The two largest financial supports for workers who can no longer work due to injury or illness are workers’ compensation and long-term disability benefits. While they both try to help a worker during times of incapacitation, they deal with different systems, rules, eligibility requirements, and procedures. Understanding how these two important benefits interlink for individuals is important as they approach the complexities surrounding workplace-related injuries and illnesses.
Dispute Resolution and Legal Considerations
If either coordination of workers’ compensation with LTD benefits is disputed or the worker is being denied one of the other of these benefits, then legal advice will likely be warranted. A LTD lawyer specializing in workers’ compensation and disability law will be better equipped to advise the worker concerning his rights and regarding the appeal process, and will ensure both forms of compensation are being fairly paid. The workers’ compensation system operates under provincial legislation, while the LTD benefits are regulated according to the insurance contract involved, often including legal and contractual issues. A lawyer can further help in appealing denied benefits and making sure that all documentation is correctly submitted to prove a claim.
Workers’ Compensation Benefits
Workers’ compensation benefits are available under provincial and territorial programs. Examples include the Ontario Workplace Safety and Insurance Board and the Workers’ Compensation Board (WCB) available for other provinces. These programs assist injured or ill workers with their lost income from injury or disease contracted while in the workplace. Normally, these are tax-free and hence very attractive to injured employees. This means that they do not have to prove negligence or fault on the part of the employer since this operates under a no-fault system.
Long-Term Disability Benefits
Long-term disability benefits are usually given through private insurance policies, many times purchased by employers as part of their packages. LTD benefits replace income if the covered cannot work due to illnesses or injuries extending beyond the period of a short-term disability. The policy might provide that benefits are continued for several years or to retirement age. Unlike workers’ compensation, LTD benefits may be taxed, and the individual is usually subject to a medical examination requirement that affirmatively indicates they cannot work due to the disability.
Coordination and Overlapping Benefits
If a worker is entitled to workers’ compensation and LTD benefits, an interesting issue involves how these two streams of income should be coordinated. Sometimes the worker receives both benefits. For these cases, the total amount an employee is awarded may be adjusted so that the employee does not exceed 100 percent of pre-disability earnings. Which of these benefits are coordinated can be contracted within the employer’s LTD policy. The policy could indicate that LTD benefits are reduced by the workers’ compensation amount that a covered employee receives. This is to ensure that the employee is not overcompensated. Though the exact mechanism of reduction varies from jurisdiction to jurisdiction, as well as depending on the insurance provider, workers will want to pay close attention to their benefits package in terms of how these two types of compensation interact with one another or consult a lawyer.
Workers’ compensation and long-term disability benefits share the same purpose of giving workers who cannot work due to illness or injury some form of sustenance, but they are two different programs that have their own rules and eligibility criteria. The interaction between the two programs for benefits is quite complex, especially in those instances where a worker is entitled to both. That is where careful coordination must occur to ensure that overcompensation does not take place, and that workers understand how their benefits are controlled. If it is disputed or, for whatever reason, becomes confusing, seeking legal advice may allow workers to better navigate the situation and enforce all the benefits of the law.
