OT and Rehabilitation Assessments

1

Hello, first I want to thank the people involved in this forum, I have been looking for a resource/support like this for so long time now and am only just coming across it, I could honestly cry.

Some background:

  • Off on LTD (mental health) with Sunlife (Federal Public Service) since Fall 2024 as they would no longer accommodate disabilities that were previously accommodated for years via telework. As per all medical professionals warnings my conditions worsened and I entered severe burnout while trying to manage illness on top of the appeal process and became fully disabled. The union advised me I should go to court and sue for human rights violations, however that was more than I could handle.
  • I thankfully had no issues being approved for LTD within a few months time.
  • C-PTSD is the main diagnosis however depression, anxiety, ADHD, and multiple chronic physical pain illnesses are issues I also deal with.
  • I am approved under CRA Disability for tax purposes and see a provincial government appointment Psychiatrist.
  • In addition for treatment I see a family doctor, Psychotherapist, Osteopath, Physical Therapist, Massage Therapist, Gynaecologist, and Naturopath. None of these people recommend that I go back to work at this point in time.

Like a lot of people on LTD it seems as though I have cycled through quite a few case workers. I’m on 3 or 4 now, I’ve lost count. I never had any issues, everyone was always very kind and empathetic. February I am contacted by yet another new case worker who is young and speaks very fast with some language barriers between us as well. Any contact from Sunlife increases my anxiety and worsens my symptoms for weeks after, so this is harder again. Without explanation he tells me he is going to make the decision or not to refer me to an OT assessment, which he does immediately. Although myself and my therapist did not feel I was able to I go through with it assuming I have to. In April I struggle through the 2 half days, including breaking down at the table sobbing while trying to complete a computer based cognitive exam. Yesterday I receive another call from my new case worker saying they do not have that report back yet but now he will decide if he is going to refer me now to a Rehabilitation Consultant, who immediately called me today and set up an hour zoom call for next week. As soon as the phone hangs up I am straight into another panic attack I have to manage with medication.

My main questions are for anyone who has been through this… how is it relevant to a mental health claim and what can they tell from these tests? What are they looking for? A large part of my PTSD and trauma stem from a lifetime of being dismissed by medical professionals before finally getting help and treatment as an adult. I attempted to ask the OT this when I was being asked to lift weights from one desk to another but she would not answer. I know I’m not alone in feeling absolutely on edge 24/7 even being off of work and relying on LTD, thinking they are trying to trip me up and say the wrong thing at every turn. Are they just trying to dot their I’s and cross their T’s because it is nearing the 2 year mark, or is there more to this? I see so many people as it is for various treatments, beyond what most people do for mental health claims, can they tell me it is still not enough? What does an OT do for mental health that a psychiatrist and therapist cannot?

Thank you all so much, I appreciate any words of wisdom.

2

If you were sent for an assessment by an occupational therapist and are going to talk to a Rehab Consultant, my guess is that your insurer is evaluating your functional limitations to see what you can and cannot do. If your insurance policy states that the definition of total disability changes from “own occupation” to “any occupation” at the 2yr mark, your insurer will be looking to see what jobs you can possibly do given your limitations.

When you have your zoom meeting with the Rehab Consultant next week, be honest, and if you need a break say so. If you’re going into a panic, tell them that as well. Just be yourself, however you are right now, and they’ll see that you’re not fit to work yet.

If you have chronic pain conditions, if I were you, I would be seeing a pain specialist that also provides chronic pain education. Your insurer will also need to see that you are getting treatment (prescription pain meds etc) from a pain specialist. If you’re not seeing a pain specialist, they may assume the pain isn’t that bad. When giving updates to the insurer, I would place just as much emphasis on the pain you live with, as the mental health issues.

The 2 year mark is stressful for most of us on LTD. I was in a total mess as well.

All the best.

3

Thank you for the reply, this is sort of what I was expecting might be going on, however was just confused at the lack of focus on the mental health aspect.

You also sort of answered another question I had which is great. Given that my claim is mental health based but I have many other issues going on I always wondered was I detracting from the original reason for being off or do they see it like the DTC, as cumulative. There are many physical issues that come as a result of poor mental health and ongoing stress, but I don’t know how educated any of the people I talk to through Sunlife are on this topic and I’m afraid I might be kicking myself in the butt mentioning it. A lot of the people I do see are to manage pain, however a pain specialist in my province is a years long waitlist and some have stopped taking patients altogether due to the way the system is overrun now. Some other issues I may have but am not even officially diagnosed with (CFS, POTS, Fibromyalgia) as we don’t have anyone in the province to do it.

4

Were you approved for CPP disability

5

No, I have not applied for this yet. I was under the impression it was something I didn’t need to, or could not apply for until the 2 year COD was up with Sunlife. Apparently this is not the case?

6

It is a government benefit and you are free to apply anytime. You absolutely should apply sooner rather than later because it goes a long way in strengthening your claim. If you are approved for CPP disability and then denied at change of definition then most lawyers would look at you as a massive source of revenue.

It boggles my mind how the disability tax credit does nothing to an LTD claim even though it is infinitely harder to get than cppd.