PTSD Disability Benefits Canada | Comprehensive 2024 Guide

Living with PTSD can make daily life feel like an unending struggle, with symptoms that affect your focus, relationships, and ability to work. From managing flashbacks and hypervigilance to dealing with overwhelming anxiety, PTSD can be both exhausting and isolating. If your condition is interfering with your ability to maintain employment, you’re not alone.

At Samfiru Tumarkin LLP, we’re dedicated to helping you secure the disability benefits you need to support both your mental health and financial stability. Our experienced team is here to guide you through Canada’s disability benefits system, ensuring you get the support you need to prioritize your well-being.

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

What is PTSD?

Post-Traumatic Stress Disorder (PTSD) is a serious mental health condition that can arise after experiencing or witnessing a traumatic event. Events such as accidents, natural disasters, military combat, or personal assaults can trigger PTSD, leading to symptoms that disrupt daily life. The impact of PTSD varies widely but often includes vivid flashbacks, heightened anxiety, and avoidance of triggers associated with the trauma.

PTSD affects people differently; for some, it manifests soon after the event, while others may experience delayed symptoms that persist or resurface years later. These symptoms can profoundly affect relationships, work, and daily activities.

Symptoms of PTSD

PTSD symptoms are diverse and may appear immediately or over time. While treatment can help, these symptoms can be challenging to manage. Common PTSD symptoms include:

Flashbacks and Intrusive Memories: Reliving the traumatic event, often with physical symptoms like sweating or a racing heart.
Avoidance of Triggers: Actively avoiding places, people, or activities that bring back painful memories.
Heightened Anxiety and Hypervigilance: Constantly feeling on edge or excessively alert to potential threats.
Emotional Numbness: Difficulty experiencing positive emotions, feeling detached from others.
Sleep Issues and Irritability: Difficulty sleeping, frequent nightmares, or irritability that affects relationships and daily functioning.

Who Can PTSD Affect?

PTSD can impact anyone who has experienced or witnessed a traumatic event. Although it can happen to anyone, certain factors increase the likelihood of developing PTSD. According to the Public Health Agency of Canada, approximately 8% of Canadian adults have moderate to severe PTSD. It’s more common for women (10%) than men (6%). Individuals more at risk include:

First Responders and Military Personnel: Those frequently exposed to life-threatening or traumatic situations.
Victims of Abuse or Assault: Survivors of physical or emotional abuse or other forms of assault.
Individuals in High-Stress Professions: Jobs that involve a high degree of exposure to trauma, such as healthcare and emergency services.
Those with a Family History of Mental Health Conditions: Genetics may play a role in susceptibility to PTSD.
People with Pre-existing Mental Health Issues: Individuals with prior anxiety or depression may be more susceptible to PTSD.

Types of PTSD

PTSD encompasses several types, each presenting unique symptoms and challenges. Understanding the different forms can help in recognizing symptoms and pursuing effective treatment:

Acute Stress Disorder: Symptoms occur immediately after trauma but last less than a month. It can sometimes lead to full PTSD if symptoms persist.
Complex PTSD: Develops from prolonged or repeated trauma, often involving childhood abuse or long-term abuse situations.
Delayed-Onset PTSD: Symptoms emerge six months or more after the traumatic event, often in response to a specific trigger.
Comorbid PTSD: When PTSD occurs alongside other mental health conditions like depression or anxiety, compounding the effects and treatment needs.
Secondary or Vicarious Trauma: Experienced by individuals who haven’t been directly affected but have witnessed others’ traumatic events, such as therapists or family members.

Is PTSD a Disability in Canada?

Yes, PTSD is recognized as a disability in Canada under the Canadian Human Rights Act and equivalent provincial human rights laws. When PTSD significantly limits a person’s ability to perform daily activities or fulfill their job requirements, they are entitled to protection from workplace discrimination. Employers are also required to provide reasonable accommodations to help individuals with PTSD manager their job effectively.

Employment Rights

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

However, eligibility for disability benefits isn’t based solely on having a diagnosis of PTSD. 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.

PTSD Disability Benefits in Canada

If PTSD makes 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 PTSD

LTD benefits provide extended financial support if PTSD 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 PTSD 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)

PTSD 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 PTSD Disability Benefits

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

1. Obtain a Formal Diagnosis

See a doctor or other qualified healthcare provider to get an official diagnosis for PTSD. 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 PTSD 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 PTSD 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 PTSD Disability Claims

Disability claims for PTSD 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 your PTSD 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 PTSD.

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 PTSD 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 PTSD 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.

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Frequently Asked Questions

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

Is PTSD Considered a Disability in Canada?

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

Is PTSD a Disability in Ontario?

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

Is PTSD a Disability in Alberta?

Yes, in Alberta, PTSD is recognized as a disability. Individuals who face significant difficulties due to PTSD 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 the disorder interferes with your daily activities and ability to work.

Is PTSD a Disability in B.C.?

Yes, PTSD is considered a disability in British Columbia. Those experiencing substantial challenges because of PTSD 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 PTSD impacts your everyday functioning and capacity to maintain employment.

Is PTSD a Permanent Disability?

PTSD can be a chronic condition, with symptoms that may persist throughout a person’s life. When PTSD significantly impairs your ability to work or perform daily activities, it may qualify as a permanent disability for the purpose of receiving disability benefits in Canada. Whether PTSD is considered a permanent disability depends on the severity and impact on your daily functioning, as well as medical evaluations.

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.

What If My Employer Denies Accommodations for PTSD?

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 PTSD 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 PTSD disability claims in Canada. Some of our lawyers have previously worked for insurers; we know how they assess claims, why they deny certain PTSD claims, and how to navigate the system effectively 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:

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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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