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Winning Disability Benefits for Visual Disorders in Canada

Posted by
David Brannen
on March 24, 2018
Applying for disability benefits for visual disorders is an uphill battle, especially because benefits providers sometimes do not recognize the seriousness of vision loss as a medical condition.


But unless you are suffering from total blindness, then you may still seem to be fit to work and is able to properly function in daily life.

Visual impairment is sometimes preventable and easily curable, although when ignored, it could lead to a significant and permanent loss of vision. The disability can also lead to decreased productivity with economic costs to the employer. So, seeking disability benefits is a practical option, even though it is not the easiest.

This article will discuss the unique challenges of applying for disability benefits for visual disorders in Canada. It will also provide tips and steps to take in order to ensure a well-deserved win. This article is part of our series looking at medical conditions and disability benefits. 


Disability from Visual Disorders: You are Not Alone


Visual impairment is the loss of the ability to see to a certain degree. This can affect either visual acuity or the visual field. The former pertains to the clarity of vision in which perfect eyesight is usually referred to as 20/20 vision.

The latter is the area of a person's surroundings that can be seen, which includes the central vision and peripheral vision. Individuals who exhibit a loss in one or both of these abilities are most likely suffering from a visual disorder.

Take note that "blindness" is the term used for almost complete or complete loss of vision. Though it is the most commonly accepted form of visual disability, other types of visual impairment also have disabling effects.


Common Causes of Vision Loss


Uncorrected Refractive Errors


A refractive error occurs when abnormalities in the eye make it unable to correctly focus light. It is the most common reason for the loss of visual acuity. There are different types of refractive errors including myopia (short-sightedness), hyperopia (far-sightedness), presbyopia and astigmatism. These conditions are frequently hereditary or caused by environmental factors. Refractive errors can be managed through the use of eyeglasses or contact lenses. For more severe cases, refractive surgery might be advised.

 

Cataracts


Cataracts are another major cause of visual impairment. A cataract is a clouding of the lens of the eye, and this leads to poor vision. They are usually a natural occurrence as one ages, but they could also be due to exposure to radiation or sunlight, trauma to the eye, genetics, medications, substance abuse and diabetes. The condition can be treated by wearing eyeglasses or through surgery on the cloudy lens.

 

Glaucoma


Glaucoma is caused by pressure inside the eye, which damages the optic nerve and leads to loss of vision. The different types of glaucoma are open-angle glaucoma, closed-angle glaucoma, and normal-tension glaucoma. They are diagnosed according to the kind of symptoms exhibited by the patient. Those who are at risk for glaucoma would usually have a family history of the condition including high blood pressure, obesity, and migraines. Treatments for glaucoma include medication, laser, and surgery. These solutions are temporary as a cure for glaucoma does not exist yet.


Age-Related Macular Degeneration


Age-related macular degeneration or ARMD affects over a million Canadians. This condition leads to blurry or lack of sight in the central field of vision. It occurs in mature individuals and progresses as one ages. ARMD is the degeneration of the macula in the retina, which is responsible for clear and sharp central vision. It can either be wet (neovascular) or dry (non-neovascular). In wet ARMD, blood and fluids leak out of blood vessels behind the retina causing damage to the retinal cells. On the other hand, dry ARMD manifests as deteriorating tissue that look like yellow spots surrounding the macula. Treatments for macular degeneration involve slowing down the degenerative process through medication.


Eye Injuries


Eye injuries are common among people under 30 years of age. The injury could directly affect the eye itself or the optic nerve that sends signals from the eye to the brain. Injuries to the brain, specifically to the occipital lobe, hinders the brain from correctly interpreting signals from the optic nerve. This type of visual impairment is called cortical blindness and can be brought about by stress or fatigue.


Types of Disability Benefits Available in Canada for Visual Disorders


There are two sources of disability benefits for Canadian workers with visual disorders: the Canada Pension Plan and Long-term Disability Insurance Benefits.


Canada Pension Plan Disability Benefits for Vision Disorders


The Canada Pension Plan or CPP is the retirement pension program of the Federal Government of Canada. It is mandatory for employers to deduct contributions from the salary of their workers for the CPP. Aside from retirement benefits, there are also other benefits payable under the program including disability benefits for workers who become disabled before the retirement age of 60 or 65 years old.

To qualify for disability benefits, you must be a recent contributor to the CPP with contributions in four of the last six years or three of the last six years for those who have contributed for at least 25 years. You must also have a disability that is both “severe and prolonged.” A severe disability makes it difficult for an individual to pursue any gainful occupation. A prolonged disability is a long-term debilitating condition that could worsen and even result in death when left untreated.

The burden of proof of the disability, its severity and persistence is always on you and should clearly be seen in your application to be considered for benefits. The agency in charge of approving and denying applications for disability benefits is Service Canada under the Department of Employment and Social Development. Appeals for claims that were denied can later be made to the Social Security Tribunal.

Workers who are seeking approval of their CPP disability benefits claims can try two approaches. A significant majority of claimants would opt for the bare minimum approach. Though popular, this method is also highly ineffective and usually leads to disappointment. To avoid delays and denials in the approval of a claim, it is better to use the Blueprint Strategy, which maximizes the chances of success by presenting a more persuasive story and including relevant documents and information in the application.

CPP Disability Blueprint Ad

 

Long-term Disability Insurance Benefits for Visual Disorders


Insurance-based disability plans are another type of benefits program available to Canadians. Such an insurance policy is usually part of an employee benefits package with the employee being insured as part of a group and the employer as a sponsor. This is different from individual disability policies that are available to self-employed professionals.

Most kinds of insurance policies protect individuals from the risk of accidentally losing their ability to work. Long-term disability insurance benefits can be claimed when a worker is suddenly unable to work due to a disability. An employee becomes eligible to receive monthly income payments in the event of long absences from work. These payments can be a specified monthly amount, a percentage of the employee’s monthly salary, or a combined computation of both. The amount, maximum period for receiving benefits and other terms should be indicated in the insurance policy.

Most workers find it more challenging to claim disability benefits from insurance companies than from the CPP. This is because private companies have a lot of resources to commit to disproving a claim. Furthermore, getting a benefits claim approved by the CPP does not guarantee an approval from insurance companies, even when the claimant is legitimately disabled.

This is why it is important to not simply prepare a <i>bare minimum claim</i>. Similar to claiming CPP disability benefits, doing the bare minimum will most likely result in a denial. Insurance companies are faced every day with applications that are technically complete and legal. To stand out from the other claimants, it is better to prepare a <i>winning claim</i> that is more comprehensive and convincing.


Order the Disability Insurance Book

 

Challenges to Winning Disability Benefits for Visual Disorders


1. Documenting visual impairment


Visual limitations or deficits must be well-documented in the claimant's application. This is necessary in order to prove the worker's visual disability and whether he or she qualifies for benefits under the terms of the benefits provider. These include medical documentation such as visual acuity and visual field tests. A qualified eye care professional such as an optometrist, ophthalmologist or optician would be able to provide these records.

 

2. Testing for vision loss


Blurry vision is not necessarily a visual impairment as defined by benefits providers. It is critical for workers to have eye tests done by an eye doctor to establish the best possible "corrected" visual acuity. A Snellen chart or eye chart and the random E test are often used to measure visual acuity. In Canada, a patient must have a vision that is no greater than 20/200 in his or her better eye to qualify as having a visual disorder. Such an eye test result is already classified by the World Health Organization as "severe."


3. Irregularities in the definition of "legally blind"


Insurance companies will fight over what it means for a worker to be legally blind. But internationally, it is defined as a decreased central visual acuity of 20/200 in the better eye (as explained in the previous section) in addition to a limited visual field of no greater than 20 degrees in the better eye (also known as "tunnel vision"). However, benefits providers might look for results that are closer to the widely-accepted definition of blindness, which is a visual acuity that is less than 20/500 and visual field that is less than ten degrees. Some providers might also only consider the visual acuity measurement of a person while he or she is wearing corrective lenses. So to be legally blind, a claimant should have 20/200 visual acuity in the better eye with eyeglasses or contact lenses on.


Winning and Keeping Your Benefits


Challenges do not end once a benefits claim has been approved. It is also very common for insurance companies to terminate benefits payments even before the agreed period. For some workers, this could occur within a month of receiving benefits.

Thus, it is important to take note of any accommodations that must be done in order to keep the insurance company satisfied. These conditions include continuing disability reviews like monthly update reports or joining rehabilitation programs. On the surface, these might seem like innocent standard procedures, but they also offer opportunities for insurance companies to find reasons to deny future benefits.

Claiming for benefits for any type of disability can be a long and demanding process, but winning is possible especially when an application goes beyond doing the “bare minimum.”

Still Feeling Unsure About Your Disability Claim? Sometimes a quick call with us can answer your concerns and help you move forward with confidence. Call us now at 888-732-0470 for a free consultation or click here to request a free consultation.

Tags: Disabling Medical Conditions

David Brannen
Founder & Managing Lawyer, Resolute Legal
David is a former occupational therapist turned disability lawyer. He is the founder of Resolute Legal and author of A Beginner's Guide to Disability Insurance Claims in Canada and The Beginner's Guide to CPP Disability.