Disability Benefits — Ontario Employment Law

9 casesDecisions from 1983–2022

About Disability Benefits

Disability benefits in Ontario provide crucial financial support to employees who are unable to work due to illness or injury. These benefits are typically categorized into Short-Term Disability (STD) and Long-Term Disability (LTD). It's a common misconception that employers pay these benefits directly; in most cases, they are provided through a group insurance policy that the employer arranges and often contributes to. This distinction is vital, as it means an employee's claim is usually with an insurance company, not the employer itself.

The employer, however, still has significant legal obligations. Under Ontario common law, employers have a duty of good faith and honesty, which includes facilitating an employee's access to disability benefits. This means they must provide the necessary application forms promptly and not interfere with the claim process. An employer who obstructs a claim or terminates an employee for attempting to access benefits may face legal consequences.

Disability benefits frequently intersect with termination and wrongful dismissal law. If an employee is terminated without cause, they may be entitled to damages for the loss of a chance to claim disability benefits during their common law reasonable notice period. For employees already receiving LTD benefits, a key legal issue is whether those payments should be deducted from any wrongful dismissal award. The answer depends on the specific wording of the employment contract and the insurance policy—if the employee paid the premiums, the benefits are less likely to be deductible. The journey through a disability claim can be complex, involving detailed insurance policies and medical evidence, and understanding how your employment status affects your benefits is critical. Each situation turns on its own unique facts and the precise language of the governing documents, making a careful review essential.

Frequently Asked Questions

What's the difference between STD and LTD benefits?

Short-Term Disability (STD) provides income replacement for a limited period, typically a few weeks to six months, starting after a brief waiting period. Long-Term Disability (LTD) begins after STD benefits expire and can last for many years, sometimes until age 65, for employees who remain unable to work.

Can my employer fire me while I'm on disability leave in Ontario?

Your employer cannot fire you because you are disabled or on leave, as this would be discrimination under the Ontario Human Rights Code. However, the employment relationship can end through other means, such as the legal doctrine of 'frustration of contract' if it becomes clear you will never be ableto return to work.

My LTD claim was denied by the insurance company. What should I do?

You should immediately review the insurer's denial letter to understand their reasoning. Most policies have a strict, and often short, internal appeal process. It is highly advisable to seek legal advice at this stage, as you may have a claim against the insurance company.

If I get LTD payments, will they be deducted from my wrongful dismissal settlement?

It depends. If your employment contract or the insurance policy clearly states that benefits are deductible, they likely will be. However, if you paid all or part of the insurance premiums yourself, courts are often reluctant to allow the employer to deduct the payments from a wrongful dismissal award.

Are there deadlines for applying for disability benefits?

Yes, absolutely. Insurance policies contain strict deadlines for submitting an initial claim and for appealing a denial. Separately, there is a two-year limitation period in Ontario under the Limitations Act, 2002, to start a lawsuit against an insurer after a claim has been denied.

When should I talk to a lawyer about my disability benefits?

You should consider consulting a lawyer as soon as your claim is denied by the insurer, if your employer is obstructing your application, or if you've been terminated while on leave. The language in insurance policies is complex, and a lawyer can help you understand your rights against both the insurer and your employer.

Common Scenarios

  • An IT consultant on LTD for two years is informed her benefits will cease because the policy's definition of disability is changing from 'own occupation' to 'any occupation'.
  • A retail manager is terminated without cause and, two months into what would have been their notice period, is diagnosed with a serious illness requiring them to be off work.
  • An administrative assistant's STD claim for a mental health condition is denied by the insurer, who claims there is insufficient objective medical evidence.
  • A construction worker on an approved LTD leave receives a termination letter from his employer stating his role has been eliminated due to a restructuring.

What You Should Know

  • Always request a complete copy of your group benefits booklet and the master insurance policy from your HR department; the specific wording is crucial.
  • Keep a detailed log of all your symptoms, medical appointments, and communications with your employer and the insurance company.
  • Be aware of strict deadlines. Insurance policies have short appeal periods, and there is a two-year limitation period to sue an insurer in Ontario after a denial.
  • If your claim is denied or you face termination while on leave, seek a consultation with an employment lawyer to review your policy and assess your options against both the insurer and your employer.

Featured Cases

Nielsen v. Sheridan Chevrolet Cadillac Ltd.

2017 ONSC 6930 (CanLII) · 2017-11-22

Wrongful Dismissal: Reasonable Notice, Mitigation, and Disability Benefits

A wrongful dismissal case where the plaintiff sought 12 months' pay in lieu of notice but was awarded 20 weeks, less the eight weeks already paid under the Employment Standards Act. The court also addressed issues of costs, mitigation of damages, common employer doctrine, and disability benefits.

common employer doctrine disability benefits mitigation of damages reasonable notice wrongful dismissal

Reddy v. Freightliner Canada Inc.

2015 ONSC 1811 (CanLII) · 2015-03-19

Wrongful Dismissal: Termination for Poor Performance and Pleading Issues

A wrongful dismissal case where the plaintiff was terminated for poor performance and sought leave to amend the statement of claim. The court applied a factually-oriented approach to determine the sufficiency of the claim and the admissibility of the Reply under the Limitations Act and civil procedure rules.

disability benefits limitations act, 2002 termination of employment wrongful dismissal

Dodgson v. Great West Life Assurance Co. et al.

2014 ONSC 389 (CanLII) · 2014-01-29

Disability Benefits Case: Employer Obligations and Mitigation of Damages

A court case involving an employee's claim for disability benefits under an employer's plan. The court found the plaintiff disabled and entitled to benefits, ruled against the employer for inadequate support, and held the plaintiff did not fail to mitigate damages. The case also addressed the sufficiency of medical evidence and the change in the definition of disability.

disability benefits employee support insurance medical evidence mitigation of damages

Altman v. Steve’s Music

2011 ONSC 1480 (CanLII) · 2011-03-08

Wrongful Dismissal: Long-Term Employee Awarded 22 Months' Salary and $35,000 in Damages

A wrongful dismissal case involving a long-term employee with 30 years of service who was terminated without notice. The court awarded 22 months' salary and $35,000 in moral damages for mental distress, and $20,000 in punitive damages for the employer's breaches of statutory obligations. The case also addressed the deduction of disability benefits from wrongful dismissal awards.

disability benefits moral damages punitive damages reasonable notice wrongful dismissal

Duke v. Toronto District School Board

2006 CanLII 16483 (ON SC) · 2006-04-28

Arbitration Dispute: Long-Term Disability Benefits Under Collective Agreement

A dispute over the entitlement to long-term disability benefits under a self-insured plan administered by an agent, with the central legal question being whether the dispute arises from the collective agreement and thus requires arbitration under the Labour Relations Act. The plaintiff sought to pursue a civil action, but the court considered whether the matter is exclusively arbitrable.

arbitration collective agreements disability benefits jurisdiction labour relations

McKay v. Camco Inc.

1983 CanLII 1644 (ON SC) · 1983-11-21

Wrongful Dismissal: Disability Benefits Deducted from Damages

A wrongful dismissal case where the employee was dismissed with notice of termination effective two months later. The employee argued for nine months' notice based on their position, age, and economic conditions, but the court found three to six months' notice appropriate. The court also ruled that disability benefits received by the employee, equivalent to five-and-a-half months' salary, should be deducted from the damages awarded, as the employer should not be required to pay the employee's salary twice.

damages disability benefits employment law notice of termination wrongful dismissal