Long-Term Disability Disputes

Denied Long-Term Disability Benefits? We Can Help.

When an illness or injury prevents someone from working, long-term disability (LTD) benefits are supposed to serve as a financial lifeline. These benefits are designed to replace a portion of one’s income, allowing an individual to focus on recovery, rehabilitation and planning for the future. Yet in practice, many Canadians who appear to qualify for LTD find themselves in a struggle just to access that support. When a claim is denied or terminated, the impact can be profound: the loss of income, the stress of litigation, the disruption to recovery and rehabilitation, and the broader financial instability for the individual and their family. That is why legal advocacy is so important: to ensure that the promise of LTD benefits is honoured and that individuals are not left to navigate these processes alone.

What Is a Long-Term Disability Claim?

Long-term disability insurance is designed to replace a portion of your income if you are unable to work due to a serious medical condition. These benefits may be available through a group policy (often arranged by an employer) or through a private individual policy.

Qualifying for LTD benefits typically requires that your condition prevents you from performing the essential duties of your own job. After a period of time, most policies become more restrictive and require that you be unable to perform any occupation for which you are reasonably suited by education, training, or experience.

Common Reasons for LTD Denial or Termination

Insurers may deny or stop benefits for a variety of reasons, including:

Claiming there is insufficient medical evidence
Alleging the condition does not meet the definition of “total disability”
Suggesting you are able to work in a different job
Surveillance or social media evidence used out of context
Failure to attend insurer-appointed medical assessments

How Beckett Personal Injury Lawyers Can Help

Our law firm has over 25 years of experience representing clients across Ontario in long-term disability disputes. We understand how overwhelming it can be to take on a large insurance company, especially when you are already dealing with serious health challenges.

We assist with:

Reviewing your denial letter and policy
Communicating directly with the insurer
Gathering and organizing medical evidence
Representing you in settlement negotiations, mediations, or court proceedings
Ensuring that your legal rights are protected throughout the process

Frequently Asked Questions

What should I do if my long-term disability claim is denied?

If your claim has been denied, the first step is to carefully review the denial letter, which should explain the reason for the insurer’s decision. You should also request a complete copy of your LTD policy and claim file. Contacting a lawyer experienced in LTD disputes can help you understand your legal options and avoid missing important deadlines.

Can I appeal the denial through the insurance company?

Most LTD policies allow for an internal appeal, but it is important to approach this with caution. These appeals are handled by the same insurer that denied your claim. Before submitting an appeal, it is often beneficial to speak with a lawyer who can advise whether it would be better to pursue a legal claim instead.

How long do I have to start a legal claim after my LTD benefits are denied?

In Ontario, there is generally a two-year limitation period from the date you are first denied LTD benefits. However, determining the exact deadline can be complicated. It is important to seek legal advice as soon as possible so your rights are not lost due to a missed limitation period.

Do I need to be completely unable to work in order to qualify for LTD benefits?

Not necessarily. Most policies first assess whether you are unable to perform the essential duties of your own occupation. After a certain period (usually two years), the definition of disability may change to require that you be unable to perform any occupation for which you are reasonably suited. A lawyer can help interpret your specific policy language.

Can I receive other benefits (such as CPP Disability) while on LTD?

Yes. In fact, many LTD policies require you to apply for CPP Disability Benefits. If you are approved, the LTD insurer may offset the amount you receive from CPPD against your LTD payments.

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