Multiple Sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. People with MS experience a wide array of symptoms, such as extreme fatigue, lack of coordination, weakness, tingling, impaired sensation, vision problems, bladder problems, cognitive impairment, mood changes, and more. These debilitating symptoms often make it hard for sufferers to work. As a result, many individuals with MS have to turn to disability benefits to help them cope with the life-long disease. However, winning disability benefits for Multiple Sclerosis is no easy task.
Despite the severity of the condition, there are several hurdles sufferers must face in order to get approved for benefits. This article discusses those unique challenges and gives a step-by-step guide on how to win disability benefits for MS.
Is MS a disability in Canada?
Yes, MS is considered a disability in Canada, and people with the condition can qualify for benefits from insurance companies and federal and provincial government programs. However, a diagnosis alone won’t guarantee approval. You must meet all the qualifying criteria, which can be difficult depending on the program.
For example, with CPP disability and long-term disability insurance benefits, claimants must prove their condition prevents them from working. Other programs, such as the disability tax credit, focus more on how a person’s disability affects their activities of daily living and don’t have any requirements surrounding their ability to work.
In this article, we will discuss how to win benefits for each disability program for MS in Canada.
Interested in learning about what other conditions qualify? Check out our article on what conditions qualify for disability in Canada or any of the articles linked below:
Disability from Multiple Sclerosis: You’re Not Alone
MS is a chronic neurological disease that attacks the central nervous system, which includes the spinal cord, the optic nerves, and the brain. It is three times more common in women than in men and typically first appears between the ages of 20 and 40 – when people traditionally first enter the workforce.
Shockingly, Canada has one of the highest rates of MS worldwide. According to current estimates, one in every 400 Canadians suffers from MS. Getting a definite diagnosis for MS is anything but simple and straightforward. To date, there isn’t a specific test that determines whether someone suffers from MS or not. More often than not, MS is only diagnosed once doctors have eliminated all other possible causes.
No two MS sufferers will experience the same symptoms. However, typical symptoms include impaired speech, blurred vision, dizziness, spasms and tremors. People with MS often also struggle with bladder and bowel dysfunctions and – in some cases – paralysis.
On top of these physical problems, MS patients often suffer from mental health conditions such as depression and will experience cognitive impairments such as problems with memory and thinking.
If you suffer from MS, you are probably already very well aware of these symptoms and the grave extent to which they can make it impossible to hold down a job and go to work every single day.
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Understanding your employment rights
Many people worry about losing their jobs because of Multiple Sclerosis (MS). Generally, employers in Canada can terminate employment, provided they give proper notice and do not do so for discriminatory reasons.
However, most employers will not fire employees who take sick leave. Under Canada’s human rights laws, employers are obligated to accommodate employees with medical conditions that affect their work. Allowing sick leave is considered a reasonable accommodation.
So, what are the MS Canada guidelines for working? If you need to go on sick leave, you must provide a doctor’s note confirming that you are unable to work and require leave. These notes should be updated regularly, typically every three to six months, to verify that you still cannot work.
If your application for sick leave is denied, you can remain on leave while you appeal the decision. Most employers will not challenge your leave as long as you have a doctor’s note.
If your employer attempts to fire you while you are on sick leave, you may have legal rights to severance pay. You might also be able to get the termination overturned if it is due to your condition. However, these situations can be complex, so it’s advisable to seek legal counsel.
Resolute Legal’s employment lawyers are here to assist you. Click on the button below to schedule a free consultation.
I have MS: What benefits am I entitled to?
If multiple sclerosis (MS) prevents you from working, you have a few options. You might be eligible for disability benefits from the government, your employer, or your insurer.
This list covers the possible MS disability benefits in Canada:
1. Disability tax credit (DTC)
2. Long-term disability insurance
3. CPP disability
4. Short-term disability insurance
5. Employment Insurance (EI) sickness benefits
6. Workers’ Compensation
7. Veterans Affairs Canada
8. Provincial disability benefits
Let’s go over each one to see if you qualify, and then we’ll explain how to apply and appeal a denial.
Disability Tax Credit (DTC) for MS
Does MS qualify for the disability tax credit in Canada? Yes, in Canada, people with MS can qualify for the disability tax credit. To qualify, you must have a severe and prolonged impairment, which this program defines more strictly than others.
Qualifying for this credit can refund some of your previous taxes, depending on your condition’s timeline. You apply by filling out a T2201 form and sending it to Revenue Canada.
If Revenue Canada denies your claim, you can request an internal appeal. If that appeal fails, you must go to the Tax Court of Canada to appeal again.
MS long-term disability insurance
Can you get multiple sclerosis long term disability? Yes, people with MS can be eligible for long-term (LTD) benefits. However, similar to other disability programs, providers don’t pay benefits based on a diagnosis alone. Instead, they approve claimants who can prove their condition is prolonged and prevents them from working.
The following is a brief overview of LTD in Canada so you can see if you qualify, as well as how to apply and appeal a denial.
As you might guess, long term disability benefits cover a longer period. If you win an LTD claim, payments can last for many years. Policies specify the duration, such as 2, 5, or 10 years, or until you reach a certain age, usually 65.
LTD payments often cover 50-67% of your monthly salary and are typically paid monthly. Most LTD benefits come from group plans or private policies.
Check if your company’s group medical plan includes LTD benefits. Union members often have LTD coverage in their medical plans. Self-employed or underinsured individuals can get LTD through private insurance policies, which may offer a fixed amount or a percentage of earnings.
Apply for LTD by submitting forms from you, your employer, and your doctor to the insurer. The insurer won’t decide until all forms are received.
You can appeal a denial, often through two or three internal appeals. Afterward, an LTD appeal hearing with an external judge may be necessary.
Looking for denied long term disability help? Contact our disability support team today to schedule a free consultation.
CPP disability for multiple sclerosis
Can I get CPP disability benefits for MS? Yes, people with MS can qualify for CPP disability benefits if they meet the program’s definition of disability. If you qualify, you can receive payments until age 65, ranging from $583.32 to $1,606.78 per month in 2024, based on your contributions.
To be eligible for the CPP disability benefits, you must have worked for four out of the past six years and paid payroll taxes. This can sometimes be difficult for MS patients, who might have worked part-time or taken short-term leaves in the past to cope with their illness.
You must also prove that your disability is “severe and prolonged.” Severe means you cannot regularly work a paying job, and prolonged means there’s little hope for improvement. This can be difficult when it comes to an illness such as MS, which often comes and goes in waves when it first appears in a patient.
You can receive LTD and CPP simultaneously, but the LTD insurer can offset your payments by the CPP amount. For instance, if you get $900 from CPP disability, your insurer can reduce its payment by $900.
Apply for CPP disability by filling out the CPP disability application form(s) and having your doctor or nurse practitioner complete the medical report. Submit your application to a designated Service Canada office.
If Service Canada denies your claim, you can appeal on two levels. First, request a reconsideration appeal within 90 days of denial. If denied again, appeal to the Social Security Tribunal within another 90 days. At the tribunal, a judge or a three-person panel will decide your claim.
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Short-Term Disability (STD) Insurance for MS
Short-term disability (STD) benefits provide temporary disability payments, usually 50-67% of your regular salary, for 15 to 17 weeks, sometimes longer. Short term disability in Canada payments are typically biweekly. Employers offer these benefits through company plans or group insurance policies, often managed by an outside agency.
You only qualify if your job includes a plan. If not, you might qualify for EI sickness benefits. If eligible for STD, you cannot claim EI benefits simultaneously.
Start the STD application process by requesting forms from your employer or insurer. The application includes forms for you, your doctor, and your employer. Submit all forms to the insurer for a decision.
If denied, request an internal appeal, where someone else in the company reviews your claim. You may have three or four appeal levels before needing an external judge or court appeal. Resolute Legal’s short term disability attorneys can help at this stage. Call us at (888) 480-9050 for a free case evaluation. Learn more in our article: reasons short-term disability can be denied.
Employment Insurance (EI) Sickness Benefits for MS
People with MS may be eligible for EI sickness, a temporary disability benefit from the federal government’s EI program, covering 55% of your salary for 15 weeks.
To qualify, you must have recently paid into the EI program through paycheque deductions. Apply for EI benefits online via Service Canada or at any Service Canada office. Your doctor must fill out a form confirming your inability to work for 15 weeks, and your employer must issue a Record of Employment (ROE) confirming your sick leave.
Note: If you qualify for short-term disability, you can’t claim EI benefits simultaneously.
Canada Disability Benefit (CDB) for MS
The new Canada Disability Benefit has yet to be released, so as of now, it’s unclear who will qualify or the application and appeals process. For updates, read our article: New Canada Disability Benefit.
Workers’ Compensation for MS
Workers’ Compensation Canada provides short- and long-term benefits for workplace injuries or illnesses. Each province has its own program, and not all employers are covered.
Proving that a workplace injury caused or worsened your MS can be difficult but possible. A doctor must support your claim that the injury or illness triggered or worsened your MS.
Workers’ compensation benefits Canada payments can overlap with EI, CPP, and short- and long-term disability. Seek legal advice for concerns about payments, as rules vary by province.
If denied, follow your province’s appeal procedures, usually involving internal reconsideration and an external tribunal, often called the Workers Compensation Appeals Tribunal (WCAT).
Veterans Affairs (VA) Disability for MS
Canadian Forces members or former members may qualify for short- or long-term disability benefits from Veterans Affairs Canada (VAC).
To claim MS-related VA disability, prove that a “service-related injury” caused or worsened your MS, supported by a doctor.
Apply online or with a paper form. The VAC will review your service medical records and request more information if needed.
Appeal denials are made through internal reconsideration, followed by the Veteran’s Review and Appeal Tribunal.
What are the chances of getting disability with MS?
No official data is available on conditions most likely to be approved for disability benefits, making it hard to determine approval odds for MS. However, as a disability law firm, we frequently represent clients with MS who have been denied benefits.
People with MS face many unique challenges in the disability claims process. The following is an overview of some of the challenges people may face throughout the application and appeal process.
1. The difficulties of the relapse/remission cycle of Multiple Sclerosis
As mentioned above, MS is often characterized by a cycle of relapse and remission, especially when it first emerges. Therefore, winning disability benefits can be very tricky when all you have is an early diagnosis.
You are looking to claim long-term benefits, but the early stages of MS often lead to a short-term disability, which disqualifies claimants from long-term payments. A person suffering from MS will often spend years on and off work until they make a final disability claim.
While this claim is perfectly justifiable, insurance companies will focus on this past pattern of leaving and returning to work and question why this time would be different and why they should now all of a sudden pay for long-term benefits.
It is, therefore, critical to document your illness diligently and have evidence to explain why this time is different.
2. Getting your doctors on board
Your doctors should be on your side, and they usually are – they want the best for you and your health.
The problem is that doctors can take a long time to get on board with supporting your claim.
This is often due to a misunderstanding. Doctors aren’t always aware of the criteria that are needed to win long-term disability benefits. It is, therefore, important to educate your doctor on what criteria you need to fulfill to be able to win benefits for multiple sclerosis and get the most out of their support.
3. Insurance companies and video surveillance
MS is known for its intense ups and downs; the severity of symptoms varies a lot, especially in the early stages of diagnosis. This can be a blessing and a curse at the same time.
When you are suffering from MS, worrying about how it might look when you are able to enjoy a good day without symptoms is probably the last thing on your mind. Unfortunately, disability insurance companies won’t be scared of taking advantage of this.
It is, in fact, very common for disability insurance companies to conduct video surveillance to obtain footage of the disability benefits claimant on a good day, when they are out and about being active – and use this to claim that they have proof that there is actually no disability in the first place and that the claimant does not have the right to disability benefits. It is shocking what lengths insurance companies will go to, but I have seen it all.
Insurance companies will take the video in secret and, at the same time, question the claimant over the phone about their condition. They do this to elicit statements from the claimant that can be viewed as inconsistent with what is seen on tape to undermine their disability benefits claim and get out of the payment. This is a very unusual challenge and a trick that anyone claiming disability benefits should be aware of to anticipate the possibility of video surveillance.
If you’ve been denied disability for MS, we highly recommend scheduling a free consultation with our team. We have helped hundreds of people with MS win back the benefits they deserve. Click on the button below to get started today!
How to win MS disability benefits in Canada
As discussed earlier, getting approved for disability benefits for MS is no easy task. So here are a few things you can do to improve your chances of winning disability benefits for MS.
Get a diagnosis
Securing a diagnosis of MS can be challenging. However, having a diagnosis will vastly improve your chances of winning disability benefits. Without one, you are significantly less likely to get approved. If you haven’t already, book an appointment with your doctor to start your journey to getting diagnosed.
Get the appropriate treatment and document it
When considering your claim, disability benefits providers will look to see if you received the appropriate treatment for your condition. Not getting the right treatment is one of the most common reasons people get denied.
This requirement covers all other conditions as well. For example, if you also have depression along with MS, you must get treatment for each condition. This can include medications, consultations with psychiatrists, or psychological treatments.
Make sure your doctor is accurately documenting all of this as well. At the end of the day, benefit providers base their decisions on the medical documents they have received. Even if you received world-class treatment for MS without the proper documentation, you received no treatment from the insurer’s standpoint.
Evidence of work-related limitations
You will also want to record all the ways in which you have modified your work habits in order to maintain employment while dealing with MS.
You should also try easier jobs within your workplace before you apply. Until you do, the disability benefits providers will always doubt you. You might show that while your job had medium duties on paper, your employer made accommodations to qualify your duties as light.
If you were forced to change jobs as a result of MS, make a note of that, too.
Being credibility is key
It is vital that a person seeking disability benefits for MS maintains a level of total honesty throughout the process. Credibility is intensely important when making a legal claim for disability benefits associated with MS. Any exaggerations or inconsistencies in descriptions of pain or disability can hurt credibility, even if the inconsistency is an honest mistake.
Things that hinder your creditability:
- Contradicting medical records or prior statements.
- Making excuses or blaming others for issues.
- Criticizing other parties involved in the claim, even if justified
- Filing complaints against professionals you view as negative or biased
- Using aggressive, sarcastic, or confrontational tones in your claim or testimony
- Blocking or delaying reasonable requests for information
- Arguing with doctors over your diagnosis instead of focusing on your disability
- Acting as if you are a medical expert
Things that boost your credibility:
- Ensure your statements align with your medical records
- Take responsibility for any errors or issues in your claim
- Be cooperative and respectful to everyone involved in the claim process
- Accept expert advice and opinions.
- Make genuine efforts to follow reasonable advice, even if you disagree
- Show clear efforts to continue working
Multiple sclerosis disability insurance claim denial: what to do next
You’ve filled out the forms, and you’ve compiled as much evidence as you could get – and yet, the insurance company sends you a letter stating multiple sclerosis disability denied.
This is a difficult time; I am well aware of that – I’ve seen it over and over again with my clients. A rejection letter can feel like a slap in the face, especially if you have in the past always pushed yourself hard to be able to go back to work after a period of relapse and are now physically unable to do so anymore, deciding to apply for long-term benefits finally. A denial can feel like your symptoms are not taken seriously and often adds considerable stress and pressure on top of the physical and cognitive symptoms of MS.
The good news is that you don’t have to accept that your rightful claims have been denied. You can appeal the insurance company’s decision; in most cases, you absolutely should. I have years of experience with disability benefits claims and a lot of experience with disability claims for MS specifically. More than that, I know what you are going through and am confident I can help you. You don’t have to let insurance companies get away with denying you the support you are entitled to by law.
If you would like to learn about alternatives if your claim is denied and inform yourself about the appeal process, you can look at my books, which you can order for free to help you consider all your options.
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