LTD Claims from Start to Finish: Gathering medical information, exploring accommodation, and facilitating return to work

Employers, unions, and employees all have an interest in ensuring that long-term disability (LTD) benefits are properly administered within a workplace. However, the LTD claims process can be complex and unwieldy, as parties seek to satisfy human rights and privacy obligations while still promoting operational efficiency and curbing abuse. A panel of experts will guide audience members through each step of the LTD claims process and discuss a range of legal issues in the area, including:

• Applying for LTD benefits: What obligation does an employer have to provide information about long-term disability benefits to an employee? What steps are required of the employee to establish his or her entitlement to LTD benefits? Is there an obligation on the employer and/or the union to assist an employee in applying for LTD benefits? If so, does the obligation end if the employment relationship is terminated?
• Gathering medical information: What medical information is an employer or insurer legally entitled to request at the outset of a claim for LTD benefits? What information can be sought in an initial versus later request? When should information from a specialist be required? When can an employer or insurer request an independent medical examination?
• Protecting privacy: What should employers, insurers and unions do to protect the confidentiality of medical information in their possession? Are employers free to share an employee’s medical information with the employee’s union in order to facilitate return to work and accommodation?
• Facilitating return to work: What are the steps that should be taken by employers to investigate the availability of return-to-work accommodation options for an employee on long-term disability? What is the union’s role in this process and how should it participate? What right/obligation does an employee have to participate in exploring return-to-work options? What steps should be taken if the insurer takes the position that an employee is not entitled to benefits on the basis that she or he could be accommodated in the workplace, but the employer and/or the union disagree?
• Conducting surveillance: Before using private investigators to conduct surveillance, must employers or insurers have a reasonable basis to suspect that an employee may be abusing disability benefits? What less-intrusive methods of investigation should employers or insurers consider before resorting to surveillance?
• Establishing undue hardship: At what point will an employer be able to establish that it has accommodated an employee on long-term disability to the point of undue hardship? Does it matter if the termination would deprive the employee of LTD benefits, or other health or insurance benefits?