What is a Recurrent Disability Clause?
If you’ve ever taken a close look at your LTD policy, you may have seen references to “recurrent disability.” What does that mean?
Let’s review some background information first. When you apply for LTD benefits, there will be a waiting period between the time when you became disabled and unable to work, to the time when you can begin receiving benefits. This is also sometimes called the “elimination period” or the “qualifying period.”
Let’s say you’ve been receiving LTD benefits for a while, but you’ve made a good recovery and you feel able to start working again. Your doctor agrees that it’s safe for you to return to work, so you do.
Once you begin work, your benefits stop because you are now earning income from your work. But after a few months, your disability returns. Perhaps your illness relapses, or your recovery backslides–either way, you can no longer work. You now need those LTD benefits again. This is where the recurrent disability provision can be helpful.
The recurrent disability clause sets out the guidelines for when LTD benefits can be reinstated without having to undergo another waiting period. The recurrent disability clause sets out a timeframe in which this can happen; usually it is within six to twelve months. Sometimes the policy will set out different timeframes for different types of occupations.
If your relapse happens after that timeframe has passed, you will have to re-apply for benefits and undergo another waiting period. It does not apply in situations where you sustain a new or un-related illness or injury.
The goal of the recurrent disability clause is to give employees the opportunity to try to return to work without the fear of having to go through a lengthy approval process if it doesn’t work out. That said, it’s not always straightforward or without trouble to take advantage of the recurrent disability provision–as is unfortunately the case with many aspects of LTD claims. It is not unusual for the insurer to push back and not accept that your disability has returned. They might also say that your reasons for not being able to work are not related to the original disability, and therefore don’t quality as a “recurrent disability”.
If you’re having issues related to LTD in Ontario, we invite you to get in touch for a free consultation with our experienced disability insurance lawyer today.