If you have a Canada Life short-term or long-term disability claim, a Canada Life disability case manager may become your main point of contact during the claims process.
Canada Life says its disability case managers assess claims, gather medical and functional information, communicate with employees, employers and health-care providers, make decisions about eligibility, and help develop return-to-work plans where appropriate.
Because the case manager can play an important role in decisions about your disability benefits, you should understand what they do, what information they may request and how to communicate clearly throughout your claim.
On This Page:
- 1. What a Canada Life Case Manager Does
- 2. How to Communicate
- 3. Medical Information & Assessments
- 4. Return to Work
- 5. If Problems Arise
- 6. FAQs
What Does a Canada Life Disability Case Manager Do?
Canada Life describes its disability case manager as the person who takes the lead in managing a disability claim.
According to Canada Life’s current disability-management information and job descriptions, a case manager may:
- review medical information;
- review the duties of your job;
- assess whether you meet the applicable definition of disability;
- speak with you, your employer and health-care providers;
- request additional medical or functional information;
- develop or coordinate a return-to-work plan;
- monitor your progress during the claim; and
- make or implement decisions about continued eligibility for benefits.
Canada Life also says case managers may work with rehabilitation consultants, medical consultants or other professionals where appropriate.
Does the Canada Life case manager decide whether my claim is approved?
Canada Life’s public disability-management material says case managers assess whether a claimant is eligible for benefits and whether they meet the contractual definition of disability.
That means information you provide to the case manager can become an important part of the claim file.
Is a Canada Life Disability Case Manager Your Advocate?
No. Your Canada Life case manager works for the insurance company. Remember that.
A case manager can explain parts of the claims process, gather information and coordinate aspects of disability management. But they are administering and assessing the claim for Canada Life.
You should communicate clearly and cooperate reasonably with the claims process, but you should also:
- Answer questions accurately
- Avoid guessing about medical issues
- Keep copies of important communications
- Make sure your restrictions and limitations are properly documented
- Get independent legal advice if a significant disagreement develops
How Should You Communicate With a Canada Life Case Manager?
Be careful and accurate when speaking with your Canada Life case manager. What you say can become part of the claim file and can affect whether your benefits are approved or continued.
1. Be accurate about your symptoms and abilities
Don’t exaggerate what you can’t do, but don’t minimize your limitations either.
An isolated good day or activity does not necessarily mean you are capable of working reliably and consistently. Make sure the case manager understands the difference.
2. Don’t guess about medical questions
If you’re asked about a diagnosis, prognosis, treatment plan or return-to-work date and you aren’t sure, say that you need to confirm the information with your doctor.
Your treating provider is generally better positioned to give medical opinions about your condition.
3. Focus on functional limitations
A disability claim isn’t only about the name of your diagnosis. It is also about what your medical condition prevents you from doing.
Depending on your job and condition, this could include difficulty:
- sitting, standing, walking or lifting;
- concentrating or remembering information;
- maintaining regular attendance;
- working at a consistent pace;
- managing fatigue, pain or medication side effects;
- interacting with others; or
- tolerating workplace stress.
4. Keep records
Save important emails, letters and forms related to your claim.
If an important conversation happens by phone, make a note afterward that records:
- the date;
- who you spoke with;
- what was discussed;
- what information Canada Life requested; and
- any deadline or next step.
What Questions Can a Canada Life Disability Case Manager Ask?
The questions will depend on your claim. Canada Life’s current disability forms and case-management material show that relevant information can include:
- when you stopped working;
- your medical condition;
- your symptoms and functional limitations;
- your treatment;
- your job duties;
- whether you have returned to work in any capacity;
- whether modified duties or hours are possible; and
- your expected return-to-work date, if known.
Canada Life’s current employee disability statement specifically asks whether a claimant has returned to regular duties, modified duties or modified hours, and which aspects of their job they remain able to perform.
Do you have to answer every question?
You generally need to cooperate reasonably with the disability claims process and provide information relevant to assessing entitlement under your plan.
If you believe a request is unusually broad, irrelevant or intrusive, don’t simply refuse it. Ask why the information is required and speak with a disability lawyer before responding if you have concerns.
Can a Canada Life Case Manager Contact Your Doctor?
Canada Life disability forms include authorizations that can permit relevant medical and health information to be obtained for the purpose of assessing and administering a claim.
Canada Life’s case-management material also says case managers may gather medical and functional information from treatment providers and communicate with physicians or other medical professionals.
Whether your case manager actually contacts your doctor will depend on the circumstances and information needed.
If Canada Life asks your doctor for information, it can help to:
- confirm what has been requested;
- follow up with your doctor’s office;
- make sure the request doesn’t get overlooked; and
- keep a copy of medical forms or reports where possible.
For more information, see our guide to the Canada Life Attending Physician Statement.
Can Canada Life Ask for More Medical Information or an Assessment?
Yes. Depending on your policy and claim, additional medical or functional information may be requested.
Canada Life’s own disability-management material says case managers may:
- collect additional medical and functional information;
- obtain information from independent assessors;
- refer claims to medical consultants; and
- involve rehabilitation professionals where appropriate.
If Canada Life asks you to attend an independent medical examination or another assessment, review the request carefully.
Canada Life Case Manager and Return to Work
Return-to-work planning is an explicit part of Canada Life’s disability case-manager role.
Canada Life says case managers can develop return-to-employment plans, coordinate with employers and work with rehabilitation professionals to support a return to work.
What if Canada Life says you can return but your doctor disagrees?
If Canada Life says you can return to work but your doctor says you aren’t medically ready, don’t assume the insurer’s assessment is correct.
Your doctor’s medical opinion about your ability to work is important.
If your doctor says you aren’t medically ready to return, ask them to clearly document:
- Why you remain unable to work
- Your restrictions and limitations
- Whether modified duties are possible
- Whether reduced hours are appropriate
- When your ability to return should be reassessed
Don’t return to work before you are medically ready simply because your disability benefits may be under review.
Can a Canada Life case manager arrange a gradual return to work?
A case manager may be involved in coordinating a gradual or modified return-to-work plan with you, your employer and medical or rehabilitation professionals.
A gradual return should reflect your actual medical abilities. Depending on the circumstances, it could include:
- reduced hours;
- lighter duties;
- temporary restrictions;
- scheduled increases in hours; or
- other medically supported accommodations.
If a gradual return is moving too quickly or your symptoms worsen, speak with your doctor and communicate the updated medical information promptly.
What Happens at the Canada Life LTD Two-Year Mark?
The two-year mark is one of the most important stages of an LTD claim. When the definition of disability changes, many people have their benefits cut off even though their health has not improved and they still can’t work.
If your policy changes from an “own occupation” test to an “any occupation” or gainful-employment test, your Canada Life case manager can reassess whether you satisfy the new definition.
Reaching two years doesn’t automatically mean your benefits should end. If you continue to satisfy the definition of disability in your policy, you can remain entitled to LTD benefits.
Read our guide to Canada Life LTD benefits after two years.
What If You’re Having Problems With Your Canada Life Case Manager?
Problems and disagreements can arise between a claimant and their Canada Life case manager during a disability claim.
For example, you may be dealing with:
- Calls or emails you believe haven’t been answered
- Confusion about what medical information is outstanding
- Repeated requests for information you believe has already been provided
- Disagreement about your ability to return to work
- Uncertainty about your claim status
- A decision to suspend or terminate benefits
What should you do first?
Try to identify the specific problem rather than simply saying the relationship isn’t working.
For example:
- Ask what exact information remains outstanding.
- Ask for an explanation of a decision in writing.
- Confirm when Canada Life expects to provide an update.
- Ask to speak with a supervisor if the issue can’t be resolved.
Can you ask for a different Canada Life case manager?
You can ask Canada Life whether your concern can be escalated or whether a different case manager can be assigned.
Whether Canada Life will reassign the file depends on the circumstances.
If your concern is primarily about service or communication, Canada Life also has an internal complaint process. If the real dispute is whether Canada Life should be paying your disability benefits, a service complaint and a legal challenge are different things.
Read our guide to Canada Life complaints and the ombudsman process.
What If Your Canada Life Case Manager Stops Your Benefits?
Canada Life’s public disability-management material says a case manager continually assesses whether a claimant meets the applicable definition of disability and can terminate the claim when Canada Life concludes that the definition is no longer met.
If your STD or LTD benefits are stopped and you remain unable to work, don’t assume Canada Life got the decision right. Insurers can cut off benefits while you’re still disabled.
Review:
- The written reason for the termination
- The definition of disability in your policy
- The medical evidence Canada Life considered
- Whether your doctors continue to support your inability to work
- Whether any important information is missing
- Any appeal or legal deadline
If your doctors continue to support your inability to work, you can take action to challenge the cutoff.
See our full guide to a Canada Life disability claim denial.
How Samfiru Tumarkin LLP Can Help With a Canada Life Case Manager Issue
Our disability lawyers bring years of industry experience to disputes involving major Canadian insurers, including Canada Life.
If a disagreement with your Canada Life case manager affects your benefits, we can review your policy, Canada Life’s requests, your medical evidence and any decision to suspend or terminate benefits.
Where legal action is appropriate, our disability lawyers can deal with Canada Life on your behalf, challenge the decision and pursue the benefits you’re owed.
Consultations for disability claims are free. If we take on your case, disability matters can be handled on a contingency-fee basis, meaning legal fees are paid from the recovery rather than upfront.
➡️ Contact Samfiru Tumarkin LLP to speak with a disability lawyer about your Canada Life claim.
Canada Life Disability Case Manager FAQs
What does a Canada Life disability case manager do?
Canada Life says its disability case managers manage STD and LTD claims by reviewing medical information and job duties, assessing eligibility, communicating with claimants and health-care providers, monitoring claims and coordinating return-to-work plans where appropriate.
Does a Canada Life case manager decide if my disability claim is approved?
Canada Life’s public material says case managers assess eligibility and determine whether a claimant meets the applicable contractual definition of disability. Depending on the claim, other medical, rehabilitation or management professionals may also be involved.
Is my Canada Life case manager my advocate?
No. Your case manager works for Canada Life — they are not your advocate. Their role includes managing and assessing your disability claim on behalf of the insurer. They are not your independent doctor or lawyer and are not responsible for protecting your legal rights.
Can a Canada Life case manager call my doctor?
Canada Life’s disability process allows case managers to gather relevant medical and functional information from treatment providers where authorized and appropriate. Whether your doctor is contacted will depend on the claim and information required.
What should I say to my Canada Life disability case manager?
Be accurate and consistent. Explain your actual symptoms and functional limitations, don’t guess about medical questions you don’t know, and make sure important medical restrictions are documented by your treatment providers.
Remember that what you say can become part of your claim file and can affect how Canada Life assesses your entitlement to benefits.
Can a Canada Life case manager make me return to work?
A case manager can be involved in assessing return-to-work capacity and coordinating a return-to-work plan. However, your medical condition and your treating provider’s opinion about your functional abilities remain important. If your doctor says you aren’t medically ready, make sure the reasons are clearly documented.
Can I ask Canada Life for a different case manager?
You can ask Canada Life to escalate a communication or service concern and request reassignment. Whether a different case manager will be assigned depends on the circumstances.
What if my Canada Life case manager stops my disability benefits?
Ask for the reason in writing and compare it with your policy and medical evidence. If you remain unable to work, don’t assume Canada Life got the decision right. A disability lawyer can challenge the cutoff and pursue the benefits you’re owed.
Independent Legal Information: This page was prepared by Samfiru Tumarkin LLP as an independent legal resource for people dealing with disability claims. Samfiru Tumarkin LLP is not affiliated with or endorsed by Canada Life. References to issues that may arise during disability claims describe general legal and insurance principles or circumstances that can arise in individual cases. Your rights depend on your policy and individual circumstances.