One of the most common questions we get is: “what are the medical conditions that qualify for disability benefits?”
If you plan to apply for disability benefits, the optimal strategy for success includes consideration of your specific disabling medical condition. This is because the type of medical condition will inform the type of evidence, testing, reports, and medical documents you need to present to have your claim approved.
Some medical conditions can be controversial or politically charged. Therefore, each case is unique and you must develop a custom game plan to maximize your chances success. Below we cover the key issues related to medical conditions and disability benefits.
List of medical conditions that qualify for disability benefits in Canada
Following is a list of medical conditions that will qualify for disability benefits:
- Back Problems & Conditions
- Bipolar Mood Disorder
- Carpel Tunnel Syndrome
- Chronic Fatigue Syndrome
- Chronic Pain
- Complex Regional Pain Syndrome
- Crohn’s Disease
- Heart Disease
- Headache and Migraine
- Irritable Bowel Syndrome (IBS)
- Knee Disorders
- Lyme Disease
- Multiple Sclerosis
- Neck and Cervical Disorders
- Psoriatic Arthritis
- Sleep Disorders
- Vestibular Disorders
- Visual Disorders
Proving disability for a medical condition
Establishing you have a certain medical condition or diagnosis is not enough to win approval for short- or long-term disability benefits. Disability benefits claims are approved based on impairment with work capacity. In other words, proving you have a medical diagnosis is not enough, you must prove that the symptoms or limitations associated with that medical condition are sufficient to prevent you from performing the duties of your job. It is possible to win approval of disability benefits if you can prove impairment, but not have a definitive medical diagnosis or cause of the impairment.
While having a diagnosis or medical condition will not – in and of itself – result in an approval of disability benefits it is still an important consideration in any claim for disability benefits. Insurance companies will only approve and pay disability benefits if they believe you are getting proper treatment for your medical condition. Therefore, have a medical diagnosis is important because it dictates your treatment plan. You must be receiving reasonable treatment based on your medical condition and diagnosis or the insurance company will deny your claim or stop payment of benefits.
While technically not required for approval of disability benefits, the lack of a diagnosis will cause problems because the insurance company may question your treatment plan as being insufficient. A lack of medical diagnosis also opens the door for the insurance company to imply that you are malingering or exaggerating symptoms because you are lazy, don’t want to work or have taken on a disability role to gain attention from others.