Short-term disability (STD) benefits are a lifeline for many Ontarians who are unable to work due to illness or injury. Whether you’re navigating the claims process or dealing with a denial, understanding your rights and options is crucial. This guide will walk you through everything you need to know about short-term disability in Ontario, including what to do if your claim is denied.
What Is Short-Term Disability (STD)?
Short-term disability benefits provide temporary income replacement if you’re unable to work due to a medical condition. These benefits are typically offered through your employer’s group insurance plan and are not provided by the Ontario government. STD benefits generally cover the first 17 to 26 weeks of disability, acting as a financial bridge while you recover or transition to long-term disability (LTD) if needed.
In short: STD is your first layer of income protection before LTD or Employment Insurance (EI) Sickness Benefits.
Who Qualifies for Short-Term Disability in Ontario?
Eligibility for STD benefits depends on your specific insurance policy, but most plans require that you:
- Are employed and covered under an active group benefits plan.
- Provide medical evidence, such as a doctor’s note or an Attending Physician Statement.
- Complete any required waiting period (usually one week).
- Are unable to perform the essential duties of your job due to a medical condition.
Common Conditions That Qualify for STD Benefits
- Mental health issues: Depression, anxiety, burnout.
- Musculoskeletal injuries: Back pain, neck strain, repetitive strain injuries.
- Post-surgical recovery.
- Pregnancy complications.
- Serious illnesses or infections.
How Long Does Short-Term Disability Last?
Most STD plans in Ontario provide benefits for up to 6 months, though the exact duration can range from 15 to 26 weeks depending on your policy. If your condition persists beyond this period, you may transition to long-term disability (LTD), often with the same insurer.
How Much Does Short-Term Disability Pay?
STD benefits typically replace 55% to 70% of your regular income, up to a weekly maximum. Whether these benefits are taxable depends on who pays the premiums:
- Non-taxable: If you pay the premiums yourself.
- Taxable: If your employer covers the cost.
Payments are usually made weekly or bi-weekly, either by the insurance company or your employer’s HR department.
Why Are Short-Term Disability Claims Denied?
Unfortunately, not all claims are approved. Common reasons for denial include:
- Insufficient medical evidence: Vague doctor’s notes or incomplete forms.
- Missed deadlines: Late submission of claims or supporting documents.
- Pre-existing condition exclusions.
- Inconsistent information: Discrepancies between forms and medical reports.
- Surveillance or social media activity: Evidence that contradicts your stated limitations.
- Insurer error or bias: Unfair evaluations or misinterpretation of policy terms.
Important: Denied claims are not the end of the road. However, internal appeals with the insurer rarely succeed. It’s best to consult a lawyer before pursuing an appeal.
What to Do if Your Short-Term Disability Claim Is Denied
If your claim is denied, don’t rely on the insurer’s internal appeal process. These appeals are handled by the same company that denied your claim and often result in delays rather than resolutions.
Steps to Take After a Denial
- Contact Kotak Law immediately.
Our team will review your denial letter, medical records, and policy terms.
- Identify errors and missing evidence.
We’ll uncover procedural mistakes, gaps in evidence, or breaches of your contractual rights.
- Let us handle communications.
We’ll take over all correspondence with the insurer so you can focus on your recovery.
- File a legal claim if necessary.
If the insurer refuses to reverse their decision, we’ll take legal action to secure your benefits and any arrears owed.
Note: Ontario has strict limitation deadlines for disability claims. Contact a lawyer as soon as possible after a denial.
Short-Term Disability vs. Long-Term Disability vs. EI Sickness Benefits
Here’s how STD compares to other forms of income replacement:
| Benefit Type | Duration | Who Provides It? | Eligibility |
|---|---|---|---|
| Short-Term Disability | 15–26 weeks | Employer’s group insurance | Unable to perform your job due to medical issues |
| Long-Term Disability | Beyond 6 months | Employer’s group insurance | Severe, prolonged disability |
| EI Sickness Benefits | Up to 15 weeks | Federal government (Service Canada) | No employer-provided STD coverage |
Why Choose Kotak Law?
At Kotak Law, we’ve helped thousands of Ontarians successfully claim disability benefits — even when insurers initially said no. Here’s how we can help:
- Understand your coverage: We’ll explain your STD policy in plain language.
- Gather strong medical evidence: We’ll ensure your claim is supported by the right documentation.
- Challenge wrongful denials: We’ll act quickly to address unfair decisions.
- Avoid insurer tactics: We know how insurers delay or reduce payments.
- Transition to LTD: If needed, we’ll help you move smoothly to long-term disability benefits.
Our experience = your advantage. We deal with insurers daily and know how to make them pay attention.
Free Case Review — No Obligation
If your short-term disability claim has been denied, delayed, or terminated, don’t wait. Contact Kotak Law today for a free case review.
- Call: (416) 816-1500 or 1-888-GOKOTAK
- Book Online: Free Case Review
- Visit Us: Contact Our Offices
Frequently Asked Questions (FAQ)
Q. How long can I stay on short-term disability in Ontario?
Most plans last up to 6 months, after which you may transition to long-term disability if you’re still unable to work.
Q. Can I receive EI Sickness Benefits while on STD?
Usually not. These benefits overlap.
Q. What if my employer refuses to submit my claim?
You can file directly with the insurer. If your employer is uncooperative, contact Kotak Law for assistance.
Q. Is short-term disability taxable?
If you pay the premiums yourself, benefits are non-taxable. If your employer pays, they are taxable income.
Q. Do I need a lawyer for a denied short-term disability claim?
Yes. Insurers rarely reverse denials on their own. A disability lawyer ensures deadlines are met, evidence is gathered, and your rights are protected.
