Chapter 31

Disabled and down

Everyone has a breaking point. After being absent on her long-term disability for 4 months Stella Asterik returned to Toronto Legal at Up Up and Away. One afternoon Sally Self was in my office and criticized me for lagging on an issue. Something in me snapped. I just looked at her and calmly said, “You know the amount of work I have been handling these past months that Stella has been disabled. You know the medical conditions I have been suffering from. You offered no meaningful help. You just let me sink. I will brief Stella before I go this afternoon about what is outstanding. I will start short-term disability tomorrow.” Self’s jaw dropped. It was my time to strike back. If I was a mean person I might have called this revenge. I felt a tremendous sense of relief.

What options did I have? I could have quit but that would have meant no income.

Yes, I was close to retirement age but not quite ready financially for retirement. Going on short-term disability meant 100% of salary and benefits for 20 weeks. If things were not dealt with and given that there was a waiting list for the brain MRI and the cognitive testing that my neurologist had ordered I rather figured it would be two years, before all necessary tests would be completed. My goodness in many respects the medical system in Ontario was very badly broken That would mean after 20 weeks on short-term disability I could go on long term disability until I was 65.

I was grateful the medical system was so slow as the delays for the MRI and cognitive testing would give me time to heal. I told you earlier I was having difficulty accepting Dr. Wong’s diagnosis of depression but gradually I felt more and more lost and proverbially I just could not find my way home. I felt numb. Simple tasks seemed insurmountable. I encountered difficulty meditating as I had so many bad thoughts racing around in my head. I was irritable and impatient getting frustrated easily. I had lost interest in just about everything and anybody. I suppose that is what depression inflicts upon you?

I had a terrible experience with my psychotherapist one day when she asked me what I felt like if I had to return to work. A wave of chilling terror swept over me and I was ready to break down in uncontrollable sobs but managed to escape her office just in time. That was frightening. How much had work traumatized me?

Dr. Wong could see me heading downwards so prescribed an anti-depressant sertraline. I can’t say it made me feel any different, but it ripped up my digestive system. We tried another anti-depressant mirtazapine which was known to be gentle on the system. No such luck. After several months I had to stop taking them but my Beck Depression Inventory scores were decreasing. I was starting to feel better and then one day after being in a funk for close to a year walking to Dr. Wong’s office on a sunny spring day a genuine smile spontaneously took me over and for the first time in a long time it felt good to be alive.

Now it is difficult to bounce back from depression when you have lost that feeling of normalcy. The stress laden life I had led made me lose touch with what normalcy was but I was feeling far better than when I initially visited Dr. Wong. Was it the rest, the psychotherapy, the drugs, the mindfulness or the bright light therapy?

But depression is a cruel disease. Often the recovery can be marred by relapses and just when I was feeling better I had a couple of short setbacks that made me feel even worse than I was in the height of my depression.

Dr. Wong advised me depression is a chronic disease and for most people it reoccurs. As she said to me most of my patients will be with me for the rest of their lives. Now isn’t that a frightening thought?

I had to apply to Happy Insurance Company for my long-term disability benefits and was approved. A rare task to succeed with as insurance companies are in the business of making profits and not necessarily looking to your health nor making long-term disability payments. So, I was down to 70% of my salary until 65 at which time the long-term disability coverage would terminate.

Now most long-term disability providers have provisions in their contract that entitle you to long term disability payments for the first 24 months if your disability prevents you from performing the essential duties of your own occupation. After those 24 months you are entitled to disability benefits until age 65 if your disability prevents you from fulfilling the essential duties of any occupation taking into consideration your training, education and past work experience. For example, if you are a lawyer the fact you can flip burgers at McDonalds doesn’t mean your long-term disability benefits can be terminated.

Don’t forget to apply for Canada Pension Plan (CPP) long-term disability benefits even if you qualify for long-term disability benefits under your employer’s long-term disability plan. You must go through the application process and your disability must be severe and prolonged which prevents you from working at any job on a regular basis. Severe means you have a mental of physical disability that regularly stops you from doing any type of substantially gainful work. “Prolonged” means long term and of indefinite duration or is likely to result in death. I managed to obtain CPP long-term disability benefits in my first application. The odds of a successful application are rare.

I have been told your chances of success in obtaining CPP long term disability benefits are about 40% but you have the right to appeal. You also have the right to appeal from any private or employer       long-term disability plan denial of benefits. My best advice is to be precise and thorough in the application process. Unfortunately, your private long term disability provider will almost always have provisions in its long-term disability plan that enable them to deduct from their disability benefits payable to you any CPP long-term disability benefits you receive. Note that many insurance companies may force you to apply for CPP long term disability benefits.

Obtaining CPP long term disability benefits also makes for a far more difficult case for an insurance company to cease making disability payments and it also increases the amount of CPP payments you’ll be entitled to when you reach 65.

A bit of advice. Understand what the insurance company can require you to do to continue receiving long-term disability benefits. Most require your health providers to provide updates as to your health and to follow treatment recommendations made by your physicians. And cheating is not a clever idea. Insurance companies won’t hesitate to dispatch a detective for surveillance.

One more piece of advice. Insurance companies will pay attention to psychiatrists if you are claiming stress, anxiety or depression as grounds to be awarded long-term disability so get one in your camp. Notes and letters from general practitioners might be good enough for short-term disability claims for stress but are virtually meaningless for long-term disability.