I wrote Depression Disability Benefits: The Ultimate Guide for 2022 for people who need to win or maintain disability benefits for depression.
This guide is based on my 25 years experience as a former occupational therapist and now disability lawyer. This guide is meant to give you an overview of the types of benefits you may qualify for and the challenges you will face.
Because you are reading this guide, I know you are on the right path. Educating yourself is the single most important thing you can do to improve your chances of success with any disability claim.
Keep on learning and I wish you all the best with your journey,
— David Brannen, disability lawyer & founder, Resolute Legal
- Is Depression a Disability in Canada?
- Depression: A Conceptualization
- Employment and Disability Rights for Depression
- Types of Disability Benefits for Depression
- How to Prove a Depression Disability Claim
- Common Reasons for Denial of Depression Disability Claims
- Final Thoughts
- Take the Next Step – Download our Free Books
Is Depression a Disability in Canada?
Yes. All disability benefits providers in Canada recognize depression as a disability. It’s a condition that can qualify for benefits.
However, a diagnosis on its own won’t qualify you.
Providers pay benefits to people who can prove their conditions keep them from working. When reviewing claims for depression, providers focus on the seriousness of your symptoms. They will consider the medical treatment you’ve had and future treatment plans. They look at how your symptoms affect your work and how hard you tried to keep working.
You must have all of this documented in medical records or other paperwork with your claim.
If you are interested in finding out what other medical conditions qualify for benefits, check out our article on Medical Conditions that Qualify for Disability Benefits.
Depression: A Conceptualization
Major depressive disorder, commonly known as depression, is a mood disorder associated with ongoing and persistent feelings of sadness and loss of interest. Depression is estimated to affect 5.4% of Canadians; however, many experts predict that number is much higher.
While symptoms of depression vary for each person. The most common symptoms are:
- Depressed mood
- Feelings of guilt, worthlessness, helplessness or hopelessness
- Loss of interest or pleasure in usually-enjoyed activities
- Change in weight or appetite
- Sleep disturbances
- Decreased energy or fatigue (without significant physical exertion)
- Thoughts of death
- Poor concentration or difficulty making decisions
Depression prevalence in disability claims
According to a 2019 study by Sunlife, mental health is by far the most common long-term disability claim. The study found that 30% of all long-term disability claims are mental health-related. This is more than the next two common causes combined with cancer at 15% and accidents at 12%.
And, of that 30%, depression accounts for more than 50% of all mental health claims. So, if you are struggling with depression, know that you are not alone. It is one of the most common reasons for going on long-term disability.
Even though depression makes up a large proportion of disability claims in Canada, it can be hard to prove to insurance companies. Unlike other illnesses such as cancer or multiple sclerosis, insurers can’t physically see the pain you are in.
We created this guide to help you prove to your insurance provider that you require disability benefits just as much as a person suffering from a visible illness or injury does.
Let’s dive in!
Employment and Disability Rights for Depression
Many people worry about losing their jobs because of depression. As a general rule, employers can fire anyone as long as they give proper notice and don’t do it for a discriminatory reason.
However, most employers won’t fire workers who need sick leaves. Under Canada’s human rights laws, employers have a duty to help employees with medical conditions that affect their work. Allowing sick leave is a reasonable accommodation that employers should give.
To take a sick leave, you’ll need to provide a doctor’s note. It should confirm that you can’t work and need the leave. You’ll need to bring these notes often — every three to six months — to confirm that you still can’t work.
If your application gets denied, you can stay on sick leave while you appeal. Most employers won’t mind, as long as you have a doctor’s note.
If your employer attempts to fire you while you’re on sick leave, then you may have legal rights to severance pay. You might even be able to get the termination overturned if it was done because of your condition. However, these situations are complicated. You should always get legal advice.
To learn more, go check out our page on disability and employment rights.
Types of Disability Benefits for Depression
If you become unable to work because of depression, 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 options for depression disability benefits in Canada:
- Employment Insurance (EI) sickness benefits
- Short-term disability insurance
- Long-term disability insurance
- CPP disability
- Workers compensation
- Veterans Affairs Canada
- Provincial disability benefits
- Disability tax credit
Let’s go over each so you can find out if you qualify. As well as how to apply, and how to appeal if they deny your claim.
Employment Insurance (EI) sickness benefits
EI sickness benefits are a temporary disability benefit. They are paid through the federal government’s employment insurance (EI) program. EI pays 55% of your salary for 15 weeks.
To qualify, you must have paid into the EI program recently. You pay through deductions from your paycheque. These are automatic. So, if you got an official paycheque, you paid into the EI program.
You apply for EI benefits online through Service Canada. You can apply from home or at any Service Canada office. Your doctor needs to fill out a form to confirm that you can’t work for the 15 weeks that EI covers. And finally, your employer will need to issue a Record of Employment (ROE) to confirm your sick leave.
Please note: If you qualify for short-term disability, then you can’t claim EI benefits at the same time.
You can learn more about EI by visiting our article on the EI sickness benefits program.
Short-term disability (STD) benefits
Short-term disability (STD) benefits are another temporary disability payment. They pay 50-67% of your regular salary. You can usually get them for 15-17 weeks, but sometimes longer. You’ll typically receive payments every two weeks.
Employers offer these benefits either through the company or a group insurance policy. In both cases, employers hire an outside agency to run the program on their behalf.
You only qualify if you have a plan through your job. Not all employers offer this to their employees. If your employer doesn’t, you might be able to get EI sickness.
As I said before, if you qualify for STD, then you won’t qualify for EI. If you can get STD payments, you have to apply for those instead of EI.
You apply by getting the forms from your employer or the insurance company. The application includes three forms. There is one for you, one for your doctor, and one for your employer. It’s up to you to get all the forms back to the insurer.
If your application gets denied, you can ask for a review. This is called an internal appeal. During the appeal, your claim gets reviewed by someone else in the company. You can have three or four of these appeals. After that, you may have to appeal to an outside judge or file with the courts. Your options will depend on your situation.
Long-term disability benefits
As you may guess, long-term disability (LTD) benefits pay for a longer period of time. If you win a claim for LTD, the payments can last for many years. A policy will specify that the benefits last a number of years — 2, 5, or 10, for example. Or, they last until you reach a certain age — usually 65.
LTD payments often cover 50-67% of your monthly salary. They are paid once a month rather than every two weeks. Like STD benefits, most LTD benefits come from group plans or private policies.
If your company offers a group medical plan, then check it for LTD benefits. If you’re in a union, your medical plan will likely include LTD.
You can also get them through private insurance policies if you’re self-employed or underinsured. With private policies, the payment is usually a fixed amount, but sometimes it’s a percentage of your earnings.
You apply for LTD by filling out forms and sending them to the insurer. Once again, you’ll probably have three forms. There should be one for you, your employer, and your doctor. And again, it’s your job to submit them. You won’t get a decision until the insurer gets all the forms.
You can appeal a denial, just as with an STD claim. Your LTD plan may allow two to three internal appeals. After, you’d need to do an appeal hearing with an outside judge — or a lawsuit.
For more information check out our Ultimate Guide to Long-Term Disability Benefits.
CPP disability benefits
CPP benefits cover permanent disability. If you qualify, then you can get paid until age 65. Currently, payments range from $524.64 to $1,457.45 per month. The amount is based on how much you paid into the program. The more you contribute, the more you’ll get back. Just like with EI, if you had a job with a paycheque, then you paid into CPP.
To qualify for CPP disability, you must have the right amount of credits. You can get credits by credit splitting with a former spouse or paying into another country’s pension plan. Or, you can qualify for credits if you left work to raise a child.
You can get LTD and CPP at the same time. The LTD insurer usually has the right to offset your payments by the same amount, however. For example, if you get $900 from CPP disability, your insurer can reduce its payment by $900 for the same month.
Even with enough credits, you still need to prove that your disability is “severe and prolonged.” A severe disability prevents you from regularly working a paying job. A prolonged disability has little hope for improvement.
You apply for CPP disability by filling out the forms. Your doctor or nurse practitioner will have to fill out the medical report. Then, you send your application to the designated Service Canada office for your province.
If Service Canada denies your claim, you can appeal on two levels. The first is a reconsideration appeal. You must request this appeal within 90 days of denial. If denied again, then you appeal to the Social Security Tribunal. The deadline is 90 days as well.
At the tribunal, a judge or a three-person panel will decide your claim. You can attend the hearing to give evidence and answer questions.
Workers’ compensation benefits for depression
Workers’ compensation pays short- and long-term benefits to people injured on the job.
Each province has its own program. To qualify, you must have suffered an injury at work. Also, your employer must be covered — not all jobs are.
It’s difficult — but possible — to prove a workplace injury caused or worsened your depression.
Historically, worker’s compensation programs only considered mental health claims that came from a single workplace incident. They wouldn’t recognize situations of chronic workplace stress caused over time.
This is changing, however. In January 2018, WSIB in Ontario implemented a new policy to allow claims for “chronic mental stress” caused by their work. This policy isn’t adopted by all workers’ compensation programs in Canada. Check with the program in your province to see if benefits are available.
To succeed in this claim, you need a doctor to support your belief that the workplace injury triggered the depression or made it permanently worse. You’ll need to have a diagnosis of depression or related mental illness. You will need to prove the specific workplace conditions or events that caused the depression. Workplace harassment and bullying are two common reasons. The workers’ compensation program will have to independently verify these events from your employer or coworkers.
Workers’ compensation payments overlap with EI, CPP, and short- and long-term disability. This can get complicated, so you should seek legal advice for any concerns about payments. Depending on your province, you may keep some (or all) of your CPP disability as well as the workers’ comp.
If workers’ compensation denies your claim, you must follow the appeal procedures for your province. These programs also have two levels of appeal: the internal reconsideration and the outside tribunal. In most provinces, this tribunal is called the Workers Compensation Appeals Tribunal (WCAT).
Veterans Affairs Canada
If you’re a member or former member of the Canadian Forces, then you may qualify for short- or long-term disability benefits from Veterans Affairs Canada (VAC).
To qualify, you need to prove that a “service-related injury” caused or worsened your depression. You’ll also need a doctor to confirm it.
You apply for VAC disability through the VAC either online or with a paper form. The VAC will review your service medical records and request more information if necessary.
The VAC follows a familiar pattern for appealing denials: internal reconsideration, then the Veteran’s Review and Appeal Tribunal.
Provincial income support benefits for depression
Each province in Canada pays income support benefits to people who can’t work because of disability. If you qualify, you can receive fixed payments for life.
You can qualify for provincial benefits even if you’ve never worked. However, they only apply if your total family income falls below a certain amount. That amount differs from province to province. Family income doesn’t affect the approval process for other types of disability benefits.
You apply for provincial disability benefits by applying through your provincial agency or program. As usual, your doctor will need to provide a report or certificate that confirms you can’t work because of your condition.
If you get denied, you can appeal internally within the agency or program. In some provinces, you can also appeal to an outside tribunal for a final decision. Check with your province for the proper procedures.
Disability tax credit for depression
The disability tax credit is a type of benefit that lowers your taxable income. To qualify, you must have a severe and prolonged impairment as defined by the program. But, this program has a higher standard than others.
Qualifying for this credit can get some of your previous taxes refunded. It depends on the timeline of your condition. 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, then you must go to the Tax Court of Canada to appeal again.
How to Prove a Depression Disability Claim
Because depression is largely an invisible illness, doctors can’t verify the seriousness of your symptoms. You will have trouble getting approved for benefits.
No one but you can say how serious your condition is. Disability benefits providers may view your claims with skepticism. After all, you could exaggerate or lie to appear more disabled than you are.
Many people with depression can manage their symptoms and continue working. So, you need to focus on proving that your case is different. Let’s go over how to do that.
Appropriate medical diagnosis
While an official diagnosis alone is not enough, you still need to have one. It must meet the criteria for depression from the Diagnosis and Statistical Manual for Mental Disorders (DSM).
We sometimes see doctors call the condition “burn out” or “stress,” but these aren’t acceptable diagnoses for a disability claim.
Your doctor must show a detailed medical history, as well as the steps taken to rule out other possible conditions. Unfortunately, some doctors will give a depression diagnosis without following the right steps. When this happens, the insurance company will dispute the diagnosis or question the treatment.
Because depression often occurs with other medical conditions, such as chronic pain, fibromyalgia, anxiety, or chronic fatigue syndrome, having these other conditions diagnosed can help because it shifts the focus beyond depression.
When considering your claim, the disability benefits providers will look to see if you received appropriate treatment. Not getting appropriate treatment is one of the most common reasons for denial.
Not getting proper treatment can happen for two reasons: either your doctor didn’t follow accepted standards for treatment, or you didn’t accept treatment. Even if you and your doctor believe that alternative methods may work better, you have to try the standard treatments to qualify for disability benefits. Otherwise, you leave the door open for someone to say that you could work if you had the right treatment.
Documented treatment plan
The lack of a well-documented treatment plan is another common reason for a denial of depression disability benefits. Your doctor may have a plan, but if it isn’t documented and communicated to the insurance company, then it’s the same as no plan. Insurance companies will never approve disability benefits for depression when there is no documented plan that follows best practices.
Sometimes you can’t get appropriate treatment because you’re waiting for an appointment with a psychiatrist or psychologist. In these situations, you can still be approved for disability benefits if your doctor has a well-documented treatment plan. The plan should include the fact that you’re waiting for a consultation with other specialists. It must also show that you’re doing all other recommended treatments in the meantime.
Medications and side effects
Serious medications make a serious medical condition more believable. So, you must try all the recommended medications even if you fear the side effects.
If you’re not taking antidepressants, then the insurance company will think your symptoms aren’t serious enough to qualify for disability benefits. It’s common for doctors to have you try multiple medications and different dosages to find the right treatment. So, if you have a bad reaction to one medication, you can’t refuse the troubleshooting that follows. You have to try all other medications or changing your dosage.
If you have bad reactions to your medications, your medical records must report that in detail. And, if your doctor recommended against a medication, you need to have it documented that the side effects were worse than the condition. Again, you run the risk of denial if you stray from standard treatments without a good reason.
Evidence of work-related limitations
With an invisible illness like depression, disability benefits providers place great emphasis on how hard you tried to stay at work.
The most common reason for a denial of benefits is “You didn’t try.” Unfortunately, this is also very difficult to beat.
So, you must go well beyond saying you can’t do your job. You need to show that you asked for help from your employer to stay at work. Such changes could include fewer hours, easier duties, or changing roles within the company. If your job was medium or heavy work, then you have to try an easier job with light or sedentary duties.
You need to give evidence to show how hard you tried to stay at work. This evidence can include:
- Medical records discussing your work attempts
- Employment records that show places you tried to work and all accommodations made
- A written statement from you that details your work efforts
- Signed written statements from your employer or co-workers describing how they observed your struggle to work
If you give strong evidence that shows you tried your best to stay at work, then you have a good chance of winning benefits. On the other hand, if you have little evidence of your efforts, or evidence that you made no effort, then you have no chance of approval.
Medical and employment documents will give you some of the best support for your claim, but the decision-makers need to believe you, too. In legal settings, credibility refers to a person’s trustworthiness or believability.
A decision-maker who finds you trustworthy may rule in your favour — even if you have weak evidence for your claim. And a decision-maker who doesn’t trust you won’t give you the benefit of the doubt in uncertain areas, even with good evidence. Being credible gives you an invisible edge that many people overlook.
- Contradicting medical records or earlier statements
- Making excuses or blaming others for problems
- Criticizing other parties in the claim (even if they deserve it)
- Filing complaints against professionals you see as negative, biased, or unprofessional
- Using aggressive, sarcastic, or confrontational tones in your claim or testimony
- Blocking or stalling reasonable requests for information
- Fighting with doctors over your diagnosis instead of focusing on the disability
- Acting like a medical expert
- Making sure what you say matches the medical records
- Taking responsibility for bad facts or problems with your claim; not blaming others
- Being cooperative and respectful of everyone in the claim
- Accepting expert advice and opinions
- Making good faith efforts to try all reasonable advice, even if you disagree with it
- Obvious efforts to keep working
Common Reasons for Denial of Depression Disability Claims
The following are the most common reasons an insurance company will deny disability benefits for depression.
Insufficient objective evidence of disability
Although insurers often cite “insufficient objective evidence of disability” to deny claims, this reason doesn’t work with depression. Modern medicine has yet to find objective evidence for depression.
If you receive this as a reason, you should address it in your appeal letter. Fortunately, objective evidence is not a requirement under plans and programs.
Your letter should then focus on how your doctor followed best practices for diagnosis and treatment. Mention how you adhered to the recommended treatment faithfully. You should also emphasize all the things you’ve done to keep working. These aspects can make up for a lack of objective evidence.
If you got the right treatment, then you wouldn’t be disabled, right? This reason for denial shifts the blame to you or your doctor. It supposes either your doctor offered the wrong treatment or you refused the right treatment. This is the most common reason for denial of disability benefits for depression.
The insurers look for examples of your doctor not following best practices. They want to make sure your doctor explores all options. This includes changing your dose or finding other medications to try. It’s especially bad if there’s evidence that you refused to take medications or stopped without your doctor’s advice.
If you refuse to attend cognitive behavioural treatment (CBT) or similar treatments, you might get denied disability benefits. This can happen if your doctor doesn’t recommend it when it would be appropriate to do so. It can also happen if CBT was recommended and you refuse to attend or drop out against your doctor’s advice.
Correct treatment, but no documentation
Insurance companies will deny many claims because of a lack of medical documentation. So, even if your doctor follows best practices and you follow their advice — if it isn’t recorded, it’s like it never happened.
It’s common in cases of depression for the insurance company to ask for your doctor’s clinical records. They do this to see if the doctor is following best practices — adjusting medication and making appropriate recommendations. If the doctor’s medical file doesn’t document what’s happening, then the insurance company will deny your claim.
Toxic work environment
The insurer may deny your claim on the grounds you have a toxic work environment. The reasoning here is that you can’t work because of the environment. If these issues were resolved, you could return to work. Therefore, this is a human resources problem for your employer — not a situation where you would qualify for disability benefits.
Your disability benefits cover you if you can’t do the duties of your job. This goes for any job — not just your current one. Therefore, if the insurer finds that a toxic work situation is the only reason you can’t work, then they can deny you. They will say that you can perform the duties of your occupation in general. In this case, the only barrier to employment is the environment.
Depression can result in severe disability. Many people with depression gradually lose the ability to work over several years. So, even if you’ve only been diagnosed recently — don’t wait. Get started on confirming your eligibility for all of these programs, just in case.
Each program has its own rules to follow. If your claim gets denied, don’t give up. It happens a lot for depression claims. You can always appeal a denial.
Winning disability benefits for depression is difficult — but not impossible. You’ll face challenges because you can’t prove beyond the shadow of a doubt how serious your condition is. To maximize your chance of success, make sure your doctor follows all best practices for depression diagnosis and treatment. Cooperate with all treatment recommendations and do your best to keep working.
If you can show you tried everything and did everything you could do, then you have a much better chance of success. Remember, your credibility counts more than you might think.
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