed medical records, including diagnosis, treatment plans, and letters from healthcare providers explaining how arthritis and arthritis treatment affects your ability to work.

Not Meeting the Definition of Disability

Each benefit program has specific criteria for what constitutes a “total disability.” This is a misleading term created by insurance companies. It simply means that your insurer believes you don’t meet the criteria for disability benefits, and that you are still capable of performing your job despite the impact of arthritis.

Solution: Ensure you understand the criteria and clearly demonstrate how your condition meets these requirements in your application.

Non-Compliance with Treatment

Failing to follow prescribed treatments without a valid reason can lead to denial.

Solution: Follow and document all recommended treatments. If you can’t follow a treatment due to side effects or other issues, have your doctor note this in your records.

Pre-Existing Condition Exclusions

Some insurance policies exclude coverage for conditions that existed before the policy started.

Solution: Review your policy to understand any exclusions.

Incomplete or Inaccurate Applications

Errors or omissions in your application can result in denial.

Solution: Double-check all sections of your application for completeness and accuracy. Consider having someone else review it before submission.

Missed Deadlines

Failing to submit your application or required documents on time can automatically disqualify you.

Solution: Keep track of all deadlines and submit materials promptly.

These are some of the common reasons your insurer may give for denying your arthritis disability claim. If your claim is denied for any reason, get a free consultation with a disability lawyer to learn how to get your benefits.

What to Do If Your Arthritis Disability Claim is Denied

Receiving a denial for short-term or long-term disability can be discouraging, but it’s important to remember that you have options.

1. Review the Denial Letter Carefully

The letter should outline why your claim was denied. Knowing the specific reasons can help you address them effectively.

2. Gather Additional Evidence

Obtain recent evaluations or additional statements from your healthcare providers that address the denial reasons. If there were misunderstandings or missing information, provide explanations or additional documentation.

3. Consult a Disability Lawyer

Before filing an appeal, consult with an experienced disability lawyer at our firm who specializes in disability claims. Samfiru Tumarkin LLP can help you decide whether to appeal internally, file a lawsuit, or take other actions.

Watch this video to learn why hiring a disability lawyer can make a difference in your case:

4. Avoid Immediate Appeals Without Legal Guidance

Internal appeals are often handled by the same company that denied your short-term or long-term disability claim and may not be in your best interest. In fact, they are rarely successful. Insurers profit by denying you access to your disability benefits and keeping your money.

There are strict time limits for taking legal action, so it’s important to act promptly.

5. Continue Following Medical Advice

Keep attending appointments and following treatment plans. This shows ongoing commitment to managing your condition. Maintain records of all medical visits, treatments, and any correspondence related to your claim.

6. File a Legal Claim

If appropriate, your Samfiru Tumarkin LLP disability lawyer may advise taking legal action against the insurer to secure the benefits you’re entitled to. Legal processes are often the most effective way to achieve a positive outcome.

Facing a denial can be stressful, but with the right support and information, you can navigate this challenge more effectively. That is why it’s crucial to get the right legal advice before appealing your insurer’s decision. An experienced disability lawyer at Samfiru Tumarkin LLP can help you determine the best course of action.

Join Thousands Who Have Achieved Positive Results

Many clients have successfully resolved their claims with the help of our expert legal team. Now it’s your turn. Let’s work together to get the outcome you deserve—reach out to us today.

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Frequently Asked Questions

Below are some frequently asked questions to help you understand more about the arthritis disability benefits process. Find more answers in our full LTD FAQ section.

Is Arthritis Considered a Disability in Canada?

Yes, arthritis is recognized as a disability in Canada. Individuals suffering from arthritis may qualify for various disability benefits if the condition significantly impairs their ability to work or perform daily activities.

Is Arthritis a Disability in Ontario?

Yes, arthritis is recognized as a disability in Ontario. Individuals experiencing significant challenges due to arthritis may be eligible for short-term and long-term disability benefits through private insurance or the Ontario Disability Support Program (ODSP). Both evaluate how arthritis affects your daily functioning and ability to work to determine eligibility for assistance.

Is Arthritis a Disability in Alberta?

Yes, in Alberta, arthritis is recognized as a disability. Individuals who face significant difficulties due to arthritis may qualify for short-term or long-term disability benefits through private insurance or the Assured Income for the Severely Handicapped (AISH) program. Eligibility is based on how much arthritis interferes with your daily activities and ability to work.

Is Arthritis a Disability in B.C.?

Yes, arthritis is considered a disability in British Columbia. Those experiencing substantial challenges because of arthritis might be eligible for short-term and long-term disability benefits via private insurance or the provincial Disability Assistance Program. Eligibility is determined by assessing how arthritis impacts your everyday functioning and capacity to maintain employment.

Is Arthritis a Permanent Disability?

Arthritis is often considered a chronic condition that can persist throughout a person’s life. When it significantly limits your ability to work or perform daily activities, it may be recognized as a permanent disability for the purpose of receiving disability benefits in Canada. This designation depends on the severity of the condition and its impact on daily functioning.

How Long Does the Disability Benefits Application Process Take?

The timeline varies depending on the type of benefit and the completeness of your application. It can range from several weeks to a few months. Prompt submission of all required documents can help speed up the process.

Do I Need a Lawyer to Apply for Disability Benefits?

Yes. While you can apply on your own, consulting a disability lawyer at Samfiru Tumarkin LLP can significantly improve your chances of approval, especially if your case is complex or has been previously denied.

Are There Arthritis Grants Available in Canada?

Yes, various grants and funding opportunities exist to support individuals with arthritis, particularly for education and treatment. This includes the DTC, CPP Disability, and provincial disability assistance programs.

What If My Employer Denies Accommodations for Arthritis?

Employers are legally required to provide reasonable accommodations, even if it is difficult or costly to do so. If they fail to accommodate, you may have grounds for wrongful dismissal and a human rights complaint. Contact us to explore your options in Ontario, Alberta or B.C.

Resources and Support

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You’re not alone in this journey.

Coping with arthritis is challenging enough; securing the disability benefits you’re entitled to shouldn’t add to your burden. At Samfiru Tumarkin LLP, we’re here to listen, support you, and advocate for your rights—ensuring you receive the compensation you’re entitled to.

Our compassionate team of experienced disability lawyers understands the complexities of arthritis disability claims in Canada. Some of our lawyers have previously worked for insurers; we know how they think, why they deny certain disability claims, and how to successfully navigate the system on your behalf.

Samfiru Tumarkin LLP is a nationally recognized leader in insurance and disability law, dedicated to informing Canadians of their rights through:

The Disability Law Show on TV and radio
Insightful livestreams
Over 1,000 media interviews
Comprehensive resources, such as FAQs on long-term disability and guides on how to apply for different medical conditions.

We’re proud to have helped clients like you overcome these obstacles and obtain the benefits they needed. Here are some of their stories:

Sandra Bullock’s Triumph After $5.3M Legal Claim

Her long-term disability coverage was reinstated after we took legal action against Sun Life. Learn more.

Teacher Secures Six Figures in Disability Benefits

We successfully won compensation for Julie after she suffered a brain injury in a student assault. Follow her saga.

Nova Scotia Man Challenges Paralysis Claim Denial

Mitch’s insurer, SSQ, said he wasn’t “totally disabled” despite his spinal fracture. We took on his case.

Mother Battles Insurer While Daughter in Palliative Care

We helped Amanda after her insurer denied her mental health benefits. Discover her story.

Whether you’re struggling to get approved for benefits, appealing a denial, or dealing with a claim cut-off after two years, we’re here to assist you. Contact us today for a free consultation and find out how we can support you through the process and protect your rights. Our services extend across all Canadian provinces, excluding Quebec.

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