The lawyers at Aaron Waxman & Associates are experienced with Disability, Personal Injury and Employment claims.
It was recently Bell Let’s Talk Day, a day to discuss mental illness and to promote mental health
awareness. The month of February has been designated as “Psychology Month” in Canada.
Why does this matter?
Mental illness is one of the leading causes of disability. It is important to bring more awareness to foster
greater understanding, so everyone recognizes that impact it has on a person’s ability to function.
The impact of mental illness:
There are many types of psychological illnesses which could affect your ability to work and lead to a
short-term disability claim or long-term disability claim.
A mental illness can disrupt various realms of your life including your employment, your ability to
interact and socialize and your ability to take care of yourself (hygiene, nutrition, sleep). Your overall
functioning is affected.
For example, major depressive disorder (clinical depression) affects 1% of Canadian men and 2% of
Canadian women at any point in time and 5% of men and 10% of women will experience clinical
depression in their lifetime. According to the Canadian Psychology Association, depression is often a
recurring condition and someone who has one episode is at risk for recurrence.
Generalized anxiety disorder can lead to social phobia, panic disorder (severe panic attacks) and
depression. One out of every twenty people will experience generalized anxiety disorder. Symptoms
included chronic excessive and uncontrollable worry, fatigue, difficulty concentrating, irritability, muscle
tension and sleep difficulties.
Obsessive compulsive disorder involves recurrent and persistent intrusive thoughts, images or impulses
that are unwanted and cause significant distress (“obsessions”). According to the Canadian Psychology
Association, the more common obsessions involve contamination, loss of control, doubts about one’s
verbal or behavioural responses, possibility of sudden sickness. Compulsions involve repetitive
behaviours or acts performed to prevent or reduce the distress or negative consequences represented
by the obsession such as prolonged washing, repeated checking or counting/repeating a certain phrase.
It is estimated that 1 to 2% of Canadians will have an episode of obsessive compulsive disorder.
Post-traumatic stress disorder (PTSD) can affect a person for several years. Research suggests that 10-
20% of people are disabled for several years after the onset of PTSD. It is important to note that PTSD
does not only occur because of combat and disaster, it also happens as a result of sexual or physical
assault, life threatening illnesses, transportation/industrial accidents or repeated exposure to other’s
physical trauma. It has been found that people who have a history of depression, anxiety, or other
traumas are more susceptible to developing PTSD.
What happens during my claim for disability?
During a disability claim, your insurance company wants to see that you are attending the right type of
Treatment for a mental illness can include seeing a psychiatrist, taking prescribed medication,
psychotherapy with a psychologist or someone licensed to provide this type of therapy and “targeted”
treatments such as cognitive behavioural therapy, dialectical behavioural therapy or a mindfulness
based stress reduction course or group therapy.
Sometimes, your insurance company may feel you are not receiving the right type of treatment or
enough treatment and arrange for you to see a psychologist/psychotherapist who will provide cognitive
behavioural therapy for a limited period (for example, 8 to 10 sessions).
Your insurer may ask your own doctor for input to see if this type of treatment would be beneficial. It is
important to make best efforts to participate in this treatment to show your insurance company that
you are an active participant in your recovery. Usually the goal of treatment is to prepare you for a
gradual return to work.
In many claims, the insurance company will write to your treating physician to ask if you can return to
some form of work and participating in a gradual return to work plan. The therapist you are receiving
treatment from will be consulted as well.
Your insurer also uses a medical consultant to review your claim (maybe on more than one occasion)
when your restrictions and limitations are not clear to them or the impact of a diagnosis is not clear, and
to ask for recommendations.
In some claims, the insurance company might even arrange an independent medical examination with a
psychiatrist and/or psychologist to clarify diagnosis, restrictions and limitations and treatment
What is the insurance company looking for?
A mental illness is often categorized as an “invisible illness” because there are no “objective” tests that
would easily show a diagnosis or explain symptoms the way that bloodwork or an x-ray would. Your
insurance company is looking for evidence that you have restrictions and limitations affecting your
In order to demonstrate the impact of your symptoms and diagnosis, you should:
It is really important for your insurer to understand your limitations and restrictions:
Your doctor may impose restrictions because you have cognitive/psychological impairments as a result
of your illness, such as:
What if my claim is denied?
Your claim may be denied at the outset, or you may be paid benefits for a period of time. In either case,
when you receive a denial letter, it is important to remember that you can fight the insurance
company’s decision. You can consult a lawyer to find out your rights as an insured person and what your
Our firm has helped clients who have had disability claims as a result of mental illness and had their
benefits denied. At Aaron Waxman and Associates, we offer a free initial consultation with a licensed
lawyer that can be arranged at a date and time that is convenient for you.
* This blog is for informational purposes only and is not meant to substitute legal advice. Please read our disclaimer for further information.
* All of our lawyers are licensed by The Law Society of Upper Canada
* Office in Toronto and able to represent people in the province of Ontario