Mental Illness Disability Benefits Canada: Ultimate Guide

Navigating the process of securing mental illness disability benefits Canada can be daunting, especially given the complexities surrounding mental health conditions. While mental illness is recognized as a legitimate disability in Canada, qualifying for benefits often requires overcoming unique challenges.

In this ultimate guide, we’ll walk you through the key steps to understanding, applying for, and successfully obtaining mental illness disability benefits. Whether you’re dealing with anxiety, depression, or another mental health condition, this guide will provide you with a clear roadmap to help you win the benefits you’re entitled to.

Firstly, is mental illness a disability in Canada?

Yes, mental illness is considered a disability in Canada. If a mental health condition significantly limits a person’s ability to work and perform daily activities, they may qualify for disability benefits for programs like the Canada Pension Plan Disability (CPPD) or long term disability insurance benefits (if they have them).

However, since it is an invisible illness, it can be challenging to secure disability benefits for mental conditions. In this guide, we will overview some of those challenges and provide you with a clear roadmap on how to win mental illness disability benefits.

This article is part of a comprehensive guide on medical conditions that qualify for disability benefits. For more information about disability benefits and qualifying conditions, explore the articles below:

Conditions that qualify for mental health benefits in Canada

Any mental condition can potentially qualify for disability benefits as long as the person applying meets all the necessary qualifying criteria. In Canada, most benefits programs do not grant benefits solely based on a medical diagnosis. Instead, they assess eligibility based on the severity of the disability caused by the condition.

In other words, the focus is always on how the medical condition impacts your ability to function rather than the diagnosis itself. To qualify for benefits for a mental health condition, you must demonstrate that the resulting level of disability meets the eligibility requirements of the specific disability benefits plan.

The following are some common examples of mental illness conditions that qualify for disability benefits. Please note this is not a comprehensive list. Just because a condition isn’t listed here doesn’t mean it won’t qualify.

Addiction

Addiction is a chronic condition characterized by the compulsive use of substances or engagement in behaviours despite harmful consequences. It affects brain function, leading to physical and psychological dependence.

In Canada, addiction may qualify as a disability if it significantly impairs a person’s ability to work or perform daily activities. Individuals with addiction may be eligible for disability benefits under programs like the Canada Pension Plan Disability (CPPD) or provincial disability assistance programs. Additionally, addiction is recognized under the Canadian Human Rights Act, providing protection against discrimination in employment and services.

Attention deficit hyperactivity disorder (ADHD)

ADHD is a neurological condition characterized by inattention, hyperactivity, and impulsivity that can interfere with daily functioning.

Is ADHD a disability in Canada? In Canada, ADHD may qualify as a disability if it significantly impacts a person’s ability to work or manage everyday activities. Individuals with ADHD may be eligible for disability benefits under programs like the Canada Pension Plan Disability (CPPD) or provincial assistance programs. ADHD is also recognized under the Canadian Human Rights Act, offering protection from discrimination in areas like employment and services.

Anxiety

Anxiety involves excessive worry and fear about everyday situations, often leading to panic attacks. It can interfere with daily life, be difficult to manage, and last for long periods. Common types include generalized anxiety disorder and social anxiety.

Is anxiety a disability in Canada? In Canada, anxiety is considered a disability and can qualify for disability benefits if it significantly affects daily functioning.

Borderline Personality Disorder (BPD)

Borderline Personality Disorder (BPD) is a mental health condition characterized by unstable moods, behaviour, and relationships. Individuals with BPD often experience intense emotions, impulsivity, fear of abandonment, and difficulty maintaining relationships. It can interfere with daily life and lead to significant challenges in personal and professional settings.

Is BPD a disability in Canada? In Canada, BPD can qualify for disability benefits if it significantly impacts a person’s ability to function in daily life.

Depression

Depression is a mental health condition marked by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. It often affects an individual’s ability to perform daily tasks, maintain relationships, and function effectively in personal and professional settings.

Is depression a disability in Canada? In Canada, depression can be considered a disability and may qualify for disability benefits if it significantly impairs daily functioning and the ability to work.

Obsessive-compulsive disorder (OCD)

OCD is a mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviours or mental acts (compulsions) performed to alleviate anxiety caused by these thoughts. OCD can significantly interfere with daily life and hinder a person’s ability to carry out routine activities.

OCD disability benefits in Canada? In Canada, OCD may qualify as a disability and be eligible for disability benefits if it severely impacts a person’s daily functioning and ability to work.

Premenstrual dysphoric disorder (PMDD)

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that involves debilitating emotional and physical symptoms in the luteal phase of the menstrual cycle. Symptoms can include extreme mood swings, irritability, depression, and significant physical discomfort, which can severely impact daily functioning and quality of life.

Is PMDD a disability in Canada? In Canada, PMDD may be considered a disability and could qualify for disability benefits if it significantly impairs daily functioning and workability.

Post-traumatic stress disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) is a mental health condition triggered by experiencing or witnessing a traumatic event. It is characterized by persistent symptoms such as flashbacks, nightmares, severe anxiety, and intrusive thoughts. These symptoms can severely disrupt daily life and affect one’s ability to function effectively.

Is PTSD a disability in Canada? In Canada, PTSD is recognized as a disability and may qualify for disability benefits if it significantly impairs an individual’s ability to carry out daily activities and work.

Schizophrenia

Schizophrenia is a chronic mental health condition characterized by disruptions in thinking, perception, and behaviour. Symptoms can include hallucinations, delusions, disorganized thinking, and impaired cognitive functioning, which can significantly affect a person’s ability to function in daily life and maintain relationships.

Is schizophrenia a disability in Canada? In Canada, schizophrenia is considered a disability and can qualify for disability benefits if it severely impacts an individual’s daily functioning and ability to work.

Bipolar Disorder 

Bipolar disorder, formerly known as manic depression, is a mental health condition causing extreme mood swings, from emotional highs (mania or hypomania) to lows (depression). These shifts can impact sleep, behaviour, and decision-making.

Is bipolar a disability in Canada? In Canada, bipolar disorder is considered a disability and may qualify for disability benefits if it significantly affects daily functioning.

Understanding your employment rights & mental health

As of 2024, individuals in Canada experiencing mental illness as a disability are entitled to specific employment rights and may be eligible for disability allowances related to mental health.

Canada’s legal framework recognizes mental illness as a legitimate disability, ensuring that individuals with mental health disorders are protected from workplace discrimination. Employers are required to provide reasonable accommodations to support the continued employment of individuals with mental health disabilities.

Additionally, those who qualify for a mental illness disability allowance may receive financial assistance to manage the challenges associated with their condition. This support is intended to help individuals overcome impairments caused by mental illness and promote their full participation in the workforce, reinforcing Canada’s commitment to inclusivity and equal opportunities for all.

Many people worry about losing their jobs due to mental illness. Generally, employers can terminate employees, provided they give proper notice and avoid discriminatory reasons.

However, most employers won’t dismiss workers who require sick leave. Under Canada’s human rights laws, employers have a duty to accommodate employees with medical conditions that affect their ability to work. Allowing sick leave is a reasonable accommodation that employers are expected to provide.

To take sick leave, you will need a doctor’s note confirming that you cannot work and require time off. You’ll likely need to provide updated notes every three to six months to maintain your leave.

If your request for sick leave is denied, you can remain on leave during the appeal process, as long as you have a doctor’s note. Most employers are understanding in these situations.

If your employer tries to terminate your employment while you are on sick leave, you may be entitled to severance pay. In some cases, you may even challenge the termination if it was due to your condition. Since these cases can be complex, it’s advisable to seek legal guidance.

Types of mental health benefits in Canada you could qualify for

What disability benefits are available for individuals with mental health conditions? In Canada, there are various disability benefits that individuals with mental health conditions may be eligible for. Here is an overview of the most common benefits available.

• Long-term disability
• Short-term disability
• Employment Insurance (EI)
• CPP Disability
• Disability Tax Credit
• Workers’ compensation
• Veterans Affairs

Long-term disability

Long-term disability benefits provide financial support over an extended period. If approved, these benefits can last for several years or until you reach a certain age, such as 65. Payments typically cover 50-67% of your monthly salary and are usually disbursed monthly. LTD benefits often come from group plans or private insurance policies. If your employer offers a group medical plan or if you’re in a union, check if it includes LTD benefits. Self-employed individuals or those with private insurance may receive a fixed amount or a percentage of their earnings.

To apply for long-term disability in Canada, you’ll need to complete and submit forms from your insurer. These usually include forms for you, your employer, and your doctor. You can appeal a denial through internal appeals with the insurer and, if necessary, an external appeal or lawsuit. For more information or help with a denied long-term disability for mental health, consult with our team.

Short-term disability

Short-term disability benefits are temporary and provide 50-67% of your regular salary for a shorter duration, typically 15-17 weeks. Payments are usually made every two weeks. These benefits are provided through employer or group insurance plans. If your employer doesn’t offer short-term disability benefits, you may be eligible for Employment Insurance (EI) sickness benefits instead.

To apply for mental health short-term disability, obtain and complete the required forms from your employer or insurance company, including forms for yourself, your doctor, and your employer. If denied, you can request an internal appeal, with up to three or four possible appeals, before needing to pursue external options. Our short-term disability lawyers can assist with the appeal process.

Employment Insurance (EI)

EI sickness benefits are temporary and provide 55% of your salary for up to 15 weeks. To qualify, you must have recently paid into the EI program through your paycheck. Apply online through Service Canada, with your doctor providing a form confirming your inability to work and your employer issuing a Record of Employment (ROE). Note that if you qualify for short-term disability, you cannot claim EI benefits simultaneously. To learn more see what qualifies for EI sick benefits.

CPP

CPP disability benefits are available for permanent disabilities and can be received until age 65. CPP disability payments range from $583.32 to $1,606.78 per month in 2024, based on your contributions. To qualify, you need sufficient CPP credits, which can be obtained through credit splitting, foreign pension plans, or time spent raising a child.

You can receive both CPP and LTD benefits, but your LTD insurer may offset their payments by the amount you receive from CPP. To apply, complete the CPP disability application forms and have your doctor fill out the medical report. Appeals can be made through reconsideration and, if needed, to the Social Security Tribunal.

Disability tax credits

Disability tax credit in Canada can help reduce your taxable income if you have a severe and prolonged mental condition. To qualify, you must meet the program’s strict definition of disability. This credit can result in a tax refund, depending on the length of your condition. Apply by completing the T2201 form and submitting it to Revenue Canada.

Workers’ compensation

Workers’ compensation provides benefits for workplace injuries, including mental health conditions, if they stem from a work-related incident. Each province has its own program, and proving that your mental condition was caused or worsened by work can be challenging. Recent changes, such as Ontario’s policy on “chronic mental stress,” may offer more support. To apply for workers’ compensation benefits, you need a diagnosis from a doctor and evidence of work-related factors contributing to your condition.

Veterans Affairs

If you’re a current or former member of the Canadian Forces, you may be eligible for disability benefits from Veterans Affairs Canada (VAC) for mental conditions related to service. You need to demonstrate that your condition is service-related and provide supporting medical documentation. Apply online or via paper form, and follow the appeals process if your claim is denied, starting with internal reconsideration and potentially moving to the Veteran’s Review and Appeal Tribunal.

How to apply for mental health disability in Canada

Securing disability benefits for mental conditions can be challenging, mainly because these conditions are often not visible. Here’s how to effectively present your case and improve your chances of approval:

1. Accurate medical diagnosis

An official diagnosis is crucial, but it must meet the standards set by the Diagnostic and Statistical Manual of Mental Disorders (DSM). Generic terms like “burnout” or “stress” won’t suffice. Your diagnosis should come with a comprehensive medical history and documentation of other conditions that were ruled out. If your diagnosis seems incomplete or rushed, the insurance company might question its validity.

When mental conditions are accompanied by other health issues like chronic pain or anxiety, having these conditions formally diagnosed can help illustrate the broader impact on your daily life.

2. Appropriate treatment

Disability benefits providers assess whether you’ve received suitable treatment. If you haven’t pursued standard treatments, your claim might be denied. It’s essential to attempt all recommended therapies, even if you and your doctor believe other approaches might be more effective. Not adhering to standard treatment protocols can suggest to the provider that you could work if you followed conventional methods.

3. Well-documented treatment plan

A thoroughly documented treatment plan is critical. Insurance companies need clear evidence that you’re following a structured plan that adheres to best practices. If you’re waiting for an appointment with a specialist, your plan should reflect this wait and show that you’re engaging in all other recommended treatments in the interim.

4. Medications and side effects

Taking prescribed medications, even if they have side effects, is important. Your disability claim may be scrutinized if you’re not following the prescribed medication regimen. Document any adverse reactions and ensure your doctor explains why certain medications might not be suitable. Trying various medications or adjusting dosages as advised by your doctor demonstrates that you are committed to managing your condition.

5. Evidence of work-related limitations

To strengthen your claim, you must show evidence of your efforts to remain employed despite your mental condition. This includes:

• Medical records detailing your work attempts
• Employment records showing accommodations or job modifications
• Personal statements outlining your work efforts
• Testimonies from employers or co-workers describing your struggles

Strong evidence of your efforts to stay at work can significantly support your claim. Inadequate or lack of evidence may undermine your application.

6. Building credibility

Your credibility is crucial in the approval process. Decision-makers need to trust that your claims are genuine. Here’s how to enhance your credibility:

Avoid Actions That Harm Credibility:

• Contradicting your medical records or previous statements
• Blaming others or making excuses
• Criticizing involved parties
• Complaining about professionals
• Using aggressive or confrontational language
• Blocking reasonable information requests
• Disputing your diagnosis with doctors

Enhance Credibility By:

• Ensuring consistency between your statements and medical records
• Taking responsibility for issues with your claim
• Being cooperative and respectful
• Accepting and acting on expert advice
• Making genuine efforts to follow all recommended treatments
• Demonstrating clear attempts to continue working

By focusing on these key areas, you can strengthen your application for disability benefits for mental conditions and improve your chances of receiving the support you need.

Reasons for denial of mental disability benefits

Mental illness disability claims often get denied due to a few key reasons: inconsistent care, not seeing a psychiatrist, skipping recommended psychological treatment, substandard care, or poor documentation. To avoid a denial, it’s essential to stay consistent with your treatment and ensure your doctors follow best practices and properly document everything.

Want to dive deeper into this? Check out our article, What to tell a psychiatrist to get disability for more tips on how to prevent a claim rejection!

What to do after being denied

If your claim for mental illness disability benefits has been denied, you typically have two options: appeal internally to the benefit provider or file an external appeal, also known as a lawsuit. Most providers offer a few rounds of internal appeals, but it’s crucial to note that there’s a deadline for filing a lawsuit—usually one to two years from the date of the first denial letter. We’ve seen many people miss this deadline, so we strongly encourage seeking legal advice as soon as possible. A lawyer can review your case, inform you of your deadline, and develop a strategy tailored to your specific situation.

Mental illness denials can be particularly challenging to overturn. Having an experienced advocate in your corner will significantly increase your chances of success.

At Resolute Legal, we’ve helped thousands of Canadians win mental health disability claims. We know why these claims get denied and, more importantly, how to overturn them. Our lawyers represent clients in short-term disability, long-term disability, CPP disability, workers’ compensation, employment disputes, and disability tax credit claims.

Provincial disability benefits for mental health conditions

Each province in Canada provides income support benefits to individuals who are unable to work due to mental conditions. If you qualify, you can receive fixed payments for life.

You can be eligible for provincial benefits even if you have never worked. However, eligibility depends on your total family income, which must be below a certain threshold that varies by province. Family income does not affect approval for other types of disability benefits.

To apply for provincial disability benefits, you must go through your provincial agency or program. As part of the process, your doctor will need to provide a report or certificate confirming that you cannot work due to your condition.

If your application is denied, you can appeal internally within the agency or program. In some provinces, you also have the option to appeal to an external tribunal for a final decision. Be sure to check your province’s specific procedures.

Ontario: Ontario Disability Support Program (ODSP)

The Ontario Disability Support Program (ODSP) provides financial assistance to Ontario residents aged 18 and over who have disabilities. Managed by the Ontario Ministry of Community and Social Services, ODSP offers monthly payments up to $1,308 in 2024, depending on living conditions. The payment consists of basic needs and shelter allowance, which varies based on whether you rent or own your home.

To qualify for ODSP, individuals must be 18 or older, Ontario residents, have assets within program limits, demonstrate financial need, and meet the program’s disability criteria or be part of the prescribed class.

Alberta: Assured Income for the Severely Handicapped (AISH)

The Assured Income for the Severely Handicapped (AISH) program in Alberta requires individuals to be at least 18 and not yet eligible for Old Age Security, be Alberta residents, and be Canadian citizens or permanent residents. Eligibility depends on the inability to work due to a permanent and disabling medical condition, with income and asset limits, ensuring they remain below-defined thresholds. Applicants may also need to apply for additional assistance programs such as CPP-D, EI, or WCB.

Nova Scotia: Disability Support Program (DSP)

Nova Scotia’s Disability Support Program (DSP) provides long-term disability benefits for individuals with intellectual, persistent mental, or physical disabilities. Financial support is based on specific needs, including housing and personal expenses, and is determined by the program’s Standard Household rate and household composition.

New Brunswick: Disability Support Program (DSP)

New Brunswick’s Disability Support Program helps with financial aid for disability-related expenses not covered by public health services. Eligibility requires residency in New Brunswick, being between 19 and 64 years old, and having a long-term disability. The program aims to enhance quality of life by supporting community involvement and providing specialized benefits.

British Columbia: Disability Assistance (PWD)

British Columbia’s Disability Assistance program offers long-term disability benefits. To qualify, individuals must be at least 18 years old, have a severe physical or mental impairment expected to last more than two years, and face significant limitations in daily living. Financial eligibility is also considered, with income and assets required to stay within specific thresholds.

Manitoba: Employment and Income Assistance Program (EIA)

Manitoba’s Employment and Income Assistance Program (EIA) provides financial support to residents with no other means. For disability support, eligibility requires residency, being 18 or older, having a disability expected to last more than 90 days, financial need, and an inability to earn sufficient income.

Saskatchewan: Saskatchewan Assured Income for Disability (SAID)

The Saskatchewan Assured Income for Disability (SAID) program offers support for individuals with significant and persistent disabilities. SAID provides financial assistance tailored to needs, covering living expenses, disability-related support, and shelter costs. Eligibility includes Canadian citizenship or refugee status, residency in Saskatchewan, being 18 or older, financial need, and having a substantial, enduring disability requiring assistance.

PEI: AccessAbility Supports

Prince Edward Island’s Disability Support Program, now AccessAbility Supports, aids Islanders with disabilities. Eligibility criteria include being under 65, a PEI resident, and having a diagnosed disability with unmet needs. The program develops a support plan covering various aspects, such as personal daily living support, housing, community and caregiver support, and financial aid, upon approval.

How we can help you

Were your disability benefits for mental illness denied? Is the insurance company or government provider claiming you don’t meet the definition of disability? If so, we’re here to help. Resolute Legal was founded by a former occupational therapist, so we understand just how debilitating mental illness can be. With a success rate of around 94 percent as of January 2024, our lawyers have the experience and expertise to help you get the results you deserve. 

Please keep in mind that past success does not guarantee future results, and litigation outcomes will vary based on the specifics of each case.

Stop worrying and start healing. Call our disability support team at 888) 480-9050 to begin your journey to financial security and peace of mind.

Our offices located in Toronto, Ottawa, Moncton, and Halifax cater to clients in all provinces except Quebec. Ninety percent of our services are provided online, with in-person visits available as required. Learn more from the pages below:

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Key takeaways on mental disability in Canada

Navigating mental illness disability benefits in Canada can be challenging, but with the right approach, you can increase your chances of success. Mental health conditions like anxiety, depression, and PTSD can qualify for disability benefits if they significantly impact your daily life and workability. To strengthen your case, ensure you have a proper medical diagnosis, follow appropriate treatments, and provide thorough documentation of your work limitations.

Understanding your rights is essential—mental illness is recognized as a legitimate disability, and you’re entitled to protections under Canadian law, including reasonable workplace accommodations. If your claim is denied, don’t be discouraged. You have options to appeal, and seeking legal advice can make a huge difference in turning things around.

Can’t work due to mental illness? Download our free books

Can’t work due to mental illness in Canada? Your well-being is our priority. Learn the secrets to winning short-and long-term disability benefits by downloading our free books.

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