Living with a concussion or post-concussion syndrome can make daily life feel overwhelming, with symptoms like constant headaches, memory issues, and fatigue disrupting your focus, mobility, and quality of life. For many, managing a concussion’s effects means coping with physical, cognitive, and emotional challenges that impact job performance and everyday responsibilities. If your work and livelihood are suffering because of your condition, support is available.
At Samfiru Tumarkin LLP, we’re dedicated to helping you access the disability benefits needed to protect your health and financial stability. Our experienced team will navigate Canada’s disability benefits system on your behalf, working to secure the compensation and support you’re entitled to, so you can prioritize your recovery.
Table of Contents
2. Types of Concussions
3. Are Concussions a Disability in Canada?
4. Concussion Disability Benefits in Canada
7. How to Apply for Concussion Disability Benefits
8. Common Reasons for Disability Claim Denial
9. What to Do If Your Disability Claim is Denied
10. FAQs
11. Expert Support for Your Concussion Claim
What is a Concussion?
A concussion is a type of traumatic brain injury (TBI) caused by a blow to the head, a fall, or any force that causes the brain to move rapidly within the skull. This sudden movement can disrupt normal brain function, leading to ongoing symptoms that affect an individual’s quality of life and ability to function. While concussions are often associated with sports injuries, they can happen to anyone and may result in long-term cognitive and physical challenges.
Symptoms of a Concussion
Symptoms vary widely and can affect physical, cognitive, and emotional well-being. Early recognition and proper management are crucial to recovery. Common symptoms include:
- Headaches: Persistent headaches that can range from mild to severe, often worsened by activity or movement.
- Dizziness and Balance Issues: Feeling unsteady or lightheaded, which can affect mobility and increase fall risk.
- Memory and Concentration Problems: Difficulty focusing, remembering details, or processing information.
- Sensitivity to Light and Noise: Heightened sensitivity to bright lights or loud sounds, often leading to discomfort in everyday environments.
- Mood Changes: Increased irritability, anxiety, or depression, which can impact daily interactions and mental well-being.
Who Can Be Affected by Concussions?
Concussions can affect individuals of all ages and backgrounds. Certain factors may increase the risk of experiencing a concussion or prolong recovery:
- Previous Concussions: A history of concussions increases vulnerability to further injury and long-term effects.
- High-Risk Activities: Participation in contact sports, physical labor, or activities with a high risk of falls.
- Age: Children and older adults are particularly susceptible to concussion effects and may experience longer recovery times.
- Gender: Some studies suggest women may be more prone to concussions and experience symptoms differently than men.
Types of Concussions and Post-Concussion Effects
Concussions can vary in severity, and their impacts can range from temporary symptoms to long-lasting challenges. Understanding the types and potential effects is crucial for seeking appropriate support and exploring treatment options:
- Mild Concussion: Short-term symptoms like dizziness and headaches, typically resolving within a few days to weeks with rest and limited activity.
- Moderate Concussion: Symptoms lasting for several weeks, affecting concentration, mood, and physical well-being, requiring closer management.
- Post-Concussion Syndrome (PCS): A condition where symptoms persist for months or even years, impacting daily life, work ability, and social interactions.
Is a Concussion a Disability in Canada?
Yes, a concussion and post-concussion syndrome can be recognized as disabilities in Canada under the Canadian Human Rights Act and relevant provincial human rights laws. This recognition can support eligibility for long-term disability benefits when symptoms from a concussion significantly limit a person’s ability to perform daily tasks or meet work responsibilities. Individuals are entitled to protection from workplace discrimination, and employers must provide reasonable accommodations—such as modified duties, reduced hours, or quiet workspaces—to help manage symptoms effectively.
However, qualifying for benefits, including long-term disability, requires more than a concussion diagnosis. You must demonstrate that your condition severely affects your ability to work and meets the criteria specified in your benefit plan. Given the challenges in proving eligibility, a free consultation with an experienced disability lawyer at Samfiru Tumarkin LLP can help clarify your options and improve your chances of securing long-term support.
Concussion Disability Benefits in Canada
If a concussion or post-concussion symptoms are preventing you from working, you may be eligible for various disability benefits:
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
LTD benefits offer extended financial support if you’re unable to return to work after STD or EI benefits for a concussion or post-concussion syndrome run out. It can last for several years, often until age 65 or until you’re able to return to work. You must meet your insurer’s definition of “totally disabled,” meaning you can’t perform your own job or any 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 concussion or post-concussion syndrome symptoms who are unable to work may qualify for Canada Pension Plan (CPP) disability benefits. Provided by the federal government, it offers 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)
A concussion can 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 Concussion Disability Benefits
Applying for short-term or long-term disability benefits for a concussion or post-concussion syndrome involves several critical steps:
1. Obtain a Formal Diagnosis
See a psychiatrist, psychologist, or other qualified healthcare provider to get an official diagnosis for a concussion or post-concussion syndrome. 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 concussion 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 concussion and post-concussion syndrome 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 Concussion Disability Claims
Disability claims for concussion or post-concussion syndrome 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 a concussion 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 a concussion.
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 concussion or post-concussion syndrome 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 Concussion 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.
Frequently Asked Questions
Below are some frequently asked questions to help you understand more about the concussion or post-concussion syndrome disability benefits process. Find more answers in our full LTD FAQ section.
Is a Concussion Considered a Disability in Canada?
Yes, a concussion or post-concussion syndrome is recognized as a disability in Canada. Individuals suffering from a concussion may qualify for various disability benefits if the condition significantly impairs their ability to work or perform daily activities.
Is a Concussion a Disability in Ontario?
Yes, a concussion or post-concussion syndrome is recognized as a disability in Ontario. Individuals experiencing significant challenges due to a concussion may be eligible for short-term and long-term disability benefits through private insurance or the Ontario Disability Support Program (ODSP). Both evaluate how a concussion affects your daily functioning and ability to work to determine eligibility for assistance.
Is a Concussion a Disability in Alberta?
Yes, in Alberta, a concussion or post-concussion syndrome is recognized as a disability. Individuals who face significant difficulties due to a concussion 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 a concussion interferes with your daily activities and ability to work.
Is a Concussion a Disability in B.C.?
Yes, a concussion or post-concussion syndrome is considered a disability in British Columbia. Those experiencing substantial challenges because of a disorder 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 a concussion impacts your everyday functioning and capacity to maintain employment.
Is a Concussion a Permanent Disability?
A concussion can lead to long-term symptoms that may persist indefinitely, especially in cases of post-concussion syndrome. If it significantly impairs your ability to work or perform daily activities, it may be recognized as a permanent disability for the purpose of accessing disability benefits in Canada. This designation depends on the severity and duration of your symptoms and their impact on your 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.
What If My Employer Denies Accommodations for a Concussion?
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.
Living with a concussion or post-concussion syndrome can be challenging, and obtaining the disability benefits you’re entitled to shouldn’t add to your stress. 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 understand the complexities of concussion 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.
Don’t wait. Discover how our experts can help with your disability claim.
Areas We Serve
Our team of experienced disability lawyers can help individuals in all provinces (excluding Quebec) when their insurance company denies their concussion or post-concussion syndrome claim or their CPP Disability benefits are denied.
Whether you’re dealing with major insurers like Manulife, Sun Life, or any other provider, we have the expertise to assist you. See our comprehensive list of long-term disability insurance companies in Canada to learn more about how we can help with your specific insurer.
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