Chronic Pain and Employment: Navigating Disability Benefits

Chronic pain affects nearly eight million Canadians, according to data from the Public Health Agency of Canada. This widespread health challenge complicates daily life for many, impacting sleep, focus, mobility, and emotional health. For individuals suffering from chronic pain, maintaining regular employment can become a significant struggle. A pressing question arises: Is chronic pain classified as a disability in Canada? The answer is yes.

Canada legally recognizes chronic pain as a disability, particularly when it significantly limits an individual’s ability to work or perform daily activities. Federal and provincial laws, including the Canadian Human Rights Act, protect those living with chronic pain from discrimination. This legal framework ensures equal treatment and the right to reasonable accommodations in the workplace.

Sivan Tumarkin, a disability lawyer and partner at Samfiru Tumarkin LLP, emphasizes the challenges many face when applying for benefits. “Many people believe that if they’re genuinely struggling with chronic pain, their insurer will automatically approve their claim. Unfortunately, that isn’t how the system works,” he explains. Employers are required to provide reasonable adjustments, such as modified duties, flexible hours, or assistive equipment, to help employees manage their condition.

When does chronic pain qualify for disability benefits?

While chronic pain can be recognized as a disability, simply having a diagnosis is not sufficient for qualifying for benefits. Individuals must demonstrate that their condition is severe and persistent, typically lasting longer than three months, and significantly interferes with their ability to work safely and reliably. Moreover, there must be evidence that the condition is under active medical treatment.

Insurers often rely on functional evidence to assess the impact of chronic pain, as it can be an “invisible” condition that does not always appear on medical imaging. Tumarkin notes that thorough preparation is essential. “Insurance companies often deny claims not because they think you aren’t sick, but because they say there isn’t enough medical documentation to prove your limitations,” he states.

To strengthen a claim, individuals should compile a range of evidence, including:

– Physician treatment notes
– Reports from specialists, such as rheumatologists or neurologists
– Records of medications and therapies attempted
– Functional assessments
– Mental health evaluations, if applicable
– A daily journal documenting limitations

Without comprehensive records, insurers may argue that the pain is exaggerated or that the individual can still perform suitable work.

Disability benefits available in Canada

If chronic pain prevents an individual from maintaining employment, several disability benefits may be available, including:

– Short-term disability (STD) through employer benefits
– Long-term disability (LTD) insurance for those unable to return to work for an extended period
– Canada Pension Plan Disability (CPP-D) for severe and prolonged conditions
– Provincial disability assistance, such as Ontario Disability Support Program (ODSP), Alberta Income Support for the Handicapped (AISH), or British Columbia Disability Assistance
– The Disability Tax Credit (DTC) for those with significant impairments in daily functioning

Each program has specific application criteria, forms, and deadlines. Claims involving chronic pain are often initially denied due to the difficulty of proving the functional impact of the condition.

What to do if your claim is denied?

A denial of a disability claim does not indicate that an individual is not disabled; it often reflects the insurer’s assertion that there was insufficient evidence or that the individual can still perform some type of work. In the event of a denial, it is advisable to:

1. Review the denial letter carefully.
2. Gather additional medical support.
3. Consult with a disability lawyer before filing an internal appeal.

Legal advice can provide clarity on the best course of action, which may be to pursue a legal claim rather than an internal review. Tumarkin emphasizes that a denied claim is not the end of the road: “Most successful disability cases are won after the insurer’s first refusal. Following your treatment plan is also critical — insurers quickly deny claims if they believe you’ve stopped trying to get better.”

Understanding your rights

Chronic pain is a real and debilitating condition, and individuals have rights under Canadian law. The disability lawyers at Samfiru Tumarkin LLP are experienced in navigating the complexities of disability claims and understand the reasons behind claim denials. They have successfully assisted thousands of Canadians in obtaining the support they deserve.

For those facing challenges with chronic pain disability claims, or for those needing assistance in applying for benefits, contacting Samfiru Tumarkin LLP for a free consultation can be a vital step in securing the benefits to which they are entitled.