Heart Disease and Long-Term Disability Benefits

Can I Get Long-Term Disability Benefits for Heart Disease?

One of the most common questions we get is “Do I qualify for long-term disability benefits if I have Heart Disease?”

Heart disease or cardiovascular disease is a broad term that is used to describe the disease of the circulatory system (heart and blood vessels), and it can qualify for long-term disability benefits (also called LTD).

Has your claim for disability benefits been denied? Has the insurance company denied your appeal? Were you receiving benefits and the insurance company terminated those benefits?

The experienced team at Ertl Lawyers can help you.

We’ll work with you and your physician to help challenge the insurance company’s denial or discontinuance of your long-term disability benefits.

Where necessary, we will engage other trusted professionals to support your case including specialists, functional capacity evaluators, and vocational evaluators to help credibly explain why your disability symptoms are preventing you from doing your “own occupation” or “any occupation”.

Our LTD lawyers in Toronto offer:

• A free case assessment
• Fair, flexible rates, including contingency fees (i.e. only pay if you win)
• Service across all of Ontario

If you are looking for long-term disability lawyers that care about your well-being, you’ve found us.

Our help can make all the difference.

Heart Disease: Key Facts

Heart disease encompasses a wide variety of diseases that involve the heart and blood vessels.  The most common include ischemic heart disease (often leading to heart attack), stroke, peripheral vascular disease, heart failure, rheumatic heart disease and congenital heart disease.

Heart disease involves any condition that affects the structure or function of the heart.  Each condition often has its own cause but can be grouped together based on how they affect the structure or function of the heart.

1. Coronary artery and vascular disease: hardening of the arteries (atherosclerosis). Coronary artery occurs when the arteries in your heart are narrowed or blocked.  This is the most common heart disease and often causes a majority of heart attacks as well as angina. Vascular disease is when there are issues in other blood vessels causing a reduction of blood flow affecting your heart.
2. Heart rhythm disorders (arrhythmias): when the heart beats too slowly, too quickly or disorganized.  Arrhythmias cause a disruption in blood flow to the heart.
3. Structural heart disease: abnormalities in the heart structure such as valve, wall, muscle or blood vessel issues. These structural heart diseases can be at birth (congenital) or can occur after birth through infection, wear and tear, etc.
4. Heart failure: occurs when the heart is damaged or weakened. Two most common causes of heart failure are heart attack and high blood pressure.

The cause of each heart disease depends on the type of disease you are diagnosed with.  Some heart diseases can be managed through treatment, surgery or medication, while others can be “cured” by surgery, lifestyle changes, etc.

Heart disease can be caused by medical conditions such as high blood pressure or high cholesterol, diabetes, sleep apnea, pre-eclampsia or lifestyle issues such as an unhealthy diet, not enough exercise, weight issues, smoking, alcohol, stress, drug use and hormonal therapy or birth control.

See: Heart and Stroke Foundation of Canada and Canada Public Health Service

Most Common Symptoms of Heart Disease

The symptoms you experience will depend on the type of heart disease you have. The most common symptoms of those diagnosed with heart disease include chest pain, fainting and shortness of breath.

Criteria for a Diagnosis of Heart Disease

A heart disease diagnosis depends on the type of signs and symptoms you are displaying.  Your doctor will review your medical and family history and perform a complete physical exam.  Your doctor may also run tests including:

• Angiography
• Cardiac catheterization
• Doppler ultrasound
• Echocardiogram
• Electrocardiogram
• Holter or event monitor

Treatment for Heart Disease

Prevention

The risk for heart disease can be detected early based on your lifestyle and medical history.  Your doctor will recommend stress management tools, healthy diet, exercise regime, maintaining a healthy weight, quit smoking, avoid alcohol use and control any underlying medical conditions you may already have such as diabetes, hypertension, high cholesterol, etc. [endnote 1]

Medication

Depending on the type of heart disease you are diagnosed with, specific medications may be prescribed to help manage your disease.  The following are common medications to assist with common heart disease:

• ACE inhibitors: control blood pressure and are prescribed to those with high blood pressure, heart failure and those at risk of developing coronary artery disease.
• Aldosterone antagonists: used to reduce stress on the heart.  Often prescribed to those with high blood pressure and heart failure.
• Antiarrhythmics: slow the electrical impulses in the hear so it can beat regularly. Used to treat arrhythmias.
• Blood thinners: reduces the risk of developing blood clots. Prescribed to those who have artificial heart valves, atrial fibrillation, cardiomyopathy or have had a heart attack.
• Beta-blockers: used to treat high blood pressure, heart failure, arrhythmia’s and chest pain. Preventative for heart attacks.
• Diuretics: used to treat high blood pressure and heart failure. They remove excess salt and water from the body to help the kidney’s produce more urine.
• Niacin: used to help lower cholesterol, it is a form of vitamin B.

Surgery

There are several types of surgery available to those with heart disease.  What is offered to you depends on the type of heart disease you are diagnosed with and the severity.

• Ablation: treatment to restore heart rhythm to normal. Used when medication has not helped.
• Atherectomy: removes plaque build up in arteries. After the plaque is removed a stent may be installed to keep the artery open.
• Cardiac Resynchronization Therapy: implant a small electronic device in your chest or abdomen to send electronic signals to your heart to synchronize your heart beat.
• Cardioversion therapy: treatment for atrial fibrillation to restore heart rhythm.
• Coronary artery bypass surgery: improves blood flow to the heart after a build up of plaque in the coronary arteries. A piece of blood vessel is removed from another part of the body and creates a detour or bypass around the blocked portion of the artery.
• Heart transplant: remove the failing heart and replace it with a new, donor heart.
• Heart valve surgery: replace or repair damaged valves.
• Implantable cardioverter defibrillator: monitors and regulates irregular heart rhythms. When the heart does not beat properly, it delivers an electrical shock to the heart to encourage it to beat at a normal pace.
• Implantable pacemaker: similar to the above, regulates heart rate and rhythm by using electrical impulses.
• Mechanical assist device: small pump to temporarily assist the hear in maintaining blood circulation.
• Percutaneous coronary intervention: formerly called angioplasty, a thin flexible tube is inserted into the heart to place a stent which will open the blood vessels that have narrowed.
• Ventricular resection: treatment for heart failure if you are diagnosed with an enlarged heart. Helps to improve pumping ability by reshaping the left ventricle.

Important: These surgeries also can be the basis of a disability claim.

Workplace Restrictions and Limitations Caused by Heart disease

After treatment for heart disease (often after surgery), cardiac rehabilitation is required.  This involves a regime of exercise, medication, diet and lifestyle changes which can significantly impact an individual’s ability to perform their jobs.

When considering your employment and heart disease diagnosis, consider how stable your condition is, how safe you are to do your job and what the demands are physically and mentally.  Many individuals suffering from heart disease may experience fatigue and lack of strength, or may be worried about experiencing a cardiac event in the workplace.

Heart Disease and Workplace Discrimination

It is unlawful to discriminate against someone in the area of employment based on their physical disability: Ontario’s Human Rights Code and the Canadian Human Rights Act.

If you are suffering from heart disease, you might face discrimination in a variety of ways:

• You are terminated from your job because you have heart disease.
• You are denied accommodation because of your heart disease.
• After returning from a disability leave, your employer places you in a lower, part-time position at a lower rate of pay
• Someone makes unwelcome remarks or jokes about your disability.
• Someone offends or humiliates you physically or verbally threatens or intimidates you because of your disability.
• Retaliating against you for filing a human rights

Ertl Lawyers are experts in Employment and Disability Law. If you have been discriminated against, we can help, including:

• Having your employer comply with their duty to accommodate you.
• Having your employer stop all forms of discriminatory conduct.
• Representing you in wrongful dismissal, constructive dismissal, and human rights matters.
• Ensuring that your employer complies with its statutory obligations, including its obligations under the Employment Standards Act.
• Negotiation severance packages (including continuation of benefits).

What Are Some Steps You Should Take Before You Apply for Long-Term Disability Benefits for Heart disease?

Review Your Policy Carefully

Your entitlement to disability benefits for heart disease depends on the specific wording of your disability policy.

Therefore, you will need to review your policy and see how it defines things like “totally disabled” and “occupation” – and whether any exclusions apply (particularly for pre-existing conditions).

Gather Medical Evidence

To be entitled to disability benefits for heart disease, every insurer requires you to provide medical evidence documenting how your illness or injury causes restrictions or lack of ability, such that you are prevented from performing the essential duties of your occupation.

Therefore, you will need a copy of your medical records to see if there is an objective basis for your diagnosis of heart disease and what your medical records say about your symptoms and your restrictions and limitations

Gather Evidence of Workplace Limitations

Because your entitlement to long-term disability benefits for heart disease depends on the strength of your evidence, you should get a copy of your employee file from work. It may show that your heart disease negatively impacted your work performance. Your work performance may have been affected by your frequent absences from work, pain, fatigue, etc.

Create a List of the Physical Duties of Your Job

You should get a copy of your job description. Based on that job description, you should write out a detailed list of the physical (and mental) duties associated with your job description – and explain how your heart disease limits or prevents you from performing you own occupation.

Ask Your Doctor for a Report

It is recommended that you provide your doctor with your occupational description. You should ask your doctor to prepare a report that clearly explains the objective basis for:

• your diagnosis of heart disease
• your restrictions and limitations
• reasons why you are unable to perform some or all of the essential duties of your own occupation.

Follow Your Doctor’s Treatment Plan

Your entitlement to long-term disability benefits also requires you to be receiving regular, ongoing care and treatment for your heart disease. In other words, don’t skip appointments, and always follow your doctor’s treatment plans.

Keep a Diary

On your end, it is important to keep a diary. A diary is a written record that (a) helps you keep track of when your symptoms interfere with your ability to do things and (b) the side effects of your medication.

What Other Benefits Might I Be Entitled to for Heart Disease?

Other than short-term and long-term disability benefits through a group or individual insurance plan, people suffering from heart disease might be entitled to one or more of the following benefits:

• Employment Insurance (EI) Sickness Benefits;
• Ontario Disability Support Plan (ODSP);
• Disability Tax Credit (DTC);
• Disability Creditor Insurance (under your mortgage or credit cards);
• Trillium (extended health benefits);
• Canada Pension Plan Disability (CPP-D); and
• Disability Pension (employer).

Heart Disease Organizations / Associations / Colleges

• The Heart and Stroke Foundation of Canada
• Public Health Agency of Canada
• Cardiac Health Foundation of Canada

Disclaimer: The content on this web site is provided for general information purposes only and does not constitute legal, medical, or other professional advice or an opinion of any kind. Users of this web site are advised to seek specific legal advice by contacting members of Ertl Lawyers (or their own legal counsel) regarding any specific legal issues. Ertl Lawyers does not warrant or guarantee the quality, accuracy or completeness of any information on this web site.