Is heart disease a disability in Canada? Yes, heart disease is a condition that qualifies for disability benefits in Canada. However, a diagnosis itself won’t qualify you for payments. In order to get approved, you will have to prove your condition renders you unable to work, which can be difficult.
This article discusses the hurdles of obtaining disability benefits for heart disease in Canada and provides guidance on increasing the chances of success. It covers understanding heart disease types, navigating diagnostic tests, and the two main benefit sources, Canada Pension Plan (CPP) and Long-term Disability Insurance, plus other beneifts for which you may qualify. Practical advice on documentation, demonstrating work-related limitations, and maintaining credibility are highlighted. Challenges like test limitations and workplace stress effects are outlined, along with the risks of benefit termination. The article emphasizes the need for a solid case and offers guidance on appealing denials and advocating for legal assistance.
If you’re struggling with a heart disease disability claim, our disability lawyers can help. Click on the button below to schedule a free consultation.
Heart disease disability guide
Applying for disability benefits for heart disease in Canada is no easy task. Even truthful and legitimately disabled people are not guaranteed the payment of benefits, as countless reasons can be given for denying claims. However, those who find themselves unable to work due to heart disease should still look at their qualifications and consider getting disability benefits despite the challenges.
Claiming for heart disease is difficult because of the uniqueness of the disability. Unlike other disabilities, it is difficult to prove the condition is legitimate. It truly is a silent killer. People with heart disease usually look relatively healthy. They don’t normally show any physical signs of being “disabled” or unfit to work.
Let’s dive in!
What is heart disease?
Heart disease, also known as coronary artery disease (CAD) or ischemic heart disease, is a category of cardiovascular disease that is caused by a build-up of fatty deposits, calcium deposits, inflammatory cells or plaque in the coronary arteries. This creates a block that limits blood supply to the heart, leading to ischemia or cell starvation due to a lack of oxygen. The patient’s heart could slow down or stop completely. Symptoms include chest, shoulder, back, jaw or neck pain, shortness of breath, nausea and vomiting, fatigue, sweating, and an irregular heartbeat.
In order to claim disability benefits for heart disease, the worker must be able to prove that his or her symptoms are due to myocardial ischemia—a blockage of the coronary artery. Diseases that fall under this category include myocardial infarction, stable angina, unstable angina and silent ischemia.
Types of heart disease
- Myocardial infarction/ heart attack. This happens when blood stops flowing to a part of the heart, damaging the heart muscle. The pain feels like heartburn that lasts for a few minutes.
- Stable angina / effort angina. It is usually triggered by physical activity like running or walking. It can also be triggered by emotional stress. Stable angina presents as chest discomfort that dissipates when the trigger is removed or ceases.
- Unstable angina / crescendo angia. Unlike stable angina, it can happen even when the patient is at rest. It usually occurs following a crescendo pattern, with each new incident being more severe than the previous one. This is often an indicator of an impending heart attack.
- Silent ischemia. It is also possible for a patient to suffer from CAD but not exhibit any obvious signs or symptoms. This is aptly called silent ischemia. It can be detected in the same way as the other types of heart disease.
Do heart stents qualify for disability in Canada?
No, a heart stint does not qualify for benefits because it is not a medical condition. However, heart stints are typically placed in the coronary arteries due to heart disease and, heart disease, and other heart-related impairments do qualify for disability benefits.
So, while you can’t get beneifts solely because you have a heart stint, you can get approved if the medical condition that required that stint (i.e., heart disease) renders you unable to work.
What heart conditions qualify for disability in Canada?
Any heart disease technically could qualify for disability beneifts so long as the claimant meets all the qualifying criteria for the disability benefits program. Some common examples include the following: Myocardial infarction or heart attack, stable angina or effort angina, unstable angina or crescendo angina, and silent ischemia.
Wondering what other conditions may qualify for benefits? Check out our medical conditions and disability benefits page, or click on any of our series below to learn more.
Heart disease statistics
Heart disease has reached epidemic levels in Canada. According to 2017–2018 data from the Canadian Chronic Disease Surveillance System (CCDSS), about 1 in 12 (or 2.6 million) Canadian adults aged 20 and over live with diagnosed heart disease.
Heart disease is as common as it is deadly. Every hour, about 14 Canadian adults aged 20 and over diagnosed with heart disease die. Heart disease is truly a silent killer. If you are struggling with heart disease, know that you are not alone. And know that you deserve disability benefits just as much as anyone else.
Testing for heart disease
Those claiming disability benefits for heart disease must subject themselves to an abnormal stress test or electrocardiographic testing (EET). Physicians rely on this test to find evidence of blockages in the coronary arteries. The test is conducted by increasing the heart rate, whether through drugs or exercise, and the increase in blood flow to the heart is measured. If the blood flow is not sufficient to meet the demand, then parts of the heart muscle start to starve. The next course of action would be an invasive procedure to open the artery, such as bypass surgery.
EET should not be mistaken for exercise tolerance tests or ETTs. Claims are often denied due to the results of ETTs, which are not very reliable in conclusively diagnosing CAD. False positives or false negatives can occur due to several factors, including medication. Moreover, the results of ETTs can be misleading. Exercises like walking or bicycling done under controlled conditions do not accurately capture the activities done by an employee in a work setting. Cold temperatures, hunger, and stress experienced in the workplace while performing duties would exacerbate the symptoms of heart disease. Thus, a normal ETT does not always indicate a healthy heart.
Denied disability beneifts for heart disease? Our disability lawyers can help! We have helped thousands of Canadians win back the benefits they are entitled to. Click on the button below to get started today.
Understanding your employment rights
Under Canadian law, employers cannot legally terminate an employee due to disability, including heart disease, as it constitutes a protected ground of discrimination. Employers are required to fulfill their duty to accommodate the employee’s disability unless doing so would result in undue hardship. This accommodation might involve modifying the work environment or adjusting job duties to enable the employee to continue performing effectively.
However, termination can still occur under specific conditions. Employers can terminate employment with reasonable notice or pay in lieu of notice, as mandated by provincial employment standards legislation or common law. The duration of notice or severance pay depends on factors such as the length of employment and any contractual agreements in place.
Moreover, termination for “just cause” is permissible, typically in cases of employee misconduct, such as theft or insubordination. The employer must clearly demonstrate the grounds for just cause.
Additionally, termination may occur if the employment contract is deemed frustrated by unforeseen events, such as the employee becoming permanently unable to perform essential job duties due to illness or disability. In such situations, the doctrine of frustration releases both parties from their contractual obligations. The applicability of this doctrine may be influenced by the foreseeability of the event and the presence of long-term disability benefits in the employment contract.
In conclusion, while termination is possible under certain circumstances, employers must ensure compliance with employment standards legislation and human rights laws. This includes providing reasonable notice or severance pay and avoiding discrimination against employees with disabilities.
Which disability benefits for heart disease do I qualify for?
There are two main sources of disability benefits for Canadian workers suffering from heart disease: the Canada Pension Plan and Long-term Disability Insurance Benefits.
CPP disability benefits for heart disease
The Canadian government mandates that employers are required to deduct Canada Pension Plan (CPP) contributions from the salary of their employees. The CPP is a retirement pension, but unknown to many employees, other benefits are also payable under the plan, including survivor, post-retirement, and disability benefits. The last type begins when an individual becomes disabled before the retirement age of 60 or 65 years old. Anyone who has “a severe and prolonged disability” and is considered a recent contributor to the CPP can qualify for benefits. The CPP administration defines a “recent contributor” as someone who has contributed to the CPP in:
- Four of the last six years, or
- Three of the last six years, if he or she has contributed for at least 25 years.
There are two types of disability benefits under the CPP. One is paid to the disabled worker. While the other goes to their children. Those who are approved for CPP disability benefits would receive a taxable monthly payment.
For more information on how to apply, check out CPP disability application.
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Long-term disability for heart disease
Another common type of disability benefits plan in Canada is an insurance-based disability plan. Insurance protects individuals from the risk of accidentally losing the ability to earn income. As such, many workers have group disability insurance policies as part of their employee benefits packages. This means that member employees were insured as part of a group with a common sponsor, usually an employer, professional organization, union or bank. The sponsor buys the policy from an insurance company for the benefit of the group’s members. The coverage can be short-term or long-term, depending on the benefits.
There are also individual disability policies sold to professionals or self-employed business people. These are bought directly from an insurance broker, and the coverage continues as long as the monthly premiums are paid.
For long term disability benefits, the employee can become eligible for monthly income payments during long absences from work. These payments are computed as a percentage of the worker’s salary, a specific monthly amount, or a combination of the two. These amounts are specified in the insurance policy, along with the maximum period of time that the benefits will be received.
Need long-term disability help? Click on the button below to schedule a FREE call with our support team. We can discuss the next steps and let you know if you have a case.
Other heart disease disability benefits
The following is a breakdown of other disability benefits people with heart disease may qualify for.
Short-term disability for heart disease
Short term disability in Canada is a benefit that provides income protection if you become ill or injured and need to take time off work. You can obtain coverage through your employer’s group benefits or purchase a private insurance plan. The amount you receive typically ranges from 60 to 70 percent of your salary, depending on your specific plan. For exact payment amounts, consult your benefits booklet or contact your plan administrator.
The process for claiming STD benefits generally follows these steps:
1. You become ill or injured.
2. You apply for STD benefits and any other relevant benefits.
3. Your application is approved or denied.
4. If denied, you can appeal the decision.
5. If approved, you receive weekly benefits until you recover or the benefits are exhausted.
6. If still unable to work after STD benefits end, you can apply for long-term disability benefits or other available benefits.
Additionally, STD insurance can be a product offered to businesses and organizations, providing employees with income protection for short-term work absences. This group insurance may not be included in all plans, so it’s important to verify your specific coverage. Each STD plan has unique requirements, so review your STD benefit booklet to understand how your plan works.
Check out reasons short-term disability can be denied and short term disability attorneys, for more information on what to do after a denial.
Employment Insurance (EI) Sickness
EI sickness benefits provide temporary income replacement for individuals unable to work due to injury or illness. These benefits are administered by the federal government through the Employment Insurance program.
To qualify, you must meet the following criteria:
- Your income must be reduced by at least 40% due to illness or disability.
- You must be employed by a qualified employer.
- You must have accumulated 600 hours of insurable employment.
If approved, you will receive payments equal to 55% of your average insurable weekly earnings, up to a maximum of $638 per week. These benefits can be received for up to 15 weeks.
Workers Compensation
Workers’ compensation is a benefit available to Canadians who have sustained a workplace injury or illness. Each province and territory in Canada has its own workers’ compensation board (e.g., WSIB in Ontario) that manages these benefits.
To qualify for workers’ compensation benefits Canada, you must be employed by a covered employer and have a work-related injury or illness. If eligible, you can receive disability income payments until age 65 and, in some cases, even longer. Additional benefits may include coverage for health care and equipment expenses, as well as compensation for pain and suffering.
Disability tax credit
The Disability Tax Credit (DTC) is a non-refundable tax credit that reduces the income tax burden for individuals with impairments and their supporting family members. Introduced in 1988 by the Canadian Government and the Canada Revenue Agency (CRA), the DTC helps cover additional expenses due to severe and prolonged impairments.
Eligible individuals can receive the base amount or the base plus a supplemental amount for those under 18. The DTC can also be back-filed for up to 10 years if not previously claimed.
The credit includes contributions from both federal and provincial sources, with provincial amounts varying. The DTC also provides access to other programs, such as the Registered Disability Savings Plan (RDSP).
Eligibility differs from other disability plans. A medical practitioner must certify that you have a severe and prolonged impairment causing marked restrictions in one category, significant limitations in two or more categories, or require therapy to support a vital function. You must also be a Canadian citizen or permanent resident.
Eligibility categories include:
- Walking
- Mental functions
- Dressing
- Feeding
- Eliminating (bowel or bladder functions)
- Hearing
- Speaking
- Vision
- Life-sustaining therapy
- Cumulative effect of significant limitations
The application process involves completing the T2201 form and the Disability Tax Credit Certificate, which requires detailed information about the applicant’s condition and certification from a medical professional. These forms are then submitted to the CRA for review.
If the initial claim is denied, applicants can request an internal review. If the review is unsuccessful, they can appeal the decision to the Tax Court of Canada.
Provincial support benefits
Here are some examples of provincial government assistance programs for heart disease in Canada:
- Ontario Disability Support Program (ODSP)
- Alberta Assured Income for the Severely Handicapped (AISH)
- Saskatchewan Assured Income for Disability (SAID) Program
- Nova Scotia Person’s with Disabilities Benefit
- Newfoundland and Labrador Income Support Program
Eligibility criteria and benefits may vary, so it’s advisable to check with the specific provincial government for more detailed information.
Veterans Affairs Canada
Veterans may be eligible for either short-term or long-term disability benefits if they can demonstrate that their condition is a “service-related injury” or that their military service substantially worsened their heart disease.
A key step in this process involves obtaining confirmation from a healthcare provider, such as a doctor, who can attest to the link between the veteran’s service and their condition.
To initiate a claim for Veterans Affairs Canada (VAC) disability benefits, individuals can apply either online through the VAC website or by submitting a paper application. Upon receiving an application, VAC will review the applicant’s service medical records and may request additional information to thoroughly assess the claim.
If an application is initially denied, VAC offers a structured appeals process. This begins with an internal reconsideration request, where veterans have the opportunity to submit new or additional information for review.
Should the claim be denied a second time, veterans have the right to escalate their case to the Veterans Review and Appeal Tribunal, an independent body that provides a final avenue of appeal within the VAC system.
How to Win Disability Benefits for Heart Disease
Heart disease is a disease frequently dismissed because those who suffer from it usually seem relatively healthy. For that reason, you must be extra diligent in your claim.
Here are some things you can do to improve your chances of winning disability benefits for heart disease.
Get a diagnosis
It isn’t easy to win disability benefits for heart disease without a diagnosis. If you haven’t already, book an appointment with your doctor to get a diagnosis as soon as possible.
Get the appropriate treatment and document it
When evaluating your claim, disability benefits providers will assess whether you’ve undergone appropriate treatment for your condition. Failure to receive adequate treatment is a leading cause of the denial of disability benefits.
This requirement extends to all other medical conditions. For instance, if you also have diabetes in addition to heart disease, it’s essential to seek treatment for each condition. This may involve medications, consultations with specialists, or psychological therapies.
Ensure that your doctor accurately documents all treatments. Ultimately, benefit providers rely on the medical records they receive to make decisions. Even if you’ve received excellent treatment for heart disease, lacking proper documentation means the insurer considers it as if you hadn’t received treatment at all.
Evidence of work-related limitations
Additionally, it’s important to document all the adjustments you’ve made to your work routine so that you can continue working while managing heart disease.
Before applying for disability benefits, consider trying less demanding roles within your current workplace. Until you take this step, providers of disability benefits may remain skeptical. For instance, you may demonstrate that although your job description stated medium-level duties, your employer accommodated your tasks to be classified as light.
If you’ve been compelled to switch jobs due to heart disease, make a note of this as well.
Credibility is key
It’s crucial for individuals seeking disability benefits due to heart disease to uphold absolute honesty throughout the process. Credibility holds immense significance when filing a legal claim for such benefits.
Given the difficulty in obtaining disability benefits for this condition, it’s imperative to avoid any activities that could compromise your credibility.
Even unintentional exaggerations or inconsistencies in describing symptoms can significantly damage credibility, regardless of whether they stem from honest mistakes.
Credibility killers
- Discrepancies between medical records or previous statements
- Offering excuses or shifting blame onto others for issues
- Criticizing involved parties in the claim, regardless of their culpability
- Lodging complaints against professionals perceived as negative, biased, or unprofessional
- Employing aggressive, sarcastic, or confrontational language in your claim or testimony
- Resisting or delaying reasonable requests for information
- Engaging in disputes with doctors regarding your diagnosis instead of focusing on the disability
- Attempting to portray oneself as a medical authority
Credibility boosters
- Ensuring alignment between your statements and the medical records
- Assuming accountability for any mistakes or issues with your claim without attributing blame to others
- Maintaining cooperation and respect towards all involved parties in the claim
- Embracing expert advice and opinions
- Making sincere attempts to follow all reasonable advice, even when in disagreement
- Demonstrating evident efforts to remain employed
Challenges of Applying for Disability Benefits for Heart Disease
The following is a breakdown of the challenges associated with applying and applealing a denial of disability for heart disease.
1. The abnormal stress test has its limitations in detecting myocardial ischemia.
The abnormal stress test is the universal screening test for plaque in the coronary arteries. However, the blockage must be significant enough in order to be detected by most types of EETs. As such, they are usually unable to detect the early onset of CAD; EETs are most effective during the latter stages of the development of heart disease. The most accurate type of stress test, the nuclear stress test, has a high sensitivity but also exposes the patient to a high level of radiation, making it not a recommended option.
2. The insurance company will examine the impact of heart disease on your work performance
The approval of a claim is usually not based on the type of heart disease and its level of seriousness. For instance, someone who has a heart attack does not necessarily have a better chance of getting approved than someone who has stable angina. What is more important is the negative impact of the disease and its symptoms on the employee’s performance of his or her work tasks. The CPP administration and insurance companies look at how heart problems make it impossible for a worker to be optimally productive.
3. You need to document the effect work stress has on your symptoms.
A disability benefits claim for CAD can be further strengthened by tracing the root cause of the disease to the workplace. Aside from the worker’s own testimony, evidence about this link could also be gathered from his or her examining physician’s medical documents as well as reports from the immediate supervisor and co-workers. Having a supportive workplace would certainly be advantageous. Also, it is crucial to be able to prove that the best treatment is to avoid any work that might have triggered the symptoms of CAD in the first place.
We are Resolute Legal Disability Lawyers, committed to ensuring no one is wrongfully denied disability benefits by insurance companies, employers, or government agencies. Our approach to achieving this vision includes education, advocacy, and legal services.
We prioritize education because we believe it is the most effective way to achieve our vision. Our motto, “educating you first,” reflects our commitment to providing honest and useful information about disability claims in Canada before you engage with us, insurance companies, or government agencies.
However, if you need legal representation to secure your disability benefits, we are here to help. Click on the button below or call (888) 480-9050 for a free consultation.
Moving Forward With a Disability Claim for Heart Disease
Heart disease is a fairly common condition that affects many Canadian workers. Those who suffer from it will find their work adversely affected to the point that claiming disability benefits becomes a necessity. However, the CPP administration and insurance companies make honest workers jump through hoops before they can even get a chance to consider their applications.
Doing the bare minimum is not enough—almost everyone does it to no avail. Recognizing the unique nature of heart disease will allow afflicted employees to choose the right approach for their claims. This includes finding a suitable doctor who will properly diagnose one’s illness and, when necessary, a lawyer who is well-informed about CAD.
Insurance companies commit a lot of time, money and effort to disprove a claim.
Winning CPP disability benefits does not guarantee approval from insurance companies. Just because an employee was successful with a CPP claim does not already prove that he or she is disabled. The CPP administration and the insurance company are two different entities. The latter would dedicate more resources toward finding negative information and evidence against a claim. This could happen even when the same facts and requirements were presented to both institutions. Thus, it is important to create a solid case for disability benefits. The guide above provides specific details on strengthening a claim, especially for long-term insurance.
Your benefits can be terminated without prior notice.
Keep in mind getting approved for benefits is only half the battle. Insurance companies will proceed to find reasons to terminate payments as soon as they get the opportunity. This could take years or just a few weeks. Be wary of any conditions that are stipulated in approvals and be diligent in fulfilling continuing disability reviews. There are insurance companies that become even more ruthless after approving a claim. They might require monthly medical reports or regular calls for updates. Those who have more resources might do undercover surveillance, like secretly videotaping the employee or monitoring his or her online activities. You may also have to participate in rehabilitation programs and counselling. Though these are ultimately for the benefit of the insurance companies, employees might as well take advantage of them so they can make the transition to going back to work.
Heart disease disability insurance claim denial: what to do next
You’ve diligently completed the necessary forms and gathered evidence, yet the letter arrives in your mailbox, informing you of the denial of disability benefits for heart disease.
Despite your urgent need for rest, you’re compelled to re-enter the workforce to provide for yourself and your loved ones.
This is undoubtedly a challenging time, a situation I’ve witnessed countless times with my clients. Being informed that your condition isn’t deemed worthy of financial assistance only amplifies the humiliation and frustration of your symptoms. Moreover, the necessity of returning to work can have profound repercussions on both your physical and mental well-being.
However, there’s a silver lining. You need not simply accept this harsh reality. Instead, you have the option to appeal the insurance company’s decision. With years of experience handling disability benefits claims, including numerous cases related to heart disease, I understand your struggle, and I’m confident in my ability to assist you. You have the power to challenge the denial of support you are rightfully entitled to under the law. Book a free consultation today.
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FAQs
Is heart failure a disability?
Yes, heart failure is a very serious condition that can qualify for disability benefits in Canada. However, in order to get approved for programs such as CPP disability or long-term disability, you must prove that the condition prevents you from working and meet all other qualifying criteria.
Does open heart surgery qualify for disability?
Open heart surgery is NOT a disability. However, it is a treatment for a condition that CAN qualify for disability. So, you can’t put heart surgery as a disability on your application. However, you could put whatever condition caused the surgery or the complications caused by the surgery.
Is a heart attack considered a disability?
Yes, a heart attack, also known as myocardial infarction, is a condition that can qualify for disability benefits. However, the event must render you unable to work if you want to qualify for programs such as CPP disability and long-term disability benefits. Other programs have different qualifying criteria.
Does congestive heart failure qualify for disability?
Yes, congestive heart failure is a serious condition that can qualify for disability benefits in Canada. To be approved for programs such as CPP disability or long-term disability, you must demonstrate that the condition prevents you from working and meet all other qualifying criteria outlined by the program.
