Own Occupation Disability: What It Means in Canada (Complete Guide)
Many Canadians are surprised to learn that their long-term disability (LTD) policy uses the “own occupation” definition of disability for the first two years of a claim. This rule plays a major role in whether your benefits are approved, continued, or cut off.
This guide explains what “own occupation disability” means, how it compares to “any occupation”, and what to do if your insurance company denies or stops your payments.
What Is Own Occupation Disability?
Own occupation disability means you qualify for long-term disability benefits if your medical condition prevents you from performing the essential duties of your specific job — not every job, just the one you were doing before your disability.
Think of it this way:
- If you can’t do your actual occupation, you usually qualify.
- Your insurer can’t deny benefits just because you “might” be able to perform some other job.
ℹ️ This is the definition used in most LTD policies for the first 24 months of a claim.
2-Year Own Occupation Definition of Disability: How It Works
Many policies contain a 2-year own-occupation period. During these first 24 months:
- Your insurer must decide whether you can perform your old job.
- If your doctor confirms you can’t perform your job’s essential tasks, you normally qualify for LTD benefits.
- Insurance companies frequently reassess claims near the two-year mark.
Own Occupation vs. Any Occupation Disability
Understanding this shift is critical.
Own Occupation (first 24 months)
You qualify if you can’t do your job.
Any Occupation (after 24 months)
You must prove you can’t perform any job you are reasonably suited for, based on:
- Your age
- Your education
- Your training
- Your experience
Own Occupation Disability Insurance: What You Need to Know
You’ll see several terms in your LTD policy:
- Own occupation disability insurance
- Disability insurance own occupation
- Own occupation disability policy
They all refer to the same concept:
Coverage that pays benefits if you can no longer perform the duties of your specific job.
If your policy is through your employer, the own-occupation period is almost always limited to 24 months. Private, individually purchased policies sometimes offer a “true own occupation” version, which can last much longer — but insurers still dispute these claims aggressively.
What Does Own Occupation Disability Mean for Your Claim?
It affects nearly every part of your LTD claim:
- How your insurer evaluates your medical evidence
- The forms your doctor fills out
- The timing of reviews or reassessments
- Whether your benefits continue past the two-year mark
- The strategy your lawyer may use if your long-term disability is denied in Canada
Insurance companies often misunderstand — or intentionally misapply — the definition. That’s when people call our disability lawyers.
Why Insurers Deny Own Occupation Disability Claims
Common reasons include:
- Claims examiners saying your job “isn’t that demanding”
- Ignoring key parts of your doctor’s report
- Suggesting you can “work modified duties” even when none exist
- Relying on a short, one-time assessment from an insurer-paid doctor
- Misunderstanding your actual job description
- Claiming you can do “sedentary work” without assessing pain, fatigue, or cognitive issues
If your claim is denied, delayed, or cut off, you don’t have to accept the insurance company’s decision.
Own Occupation Disability and the 24-Month Cut-Off
As the two-year mark approaches, insurers often start:
- Increasing surveillance
- Sending you to Independent Medical Examinations (IMEs)
- Requiring more forms
- Requesting updated medical records
- Suggesting “return-to-work programs”
- Asserting you can work some other job
This is not random — it’s intentional, because switching definitions makes it easier for insurers to stop paying you.
What To Do if Your Own Occupation Disability Claim Is Denied or Cut Off
Your next steps matter. Here’s what most people do:
- ❌ File an internal appeal
- ❌ Send more forms
- ❌ Wait months for insurance reviews
Unfortunately, these steps rarely work. Insurance companies overwhelmingly uphold their own decisions.
The most effective option is to speak with a disability lawyer. In Canada, you can start a legal claim (not an appeal) to force the insurance company to pay what you are owed. In most cases, this is the only step that works.
How Our Disability Lawyers Help
At Samfiru Tumarkin LLP, we’ve represented thousands of people across Canada dealing with own-occupation and any-occupation LTD disputes. We know how insurers operate — and how to hold them accountable.
There are no upfront fees. You don’t pay unless we win.
📞 Call us at 1-855-821-5900, email help@disabilityrights.ca, or use our online form for a FREE consultation.