Applying for vision disability benefits in Canada is an uphill battle, especially because benefits providers sometimes do not recognize the seriousness of vision loss as a medical condition. This is because unless you suffer from total blindness, you may still seem fit to work and function properly in daily life.
Visual impairment is sometimes preventable and easily curable. However, it could lead to a significant and permanent loss of vision when ignored. The disability can also lead to decreased productivity with economical costs to the employer. So, seeking disability benefits is practical, even though it is not the easiest.
This article will discuss the unique challenges in applying for vision disability benefits in Canada. It will also provide tips and steps to take in order to ensure a well-deserved win.
- Disability from Visual Disorders: You Are Not Alone
- Common Causes of Vision Loss
- Types of Disability Benefits for Visual Disorders in Canada
- How to Win Vision Disability Benefits Canada
- Winning and Keeping Your Vision Disability Benefits Canada
- Denied Disability Benefits for Visual Disorders: What You Can Do
- Next Step – Get Your Free Books
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, including central and peripheral vision. Individuals who exhibit a loss in one or both of these abilities are most likely suffering from a visual disorder.
Note that “blindness” is the term used for almost complete or complete vision loss. Although it is the most commonly accepted form of visual disability, other types of visual impairment also have disabling effects.
Common Causes of Vision Loss
The following is a list of the most common reasons for vision loss.
A refractive error occurs when abnormalities in the eye make it unable to focus light correctly. 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. People can often manage refractive errors with eyeglasses or contact lenses. However, in more severe cases, people may require refractive surgery.
Cataracts are another major cause of visual impairment. A cataract causes clouding in the eye’s lens, leading to poor vision. They are usually a natural occurrence as one age, but they could also be due to exposure to radiation or sunlight, trauma to the eye, genetics, medications, substance abuse and diabetes. In most cases, cataracts can be treated with eyeglasses or through surgery on the cloudy lens.
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. Those at risk for glaucoma 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 (ARMD)
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 age. ARMD is the degeneration of the macula in the retina, which is responsible for clear and sharp central vision. There are two types of ADMR: wet (neovascular) and 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 looks like yellow spots surrounding the macula. Treatments for macular degeneration involve slowing down the degenerative process through medication.
Diabetic retinopathy is the most common cause of blindness in work-age Canadian adults. The condition occurs when high blood sugar levels cause damage to blood vessels in the retina. In its early stages, it might cause no or mild symptoms. However, it can lead to blindness if left untreated. People who suffer from any kind of diabetes can get diabetic retinopathy — including people with type 1, type 2, and gestational diabetes.
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, hinder the brain from correctly interpreting signals from the optic nerve. This type of visual impairment is known as cortical blindness and can be caused by stress or fatigue.
Types of Disability Benefits for Visual Disorders in Canada
There are two sources of disability benefits for Canadian workers with visual disorders: the Canada Pension Plan and Long-term Disability Insurance Benefits.
CPP disability benefits for visual disorders
The Canada Pension Plan (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 other benefits payable under the program, including disability benefits for workers who become disabled before the retirement age of 60 or 65.
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 is always on you. Your application must demonstrate that the disability not only exists, but it should also illustrate its severity and persistence. Service Canada, under the Department of Employment and Social Development, is responsible for approving and denying applications for disability benefits. Appeals for denials go through the Social Security Tribunal.
Workers who are seeking approval for 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.
Long-term disability insurance benefits for visual disorders
Insurance-based disability plans are another type of benefits program available to Canadians. There are two types of insurance policies. The policy your employer buys: is a group insurance policy, and the one you buy: is an individual insurance policy. Group insurance policies are usually part of an employee benefits package. In contrast, individual policies are more common among 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 approval from insurance companies, even when the claimant is legitimately disabled.
This is why it is important not simply to prepare a “bare minimum claim”. Similar to claiming CPP disability benefits, doing the bare minimum will most likely result in a denial. Insurance companies are faced daily with technically complete and legal applications. To stand out from the other claimants, it is better to prepare a winning claim that is more comprehensive and convincing.
How to Win Vision Disability Benefits Canada
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 measure visual acuity. In Canada, a patient must have a vision no greater than 20/200 in his or her better eye to qualify for 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 closer to the widely-accepted definition of blindness: visual acuity of less than 20/500 and a visual field of fewer 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.
4. Your Credibility is Critical
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. Credibility gives you an invisible edge that many people overlook.
When preparing your claim, make sure that all your statements are truthful and can be backed by solid proof. Any suspicions that your benefits provider has about your credibility will lead to a denial. Aside from the medical evidence discussed above, your family, friends and employer should also be able to corroborate your statements. Inconsistencies in your reports will shed doubt on the legitimacy of your condition. It is also important to show that you have been seeking treatment and following your doctor’s orders. However, despite that, your disability negatively affects your work and life.
- 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 errors 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
3. Give a proper description of job demands.
You must be able to establish what your work entails to prove that you cannot perform your job demands. This might seem obvious to you, but it is not always clear to your benefits provider. For instance, visual disorders are a hazard for professions that require excellent vision, such as pilots, firefighters, police officers and more. However, visual disorders can still affect your work demands even if your job doesn’t necessarily hinge on 20/20 eyesight. For instance, a software developer could have trouble writing code if they were struggling with a visual disorder. Therefore, explaining why your visual disorder prevents you from executing the duties of your occupation is extremely important. Make sure your benefits provider knows your job duties and how your disorder affects your ability to do them.
Winning and Keeping Your Vision Disability Benefits Canada
You will still face challenges even after getting approved for vision disability benefits. It is 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 made 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.”
Denied Disability Benefits for Visual Disorders: What You Can Do
So, you’ve filled out all the forms and submitted as much evidence as you can find. Then, a few weeks later, you receive a rejection letter denying you the right to disability benefits. This means that you must go back to work despite greatly suffering from your condition.
This is devastating news and only adds to the pain that your disorder is already causing you. Fortunately, you don’t have to simply accept the rejection and bear your burdens for the rest of your life. You can still appeal the decision of either Service Canada or your insurance company.
Download our books if you want to learn about your options after a denial.
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 schedule online.
Next Step – Get Your Free Books
We hope this article helped you better understand how to win vision disability benefits in Canada. For more information, click on the image below to download free copies of our books on CPP disability and long-term disability benefits.