Applying for disability benefits for sleep disorders might be the only option left for you if your condition is negatively affecting your ability to do your job.
You might experience difficulty staying focused throughout the day or find it a challenge to wake up in the morning. Some employers understand that sleep disorders are legitimate medical conditions and give their employees nap breaks or more flexible work hours. However, you might not be that fortunate, so it is best to know what benefits are available to you.
Winning disability benefits for any condition is not easy, but it is possible. This article will discuss how you can apply for benefits for sleep disorders in Canada and the tried-and-tested techniques that will increase your chances of success. This article is part of our series looking at medical conditions and disability benefits.
Disability from Sleep Disorders: You are Not Alone
A majority of the population have suffered from irregular sleep patterns and behaviours at some point in their lives. These sleep disorders become a disability when they hinder the normal daily functioning of an individual and severely affect their mental, physical and emotional health.
Sleep disorders can be classified into four categories: insomnia, hypersomnia, parasomnia and circadian rhythm sleep disorder (CRSD).
Insomnia or the lack of sleep is often related to either a mental disorder like anxiety, stress or depression, or a health condition like heart disease, diabetes or brain injury. The use of drugs, type of diet and hormonal shifts can also cause individuals to have difficulty sleeping. A person suffering from insomnia would find himself unable to fall asleep or stay asleep. Taking sleeping pills is a common treatment for insomnia, but pills can worsen the condition in the long run.
Hypersomnia or excessive sleep has several types. The most commonly known is narcolepsy, which is a condition that causes individuals to uncontrollably fall asleep. These sleep attacks occur throughout the day even when the person is busy with a task. Narcolepsy is sometimes accompanied by cataplexy or a weakness of the muscles. So, narcoleptics often injure themselves at work, especially when engaged in a risky activity like driving or operating heavy machinery.
Parasomnias are abnormal behaviours that occur during the different stages of sleep. They can either be non-rapid eye movement (NREM) or rapid eye movement (REM) parasomnias. The first type occurs between the patient’s waking and NREM sleep states. Specific disorders include teeth grinding (bruxism), sleepwalking (somnambulism), sleep apnea (disordered breathing, e.g., snoring) and restless legs syndrome (RLS). The second type occurs between the patient’s waking and REM sleep states. Specific disorders include sleep paralysis, catathrenia and REM sleep behaviour disorder (RBD). Those suffering from parasomnias have no control over what they are doing while they are sleeping. They are prone to harming themselves and others – with extreme cases resulting in crime and death.
Circadian Rhythm Sleep Disorder
Circadian rhythm sleep disorders (CRSD) affect the timing of an individual’s sleep. People suffering from such conditions are unable to maintain a regular sleep-wake schedule. Their irregular body clock makes it difficult to attend school or go to work at the required times. Shift work sleep disorder is common among people who work rotating or night shifts. Advanced sleep phase disorder (ASPD) is characterized by trouble staying awake at night and staying asleep in the morning. Delayed sleep phase disorder (DSPD) is characterized by peak alertness at night and the delayed onset of sleep.
Types of disability benefits for sleep disorders in Canada
There are two sources of disability benefits for Canadian workers with sleep disorders: the Canada Pension Plan and Long-Term Disability Insurance Benefits.
CPP disability benefits for sleep disorders
The Canada Pension Plan (CPP) is the pension program of the Federal Government of Canada. If you are working in Canada, then it is highly likely that you are part of the CPP, because it is mandatory for all employees. By law, every employer is required to deduct contributions from the salary of their workers. While most people know that it is the source of retirement pension from the government, you can also get other benefits under the CPP including disability benefits.
It is possible for you to apply for disability benefits if you meet the following criteria:
- You are considered a ‘recent contributor’ to the CPP with contributions in four of the last six years, or three of the last six years if you have contributed for at least 25 years.
- You became disabled before the retirement age of 65.
- Your disability is both ‘severe and prolonged’. A severe disability makes you incapable of pursuing work and earning an income while a prolonged disability is one that is chronic, long-term and will result in permanent damage to your health.
The disability benefits come in the form of monthly payments to both you and your children who are minors, or between 18 and 25 years old and attending school full time. You will receive this as a cheque in the mail or as a deposit to your nominated bank account.
The CPP Disability Program is operated by Service Canada, an agency within the Department of Employment and Social Development. They are the ones who initially approve or deny disability benefits claims. If denied, you may appeal for a reconsideration of your application. Claims repeatedly denied by Service Canada can be appealed to the Social Security Tribunal, an administrative law court.
Long-Term disability insurance benefits for sleep disorders
Long-term disability insurance benefits are usually part of an employee’s benefits package. If you are employed by a private company, then it might be providing group insurance for all its employees. Take a look at your insurance policy booklet to see if your benefits plan includes insurance for long-term disability. Also, consider any terms and conditions that may apply to you – especially concerning your particular sleep disorder. The types of benefits include employment insurance, monthly disability payments and paid sick leave.
There are disability benefits that are available for individuals who have become disabled due to an accident or illness. Sometimes, benefits are only given to those who are totally disabled and unable to do any kind of work for a specified period. It is best to seek advice from a benefits lawyer when trying to determine your rights under a particular insurance policy.
Those who work for public sector organizations might be able to claim disability benefits through non-profit insurance plans. It is important to understand that unlike group insurance plans, these are merely administered by the insurance company on behalf of the organization. So, the insurance company is not the entity directly providing the plan. If this applies to you, it would be prudent to get a lawyer to help you trudge through the complex process of claiming benefits.
How to win disability benefits for sleep disorders
1. Be aware that insurers may argue that sleep issues are caused by a mental disorder.
Insurance companies do this because it is much harder to win a claim for mental disorders compared to other medical conditions. Also, many insurance policies limit benefits for mental illness claims to only two years because psychological disorders as considered to be treatable within that timespan. Furthermore, you might be required to undergo regular treatments and provide progress reports about your mental illness to continue receiving your benefits.
2. It is critical to include all your other disabling conditions as part of your claim.
You can strengthen your claim by including other conditions you might have that are contributing to your disability. This is important even though you may feel that your sleep disorder is the primary issue. Disabling conditions that are often diagnosed in conjunction with sleep disorders include the following:
- Heart disease
- Lung disease
- Lyme disease
3. Proper diagnosis and testing by a sleep specialist are critical.
Because there are many kinds of sleep disorders, testing varies for each one of them. Your primary care physician might be able to begin the evaluation of your sleep disorder by identifying common symptoms. However, a sleep specialist would be able to give a more comprehensive assessment of your condition. Sleep specialists will also have the proper tools and equipment in their clinics to give you a definitive diagnosis to support your claim. You might be referred for a polysomnogram or sleep study in which you spend a night in a facility where your biological functions will be recorded as you sleep. Some sleep disorders can also be detected using an electroencephalogram or a genetic blood test.
When preparing your claim, it is important to include all documents and medical reports that you need to prove that you do have a sleep disorder. It is not enough to state that you suffer from the condition. Benefits providers will want solid data and the assurance of a sleep physician.
4. You must demonstrate that you have followed all treatment recommendations and show that they have not been successful.
Initial treatments for sleep disorders include medication, melatonin supplements and the use of devices (e.g., breathing apparatus for sleep apnea). Your doctor should keep a record of all the treatments that you have tried and their effect on your sleep disorder. In some cases, patients might even experience a worsening of their condition after various treatments. You have to show that simply changing your diet or taking sleeping pills is not working. Some people, including those working for insurance companies, have a misunderstanding of the nature of sleep disorders. They might think the best way to cure the condition is simply to sleep properly, but you know only too well it is easier said than done.
The Winning Method for Disability Benefits Claims
Whether applying for disability benefits under the CPP or through an insurance plan, you will be doing the bare minimum method. This entails going through the whole application process as prescribed by the benefits providers. You submit a complete application with all the requirements and do as you are told. Everyone does this, and they are usually denied. In contrast, you should make your application stand out by going beyond doing the bare minimum to increase your chances of getting your claim approved. We call this the winning method.
For CPP disability benefits claims, the Blueprint Strategy by Resolute Legal identifies the six key elements that your application must contain. You can read more about this in our free guide. Essentially, you must be able to tell a comprehensive and persuasive story of your disability and its effect on your life. You can also use the strategy for appeals to both Service Canada and the Social Security Tribunal
For disability insurance benefits, Resolute Legal also has a free guide that even beginners can follow. It contains proven techniques for preparing a winning claim. The book also explains why insurance companies deny those who are legitimately disabled and how you can counteract their practices.
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