Living with chronic pain can make daily life and work incredibly challenging. If chronic pain symptoms are preventing you from maintaining your job, know that you’re not alone—and there is help available.

At Samfiru Tumarkin LLP, we specialize in navigating the complex disability benefits system in Canada. Our dedicated team is here to ensure you receive the support and benefits you’re entitled to, helping you regain stability in your personal and professional life.

Table of Contents

What is Chronic Pain?

Chronic pain is pain that lasts for more than three months, continuing even after an initial injury or illness has healed. Unlike acute pain, which acts as a warning signal for your body, chronic pain often doesn’t have a clear cause and can deeply impact your daily life. The World Health Organization recognizes chronic pain as a disease and not just a symptom of something else.

Symptoms of Chronic Pain

Everyone experiences chronic pain differently, but there are several common symptoms you might notice. Recognizing these can help you seek effective treatment:

  • Persistent Pain: Continuous aching, throbbing, or burning sensations that last for months or even years.
  • Fatigue: Feeling constantly tired and lacking energy, even after getting enough rest.
  • Sleep Disturbances: Struggling to fall asleep or stay asleep because of pain, leading to unrefreshing sleep.
  • Cognitive Impairments: Problems with memory, concentration, and decision-making, commonly known as “brain fog.”
  • Emotional Distress: Experiencing anxiety, depression, and mood swings as a result of living with chronic pain.
  • Decreased Mobility: Limited movement and flexibility due to persistent pain, affecting your daily activities.
  • Headaches: Frequent tension headaches or migraines often accompany chronic pain conditions.
  • Digestive Issues: Conditions like irritable bowel syndrome (IBS) can be associated with chronic pain.
  • Neuropathic Pain: Sharp, shooting, or burning pain resulting from nerve damage or dysfunction.
  • Allodynia: Experiencing pain from stimuli that don’t normally cause pain, such as light touch or mild temperature changes.

Understanding these symptoms can help your healthcare provider create a treatment plan tailored to your needs.

Who Does Chronic Pain Affect?

Chronic pain affects nearly 8 million Canadians. It can affect anyone, regardless of age, gender, or background. However, certain groups may be more susceptible or face unique challenges related to chronic pain:

  • Adults: Most commonly affected, with higher prevalence in middle-aged and older adults.
  • Women: Women are more likely to report chronic pain conditions compared to men.
  • Older Adults: Aging increases the risk of chronic pain due to degenerative conditions like arthritis and osteoporosis.
  • Individuals with Chronic Conditions: Those with conditions such as diabetes, cancer, or autoimmune diseases may experience chronic pain as a symptom or complication.

What Causes Chronic Pain?

Chronic pain can result from a variety of factors, often involving complex interactions between biological, psychological, and social elements. Here are some common causes:

  • Injuries: Severe or repeated injuries can lead to persistent pain even after the initial injury has healed.
  • Medical Conditions: Diseases such as arthritis, fibromyalgia, and multiple sclerosis are common causes of chronic pain.
  • Nerve Damage: Conditions like neuropathy or shingles can result in long-lasting nerve pain.
  • Surgery: Some individuals experience chronic pain following surgical procedures.
  • Psychological Factors: Stress, anxiety, and depression can exacerbate the perception of pain.
  • Genetics: A genetic predisposition may increase the likelihood of developing chronic pain conditions.
  • Inflammation: Chronic inflammatory conditions can cause ongoing pain and discomfort.
  • Lifestyle Factors: Poor posture, lack of exercise, and unhealthy habits can contribute to chronic pain.

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Types of Chronic Pain

Chronic pain is a broad term that encompasses various types of pain, each with distinct characteristics and underlying causes. Understanding these types can help in selecting the most effective treatment strategies. Here are some common classifications:

  • Neuropathic Pain: Results from damage or dysfunction in the nervous system. Common examples include diabetic neuropathy and postherpetic neuralgia.
  • Musculoskeletal Pain: Arises from muscles, bones, ligaments, or tendons. Conditions like arthritis and fibromyalgia fall under this category. It also includes back pain.
  • Inflammatory Pain: Caused by inflammation in the body, often associated with autoimmune diseases such as rheumatoid arthritis or lupus.
  • Functional Pain: Occurs without an identifiable structural or biochemical cause. Examples include irritable bowel syndrome (IBS) and tension headaches.
  • Cancer-Related Pain: Caused by the cancer itself or as a side effect of treatments like chemotherapy and radiation therapy.
  • Mixed Pain: Involves a combination of different types of pain, such as both neuropathic and musculoskeletal pain.
  • Psychogenic Pain: Pain that is influenced or exacerbated by psychological factors, including stress and mental health conditions.
  • Idiopathic Pain: Pain with no identifiable cause despite thorough medical evaluation.

Recognizing the specific type of chronic pain you are experiencing is essential for developing an effective and personalized treatment plan.

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Is Chronic Pain a Disability in Canada?

Yes, chronic pain is recognized as a disability in Canada, particularly when it significantly impacts a person’s ability to function in daily life or perform their job.

Legal Recognition

Under the Canadian Human Rights Act, chronic pain is recognized as a disability, entitling individuals to protection from discrimination and access to reasonable workplace accommodations.

Employment Rights

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

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

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Chronic Pain Disability Benefits in Canada

If chronic Pain 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 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 chronic Pain 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)

Chronic Pain 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.

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How to Apply for Chronic Pain Disability Benefits

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

1. Obtain a Formal Diagnosis

See a psychiatrist, psychologist, or other qualified healthcare provider to get an official chronic pain diagnosis. 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 chronic pain 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 chronic pain 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.


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Common Reasons for Denial of Chronic Pain Disability Claims

Disability claims for chronic pain 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 chronic pain 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 chronic pain.

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 chronic pain 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.


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What to Do If Your Chronic Pain 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 chronic pain disability benefits process. Find more answers in our full LTD FAQ section.

Is Chronic Pain Considered a Disability in Canada?

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

Is Chronic Pain a Disability in Ontario?

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

Is Chronic Pain a Disability in Alberta?

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

Is Chronic Pain a Disability in B.C.?

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

Is Chronic Pain a Permanent Disability?

Chronic pain is often considered a chronic condition that can persist throughout a person’s life. If it significantly impairs your ability to work or perform daily activities, it can be recognized as a permanent disability for the purposes of disability benefits in Canada. This designation depends on the severity of the condition and how it affects 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 Chronic Pain Grants Available in Canada?

Yes, various grants and funding opportunities exist to support individuals with chronic pain in Canada, particularly for education, treatment, and daily living expenses. These include the Disability Tax Credit (DTC), Canada Pension Plan (CPP) Disability benefits, and provincial disability assistance programs.

What If My Employer Denies Accommodations for My Chronic Pain?

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 chronic pain 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 understands the complexities of chronic pain 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:

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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Our team of experienced disability lawyers can help individuals in all provinces (excluding Quebec) when their insurance company denies their chronic pain 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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