If your long-term disability (LTD) benefits have been denied, delayed, or terminated, you should not have to face the insurance company alone. At Foster Injury Law, our Ontario long-term disability lawyers help people across the province challenge unfair LTD decisions and fight for the benefits they deserve. Insurance companies often deny legitimate claims. We step in to handle the legal and insurance issues so you can focus on your health, stability, and recovery. We offer free consultations and charge no legal fees unless your claim is resolved successfully.

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Who We Help

 

We assist clients across Ontario whose LTD benefits have been:

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• Denied after submitting a claim

• Terminated after months or years on claim

• Delayed with no explanation

• Suspended pending medical reviews

• Challenged due to surveillance

• Refused because of an insurer-arranged medical examination (IME)

• Denied based on “insufficient medical evidence”

• Discontinued at the 24-month “any occupation” changeover

 

Whether your insurer is Manulife, Sun Life, Canada Life, Desjardins, RBC Insurance, Co-operators, Empire Life, Industrial Alliance, or another provider, we are able to help.

 

Understanding Long-Term Disability Benefits in Ontario

 

LTD benefits are usually provided through:

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• Employer group disability policies

• Union disability plans

• Private long-term disability insurance

• Professional association plans

 

Benefits typically cover:

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• 60–70% of your income

• Medical and rehabilitation supports

• Vocational assistance

• Return-to-work planning when appropriate

 

Common Conditions That Lead to LTD Claims

 

• Chronic pain and orthopedic injuries

• Traumatic brain injuries and post-concussive symptoms 

• Depression, anxiety, PTSD, and other psychological conditions

• Autoimmune disorders (fibromyalgia, lupus, rheumatoid arthritis)

• Neurological disorders

• Cancer and cancer-related limitations

• Chronic fatigue syndrome

• Degenerative spine conditions and spinal cord injuries

• Vestibular and migraine disorders

• Long COVID

• Post-surgical complications

 

Why LTD Claims Are Denied in Ontario

 

Insufficient medical evidence:

Insurers may claim your records do not support your limitations—even when your doctor disagrees.

 

Own occupation vs. any occupation:

Most policies use the “own occupation” test for the first 24 months, then switch to “any occupation.”

 

IME reports:
An insurer-arranged assessment may contradict your treating physician’s opinion.

 

Surveillance:
Short video clips are often misinterpreted to suggest you can work.

 

Return-to-work pressure:
Insurers frequently push people back to work prematurely.

 

Mental health claim minimization:
Insurers often argue psychological conditions lack objective proof.

 

Administrative or technical issues:
Missing forms, incomplete records, or minor errors are commonly used as justification for denial.

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How We Help With Denied or Terminated LTD Benefits

 

• Reviewing your LTD policy

• Gathering supportive medical records

• Coordinating evidence from specialists

• Challenging inaccurate IME reports

• Handling all communication with the insurer

• Negotiating fair lump-sum settlements

• Preparing your case for litigation if needed

 

Total Disability: What It Really Means

 

Under the own-occupation test (typically first 24 months), you qualify for LTD if you cannot perform the essential duties of your job. Under the any-occupation test (after 24 months), you must be unable to work in any job for which you are reasonably suited based on training, education, and experience.

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Internal Appeals: Should You File One?

 

Insurers encourage internal appeals, but they are rarely effective and often delay your case. Speak to a disability lawyer before appealing, as internal appeals can harm your claim or cause missed deadlines.

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LTD Lawsuits in Ontario

 

If your appeal is unsuccessful—or if you choose to skip the internal appeal—we can file a lawsuit to recover:

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• Back-dated benefits

• Future benefits

• Aggravated and punitive damages (when appropriate)

• Interest and costs

 

Most LTD lawsuits settle without going to trial.

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CPP Disability and LTD Claims

 

Most insurers require claimants to apply for CPP Disability, which can strengthen your LTD case. Information: 

 

FSRA

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Insurance companies are regulated by the Financial Services Regulatory Authority of Ontario (FSRA)

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Human Rights and Disability

 

Human rights protections related to disability are outlined by the Ontario Human Rights Commission.

 

Related Pages

Ontario Catastrophic Injury Lawyers
Ontario Car Accident Lawyers

Barrie Long-Term Disability Lawyers
Newmarket Long-Term Disability Lawyers
Vaughan Long-Term Disability Lawyers

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Insurer Tactics and Strategies

 

• The paper review – internal consultants give opinions without examining you.

• Bias in IMEs – insurer-arranged assessments often minimize limitations.

• Surveillance – video clips are frequently misinterpreted.

• Inconsistent-use arguments – momentary activity does not equal work capacity.

• Return-to-work pressure – threats to terminate benefits if you don’t attempt work.

• Vocational assessments – recommendations may be unrealistic.

• Selective use of medical records – isolated positive notes are overemphasized.

• Psychological claim minimization – demands for “objective proof” not required by policy.

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LTD Policy Terms and Definitions (Glossary)

 

Total Disability: The degree of limitation required to qualify for LTD benefits.

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Own Occupation: You qualify for LTD if you cannot perform the essential duties of your specific job.

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Any Occupation: After 24 months, you must be unable to work in any job reasonably suited to your education, training, or experience.

 

Elimination Period: The waiting period (often 90–180 days) before LTD benefits begin.

 

Attending Physician’s Statement (APS): A form your doctor completes to support your disability.

 

Claimant Statement: Your personal description of your symptoms, limitations, and work duties.

 

Functional Capacity Evaluation (FCE): A test used to assess your physical abilities and tolerances.

 

Independent Medical Examination (IME): An insurer-arranged medical assessment.

 

Vocational Assessment: An analysis of your skills, work history, and potential for alternative employment.

 

Offsets: Reductions to your LTD payment based on CPP-D, WSIB, severance, or other sources.

 

Residual Disability: Partial disability that still qualifies for benefits under some policies.

 

Frequently Asked Questions

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What should I do immediately after my LTD benefits are denied?

 

Contact a disability lawyer.

 

Do I need to appeal internally before starting a lawsuit?

 

No. Internal appeals are optional and often ineffective.

 

How long do LTD appeals and lawsuits take?

 

Many cases settle within months.

 

What medical evidence do I need?

 

Functional limitations from your doctor are most important.

 

What if an IME contradicts my doctor?

 

This is common. IMEs can be challenged or discredited.

 

Will surveillance ruin my LTD claim?

 

Rarely. Surveillance is often misleading or taken out of context.

 

Do mental health conditions qualify for LTD?

 

Yes. Psychological disabilities qualify if they prevent you from working.

 

Can I receive LTD and CPP-D?

 

Yes, though CPP-D may offset LTD depending on your policy.

 

What happens at the 24-month mark?

 

Policies typically switch to the “any occupation” test.

 

Can I work part-time while on LTD?

 

It depends on your policy. Some allow limited income.

 

What if I was injured in a car accident?

 

You will likely still receive LTD. LTD and auto insurance benefits can overlap.

 

When should I hire a disability lawyer?

 

As soon as your claim is denied, delayed, or threatened.

 

Why Choose Foster Injury Law

 

We provide free consultations, no upfront fees, and a you-only-pay-if-we-win structure. We have extensive experience with all major disability insurers and offer personalized service across Ontario.

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Book a Free Consultation

 

If your long-term disability benefits were denied or terminated anywhere in Ontario, contact Foster Injury Law today for a free consultation. We can help you understand your options and pursue the benefits you deserve.