Mental Illness Disability Benefits for Canadians (2023 Guide)Browse all therapists
First Session helps connect Canadians with counsellors or therapists … but we know that sometimes more help is needed. That’s why we created this guide to mental illness disability benefits in Canada: to help you navigate another level of available support. This kind of support usually takes place after counselling and therapy is underway. It’s important to consider consulting your doctor, legal or insurance experts when accessing disability benefits.
Everyone experiences moments when they’re low on energy because of stress or sadness. It can be difficult during those times to keep up with the day-to-day. Many people in Canada struggle consistently with their mental health, and it can deeply impact daily life, including when it comes to employment.
Recent data show about 1 in 5 (20%) of Canadians experience mental illness each year. If you’ve felt a high level of anxiety, stress or depression (or have been diagnosed with a mental health disorder or illness), the first thing to remember is you’re not alone.
If you’ve already used support systems like your family doctor, a counsellor or therapist, or medication but it’s not helping you keep up with employment and income, you might be wondering if there is additional support out there for you. Yes, but…it can be difficult to navigate this complex system.
In Canada, mental illness is a significant public health concern. In some cases, mental illness is considered a disability, which allows Canadians to qualify for similar benefits as someone who has a physical ailment or other health conditions that affects their ability to work (e.g. fibromyalgia, ALS, epilepsy, cancer).
Mental illness disability benefits play a critical role in Canada’s healthcare system for those who are unable to work because of mental health conditions.
Understanding Mental Illness as a Disability in Canada
Mental illness disability benefits are covered between federal, provincial or territorial healthcare, and private insurance (paid for by workplaces or individuals). The options you access depend on your needs, your demographic, and your health profile.
The benefits are designed to provide a source of income when regular employment is impacted by illness. Those benefits typically provide some type of financial aid for basic living expenses, treatment and medical bills.
The Canada Health Act (CHA) requires provinces and territories to cover medically required or necessary services for Canadians. Even so, mental health and counselling services are often limited or under-serviced across Canada.
It’s important to do your research, apply for the correct program and manage your expectations before starting the process.
Private insurance companies play a role in providing additional coverage for care outside of what is offered by public healthcare. Many private insurers offer packages that include mental illness in their disability benefits.
The majority of private insurance plans are paid for through Canadian employers, but plans can be purchased by individuals as well.
Why do these plans include mental illness, and why is it beneficial for employers to cover this benefit? There is no legal requirement for this, even within the health act. However, studies show mental illness has an economic impact to Canada of around $50 billion each year.
Many employers are keen to provide their employees such benefits as it demonstrates they are a responsible employer, and because it has economic and productivity benefits to them—and for good reason. Sunlife, one of Canada’s largest insurance companies, reported that mental health claims account for 30% of all disability claims and 45% of total claims costs. Depression continues to be the number one reason for a claim year-over-year.
Whether through government or private insurance benefits, common inclusions for mental illness disability in Canada are:
- Attention-deficit/hyperactivity disorder (ADHD)
- Major depressive disorder
- Generalized anxiety disorder
- Bipolar disorder
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Borderline personality disorder (PTSD)
These are just a few examples, it’s important to consult the specific eligibility requirements where you live, or within your private health coverage.
Types of Disability Benefits Available for Mental Illness
There are a few different sources for mental illness disability benefits in Canada. The eligibility criteria, requirements and coverages can vary:
- Employment Insurance (EI): This provides temporary financial assistance to individuals who are unable to work due to job loss through no fault of their own, including for medical reasons. You can only access EI if you’ve been employed in an insurable job (i.e. you’ve paid into this program through employment or self employment) and you’ve worked the minimum number of hours in the previous year. EI benefits offer up to a max dollar amount for a set number of weeks. The government suggests looking at employer-paid sick leave before applying for EI.
- Short Term Disability (STD) and Long Term Disability (LTD): These are short and long-term insurance options that are part of employer benefits packages. The amount of these benefits will depend on your coverage package, but typically Short Term Disability will provide some financial assistance for a percentage of your salary (usually 60-70%) for up to 6 months, and anything after 6 months will require an application for Long Term Disability. If you’re not covered for STD or LTD, you can apply for EI.
- Canada Pension Plan Disability (CPP-D): This is a federal government program for those who have contributed to the Canada Pension Plan (CPP) through employment. The disability benefit is available to those under 65 who are unable to work due to a prolonged or terminal illness. There is also a child benefit available to those who may need assistance if they have dependents. The coverage will depend on how much the individual contributed to the CPP and their average earnings.
- Workers’ Compensation: This benefit is offered through compensation programs that are offered through government agencies, like WorkSafeBC in British Columbia, or the Workplace Safety and Insurance Board (WSIB) in Ontario. This provides coverage for those who became injured or ill due to work-related factors. If a connection can be made between mental health and work-related events, you may be eligible. Coverage will vary, but can offer benefits to cover a percentage of previous salary, medical expenses and rehabilitation.
- Veterans Affairs Canada (VAC): This program is delivered by the federal government to those who experience mental health conditions due to their service in the Canadian Armed Forces. Support can include financial compensation, rehabilitation and other types of assistance.
- Tax credits: There are income tax reliefs available to those who are living with a prolonged or severe mental or physical disability that impacts their quality of life or ability to work, such as the Disability Tax Credit (DTC). This can be broken down into federal and provincial amounts on your tax return, and the amount will vary by-province, just like any other tax credit.
- Provincial Supports: Each province and territory provides assistance programs to those with disabilities. These programs can include financial support to cover living and medical expenses, and other offerings like employment support such as job coaching, assistive devices or transportation. These programs vary by province:
- British Columbia: Persons with Disabilities (PWD) Benefit
- Alberta: Assured Income for the Severely Handicapped (AISH)
- Saskatchewan: Saskatchewan Assured Income for Disability (SAID)
- Manitoba: Employment and Income Assistance (EIA) Disability Assistance
- Ontario: Ontario Disability Support Program (ODSP)
- Quebec: Social Solidarity Program (SSP)
- New Brunswick: Social Assistance Program for Persons with Disabilities
- Nova Scotia: Income Assistance for Persons with Disabilities
- Prince Edward Island: Social Assistance Program for Persons with Disabilities
- Newfoundland and Labrador: Income Support Program for Persons with Disabilities
- Yukon: Territorial Disability Benefit
- Northwest Territories: Persons with Disabilities Program
- Nunavut: Income Support Program
Typically, you will need to have significant documentation from medical professionals to prove your health claims. Unfortunately, when it comes to mental illness, it can be more difficult to demonstrate a health claim than other ailments and conditions.
If you are applying for disability benefits, consider seeking guidance from your insurance provider, your counsellor or therapist, medical practitioner, legal professionals or advocacy groups that specialize in disability rights.
The Application Process for Mental Illness Disability Benefits
The process of applying for mental illness disability benefits in Canada can be complex and confusing, particularly if you’re already struggling in daily life (the exact reason you might need such support). It shows immense strength to make the decision to try to access some of these benefits, and you should be proud of yourself for taking this step, regardless of the outcome, and don’t give up if you’ve been declined once.
Here are some of the factors to consider to prepare for the application.
- Medical Documentation: Each program requires medical documentation to apply, so it’s of utmost importance that you have comprehensive proof of your work with medical and psychological services to-date. These can include medical records of your diagnosis, treatment plan, medications (those you take now and, importantly, those you’ve tried and weren’t successful) and any documented limitations due to your illness.
- Selecting the Right Program: Each program meets slightly different needs and circumstances for individuals. Choosing the right program can increase your chances of success. For example, workers’ compensation can be especially difficult for mental illness, as rationality such as a toxic work environment causing mental distress is not enough to prove assistance is needed; the program will likely determine you can change your circumstances. However, if you have documented diagnosis and otherwise substantial medical records, you’ve contributed to your EI or CPP and/or have good workplace benefits, one of the other programs may work for you.
- Medical Assessment: Regardless of medical documentation, you may still be required to have an assessment done by a professional designated by the program to evaluate the severity of your illness and how it impacts your ability to work.
- Application Form: Each program will have its own application form. Take time to understand where to apply and who evaluates the application. For example, an application to short- or long-term disability will be through your HR or benefits provider, whereas an application to EI will be through the government. Answer the questions thoroughly and honestly. Leave yourself enough time as they’re often thorough and you may not have all of the answers when you first encounter the form. You may need time to source the information you need. Keep in mind, some programs can offer almost immediate support, whereas others, like CPP-D may take up to 4 months for benefits to start.
Challenges in proving mental illness:
- Stigma, subjectivity and misunderstanding disabilities: Unfortunately, these application processes are designed and reviewed by humans with their own level of knowledge and biases. Reviewers or assessors may have limited understanding of a mental illness, skepticism or even pressure from their organizations to be scrutinizing of these applications. Working with an advocacy group or organization specializing in these programs can help through the application process.
- Inconsistent medical records: It’s so important that you document every step you take with your medical practitioners. You may be seeking help from a few different sources of care who don’t necessarily talk to each other. It’ll be in your best interest to keep records of your appointments, interactions, medications or treatments you’ve tried, etc. to prove your case. This could include documentation of missed work or proof of your limitations, such as any adjustments to your work you’ve already undertaken with HR.
- Incorrect or incomplete treatment: Your application may be impacted if you’re given a course of treatment not aligned with your illness diagnosis, or you’ve received a diagnosis but your practitioner did not take the correct steps to diagnose, or you refuse to try certain treatments recommended by professionals—this can include stopping treatments against your doctors’ advice. It’s important to be working with health professionals who are collaborative with you, and who can advocate for you, if possible.
- Complexity of the system: You might take every step necessary to prove your case and apply thoroughly, but the sheer complexity of these systems can be overwhelming, especially when dealing with conditions that affect your ability to support yourself mentally. Be patient with yourself, and ask for help through the process.
Throughout the process, your credibility and the credibility of the professionals you’re working with will be a relevant factor in your success. Here are a few ways you can boost your credibility when working with assessors and reviewers through the application process:
- Review your medical records and ensure your claims match your records.
- Take responsibility for gaps or potential problems with your claims; do not blame others.
- Be cooperative and respectful, even if you disagree with the reviewer’s assessment. Try asking questions, defer to professionals and go through the designated appeals channels to challenge denials.
- Try reasonable advice throughout the process, including if you’re working with medical professionals now and you think you may make a claim later.
- Make obvious efforts to keep working on your wellbeing.
Challenges and Common Reasons for Denial of Mental Illness Disability Claims
According to the Canadian government, over 17% of the reported illnesses or injuries for EI is for stress/anxiety/mental health issues—the second most reported reason above injury, surgery and disease. Other reports show 30% or more of Canada’s disability claims are related to mental illness.
While this demonstrates, in one way, the severity of the mental health crisis in the country, it is encouraging to know Canadians are making these claims and are successfully receiving them. Data is lacking, however, around how many mental illness disability claims are denied each year.
There are numerous reasons someone’s claim might be denied and it can be specific to the requirements of the program, documentation provided by the individual, or other unique circumstances. Some reasons for a denial of a mental illness disability claim include:
- Insufficient medical documentation: This is one of the primary sources of proof for assessors and reviewers; if documentation doesn’t clearly demonstrate the necessary level of severity or treatment plan to-date, and the impact on someone’s ability to work, the claim could be denied.
- Limited treatment: This could include gaps in your records, or inconsistency in the help and treatments at the time of the application. Inconsistencies and limitations might raise concerns about the legitimacy of the claim.
- Medical credibility: If the medical assessments between professionals are inconsistent or if the reviewing medical professional disagrees with a diagnosis, the claim could be denied. It’s also important that the evidence you do have from your medical history is from licensed and registered specialists.
- Limited work history: Some programs like the CPP-D or EI require you to pay into them before they can be accessed. If you have a limited work history, you may not have contributed enough to access the program.
- Inconsistent or incomplete applications: It’s so important to ensure the information in your applications are complete and consistent. Contradictions, even if a mistake, could lead to a claim being denied.
- Unproven connection to work: The condition is not adequately connected to your ability to function at work, or you’ve not demonstrated other other workplace concessions have been unsuccessful, you could be denied.
Overcoming these challenges can seem daunting. If your claim is denied, be sure to read your denial letter closely to understand the factors for that decision, gather any additional documentation you might need, and file an appeal. There are appeals processes for each program.
If needed, look for disability or legal professionals who work in this space to help with the appeals process; some groups may be free of charge as part of broader social services in your area
Recap: Accessing mental illness disability benefits in Canada
While the system is complex and can be challenging, the availability of mental illness disability benefits in Canada is a crucial part of our public healthcare system. These benefits are available to help Canadians who are otherwise unable to work.
Remember, many of these programs are either offered by your employer or are available to those who have paid into them through their employment (i.e. deductions on your pay cheque). You are fully within your right to access those benefits if you’ve contributed to; there is no shame in applying, that’s what they are there for, and you’ve paid for them!
To prepare for a potential application to one of the available programs in the country, remember:
- Document everything to the best of your ability;
- Accept treatment plans as directed by your doctor or licensed mental health professional;
- You can change course if something is not working, but work collaboratively with your health team to make those changes;
- Be cautious when declining care; this may work against you in an application or review;
- Look for the program that best suits your circumstances and your work history;
- Take your time; the application processes can be daunting and, in some cases, may not result in financial support for several months;
- Keep in mind, some programs are very limited in their monthly benefits; consider your living and medical expenses carefully;
- Work with credible medical and mental health professionals.
If you’ve not yet started working with a mental health professional, this is a good first step to take. You may even find your mental health plan helps you in day-to-day life. Seeking counselling is a huge accomplishment in itself, and can have a positive effect even if it’s the last thing you want to do, or the last thing you think you can do.
If you’re not sure where to start, you can find a counsellor or therapist in Canada on First Session. On your own time, browse professionals working in your area, filter by specialization, watch intro videos to “meet” them before reaching out.
Keep in mind, if you’re seeking a mental illness diagnosis, only some counselling professionals are licensed to diagnose in Canada: psychiatrists and psychologists. You can start with a referral to a psychiatrist or psychologist through your general practitioner, or seek the help of those professionals on your own.
Taking positive steps toward your mental wellbeing is so important, whether that’s financial support to help you through difficult times, or just finding a professional you trust who you can talk to. Therapy support is just one factor in accessing mental illness disability benefits in Canada, but you might find you benefit from the help of a counsellor.