If you’ve recently been in a debilitating car accident, the last thing on your mind is filing a disability claim. But, filing your claim is a highly important step to making sure your rights are protected as you begin your road to recovery.
On the bright side, we’ve put together a comprehensive guide which will walk you through the process of filing a disability claim in British Columbia, so you’ll be able to focus less on paperwork and more on getting better.
Part 7 Benefit Basics
Drivers in British Columbia have all been covered by the Insurance Company of British Columbia since the 1970’s. This insurance provides drivers with coverage against accidents and injuries sustained as a result of those accidents. These benefits are often referred to as total disability benefits or part 7 benefits.
Who is Entitled to Part 7 Benefits?
Every insured driver in British Columbia has a right to these benefits. If a driver is injured in an automobile accident, regardless of fault, they’re covered by insurance from the ICBC. The level of benefits you’re entitled to will vary based on the severity of the injury(s) you have sustained.
What is Provided by These Benefits?
Part 7 benefits entitle the insured to four different types of benefits: medical, rehabilitation, wage and death benefits.
The ICBC is required to pay for the medical and therapeutic expenses that are reasonable and necessary as a result of the injury. The insured is also covered if any assistance aids, such as a prosthetic or orthotic is required. What the ICBC sees as reasonable and necessary often differs from the view of medical professionals, and this is often the source of many disputes with the ICBC.
The ICBC may also pay for rehabilitative services that are necessary as a result of the injury. These types of benefits are there to cover costs associated with any changes in lifestyle a person must undergo as a result of the injury. For example, these benefits may cover attendant care at home, alterations to a home to make it handicap accessible, wheelchairs, or other kinds of equipment.
Part 7 wage benefits provide the injured individual with partial salary restitution if the person is unable to return to work or continue to hold a job. To qualify for these benefits, the insured must either be employed at the time of the accident or been employed for more than 50% of the past year. These benefits provide the insured with 75% of the salary they’ve earned over the last 52 weeks, but cap off at a maximum of $300 per week.
Individuals who have been injured in an accident but do not qualify for wage benefits may still be eligible for homemaker benefits. These benefits entitle a person to a maximum of $145 per week if they’re unable to return to the duties they attended to at home as a result of the accident.
Wage benefits can be paid for up to two years if the insured is unable to return to their job after an accident. To qualify for wage benefits longer than two years, the insured must be able to prove that they’re unable to return to any kind of employment which they may be qualified for.
These benefits can be paid up to the age of 65. In some cases, the ICBC may require an individual who is receiving long term wage benefits to apply for benefits from the Canadian Pension Plan. If eligible, your part 7 wage benefits will be reduced by the benefits you receive from the pension plan.
If the worst imaginable situation is realized, and the insured individual dies as a result of their accident, or injuries sustained from that accident, they’re entitled to death benefits from the ICBC.
For immediate funeral expenses, the ICBC will pay out a maximum of $2,500. Beyond that, there are also benefits available to the surviving family members of the deceased. These benefits will vary based on the relationship between the surviving and the deceased. For example, if the head of household is deceased, the benefit amount will be greater than if a spouse or child has died.
How to Apply for Part 7 Benefits
You can apply for part 7 benefits by phone or online at any time. Usually, the ICBC is notified by one of the drivers involved in an accident immediately after a crash. As a general rule, the ICBC wants to be notified in writing of a claim within 30 days of the accident.
There is certain information the claimant must have before filing. This information includes the license plates of the cars involved in the accident, the driver’s license numbers of the drivers involved and the police file number (if applicable).
However, there is much more information regarding the accident that you are not required to provide the ICBC. In fact, certain information may prove detrimental to your case with the ICBC. If you’re unsure at all about your rights or how to complete your claim for benefits, you should contact a lawyer for help.
A lawyer will be able to walk you through all of the requirements and best practices for filing your claim. If you’re confident you can handle filing a claim on your own, an ICBC representative will be able to guide you through the filing process.
Other Programs You May Be Entitled To
Beyond the insurance you have with the ICBC, there are many other programs you may be entitled to. These types of programs can be especially helpful if your injuries are not the result of an automobile accident.
At the same time, some of these programs may provide supplemental benefits in addition to your part 7 benefits. Before you can begin the application process, you’ll need to figure out the extent and severity of your injury and how long you’re expecting to miss work as a result of your injuries.
Next, you’ll need to find out what you’re qualified for under the law. In Canada, there are several different types of benefits you may be eligible for. However, you may not be qualified for some of these programs. Read on and learn about the different types of disability benefits that you may be entitled to.
Depending on your job, one of the benefits you may receive is sick time. Before you can exercise any of the other programs below, your employer will pay you from the sick time that you have accumulated on the job. Most employers cap the amount of sick time an employee can accumulate either with deadlines for the use of sick time, or a maximum number of hours of sick time you can save.
For eligible workers, the employment insurance program provides workers with income replacement benefits for up to 15 weeks. If you’re covered by employment insurance, there are some requirements you’ll need to meet to collect.
First, you must be employed by a participating company for at least 600 hours of work. You’ll also need to be able to prove that your income has been lowered by 40% or more.
If you have been injured on the job, then chances are you’re entitled to workers compensation. For almost all industries, enrollment in a workers compensation program is required by law.
Workers compensation provides employees with income replacement benefits for injuries which they sustained while working. You can learn more about claiming workers compensation in British Columbia here.
Short Term Disability Insurance
Many businesses in Canada offer their employees short term disability insurance which provides them with salary restitution for injuries that are expected to keep the employee from working for a period up to three months.
Some disability insurance plans may extend short term disability insurance further than the three month period. Not everyone is covered by this insurance, so you’ll need to check with your employer if you’re unsure whether or not you have coverage.
Long Term Disability Insurance
For more serious injuries that will keep the employee out of work for a period longer than three months, there is long term disability insurance. Some people have their own individual long term disability insurance, but most are covered under a group plan offered by their employer. If you’re unsure if you qualify for long term disability insurance, you’ll need to consult with your employer.
Canada Pension Plan
Many workers who aren’t entitled to long term disability benefits may be covered by the Canada Pension Plan. To be eligible for benefits under the CPP, you’ll need to have been unable to keep a job or work effectively as a result of your disability and under the age of 65.
This program is only open to Canadians who have been making contributions to the Canada Pension Plan before becoming disabled. You’ll also need to be out of work for at least four months before you are able to apply for benefits from the CPP.
Veterans Affairs Benefits
If you’re a member of the Canadian Armed Forces and you’ve been injured as a result of your military service, you may qualify for benefits from Veteran Affairs Canada. Even if your injury doesn’t affect your ability to work, you may still qualify for benefits based on the severity of your condition.
If you are disabled, or you’re caring for a disabled person, you may qualify for tax benefits because of that disability. If you are entitled to these benefits, a deduction for your taxable income is made on your taxes, which can result in substantial tax refunds.
Other Considerations to Make When Applying for Benefits
Regardless of the type of benefits you’re entitled to or applying for; there are some best practices you’ll want to follow to ensure that you’re receiving the different benefits you’re entitled to.
Consult With Your Doctor
Having your doctor’s support regarding any injury claims you’re making is of paramount importance. Any benefits that you may be entitled to must be confirmed by your physician. If your personal doctor is unwilling to confirm your injuries for the sake of an insurance claim, there’s practically no chance a doctor appointed by the various insurance companies that may cover you will vouch for your injuries.
Sit down with your doctor and discuss the severity of your injury(s) and how they’re affecting your ability to work or lead a normal life as a result of your accident.
Understand Your Disability and Employment Situations
Changing your employment status as a result of your injury can have a huge impact on your ability to collect benefits related to your accident. You must carefully manage your employment situation following your injury to ensure that you’ll be protected moving forward.
Resigning from employment, retiring or accepting a severance package could all have dramatic effects on your ability to collect benefits. So, be sure to go through the proper channels, keep your employer abreast of the situation, and don’t react hastily when dealing with employment following your accident.
Understand the Different Requirements for Claiming Benefits
Most of the different types of benefits we’ve outlined above require a range of different paperwork which must be received by the insurance company for the insured to receive benefits.
In many cases, there are forms that the insured must fill out, forms that must be filled out by your doctor, and forms that must be filled out by your employer. Be sure you’re staying on top of all of the required paperwork, and working with all of the involved parties to make sure your claim is on the proper track.
Fill Out All Forms Completely and Thoroughly
It may go without saying, but you’d be surprised by how many people are denied benefits because they’ve done a shoddy job filling out paperwork for their claim. Do not let your ability to collect benefits be affected by poor attention to detail or laziness.
When filling out any forms related to disability insurance, be sure to take your time, be thorough, and make sure that you’re providing every piece of required information.