Addiction and Substance Abuse and Long-Term Disability Benefits in Canada

Living with addiction or substance abuse can significantly impact one’s ability to maintain employment and financial stability. For individuals facing these challenges, long-term disability (LTD) benefits can provide crucial support during their journey to recovery. However, understanding how addiction and substance abuse intersect with LTD benefits is essential for navigating the claims process effectively.

At Preszler Injury Lawyers, we understand the complex challenges that come with addiction and substance use disorders. Our long-term disability lawyers are here to support you, whether you’re applying for LTD benefits or appealing a denied claim. Contact us today to schedule your free consultation and get the legal help you need.

Understanding Addiction and Substance Abuse

Addiction and substance abuse are complex conditions characterized by compulsive drug or alcohol use despite harmful consequences. Addiction is a chronic and relapsing medical condition. These conditions can lead to physical, psychological, and social impairments that interfere with daily functioning and employment. Common substances of abuse include:

• Alcohol
• Prescription medications
• Opioids
• Stimulants
• Sedatives
• Illicit drugs
• And more

The clinical term for addiction is Substance Use Disorder (SUD), which can range from mild to severe. SUD can co-occur with other mental health conditions such as anxiety, depression, or post-traumatic stress disorder (PTSD).

Addiction and Long-Term Disability

Individuals struggling with addiction or substance abuse may qualify for LTD benefits if their condition prevents them from performing essential job duties. However, there is still a lot of social stigma around addiction, and so insurance policies vary in their coverage of addiction-related disabilities. Some policies may exclude coverage for substance abuse-related conditions, while others may provide limited benefits or require proof of functional impairment.

Are Addiction and Substance Abuse Covered by my LTD Policy?

In Canada, severe addiction may qualify as a disability under long-term disability insurance policies or the Canada Pension Plan Disability, especially if the condition prevents gainful employment. Review your long-term disability insurance policy to understand if addiction and substance abuse are covered conditions. Some policies may exclude coverage for conditions related to substance abuse or may have limitations on coverage for mental health-related issues.

When applying for LTD benefits related to addiction or substance abuse, it’s essential to provide comprehensive medical documentation supporting your diagnosis, treatment history, and functional limitations. Additionally, demonstrating compliance with treatment recommendations and efforts to address your addiction can strengthen your disability claim.

Here are some of the ways you may be asked to support your claim:

• Medical Documentation: Provide comprehensive medical documentation from healthcare professionals outlining your addiction or substance abuse diagnosis, treatment history, and prognosis. This documentation can be crucial in supporting your disability claim.
• Treatment Compliance: Demonstrating compliance with treatment recommendations, such as attending therapy sessions, participating in rehabilitation programs, or taking prescribed medications, can strengthen your disability claim.
• Functional Limitations: Clearly articulate how your addiction or substance abuse impairs your ability to perform essential job functions. Document any functional limitations or restrictions imposed by your condition that prevent you from working.
• Explain Impact on Work Performance: Describe how addiction or substance abuse affects your work performance, including absenteeism, decreased productivity, impaired decision-making, and conflicts with colleagues or supervisors.
• Rehabilitation Efforts: Provide evidence of any efforts you’ve made to address your addiction or substance abuse, such as participation in support groups, counselling, or detox programs. Highlight your commitment to recovery and rehabilitation.

By addressing these facts and considerations, individuals dealing with addiction and substance abuse can better navigate the complexities of the long-term disability benefits system and increase their chances of obtaining the support they need for recovery.

What to Do If Your LTD Benefits Have Been Denied for Your Substance Abuse

Unfortunately, disability benefits for addiction or substance abuse-related conditions may be denied by insurance providers. Common reasons for denial include policy exclusions, insufficient medical evidence, and failure to meet eligibility criteria. Insurance companies may also argue that addiction-related disabilities do not meet the definition of “total disability” under the policy.

If your LTD benefits have been denied for addiction or substance abuse, it’s essential to take action promptly. Begin by reviewing the denial letter you received carefully to understand the reasons for the denial. Then, gather additional medical evidence, treatment records, and expert opinions to support your claim. Consider filing an appeal with the assistance of a long-term disability lawyer who has experience in handling addiction-related long-term disability claims.

It can also be helpful to build a support network of family, friends, healthcare professionals, and addiction recovery resources to assist you throughout the disability claims process and your journey toward recovery.

Contact Our Long-Term Disability Lawyers For Assistance With Your LTD Claim

Navigating the appeals process for denied LTD benefits can be challenging, especially when dealing with addiction or substance abuse-related conditions. Living with addiction or substance abuse is a difficult journey, but individuals facing these challenges should know that support is available. Long-term disability benefits can provide financial assistance and peace of mind during recovery.

If your LTD benefits have been denied for addiction-related reasons, contact our long-term disability lawyers at Preszler Injury Lawyers today. You can schedule your free consultation online or call 1-800-JUSTICE® now.