Any Occupation vs Own Occupation Disability in Ontario

What Long-Term Disability Insurers Don’t Explain Clearly

If you receive long-term disability (LTD) benefits in Ontario, the definition of disability in your policy matters just as much as your medical condition.

Most LTD policies use two different definitions of disability:

• Own occupation (early stage)
• Any occupation (later stage)

Understanding the difference can explain why benefits are approved at first — then suddenly cut off, often around the 24-month mark.

What Is “Own Occupation” Disability?

Under an own occupation definition, you are considered disabled if:

• You can’t perform the essential duties of your own job due to illness or injury.

Key Points:

• Focuses on your actual job, not a generic role
• Applies during the first phase of most LTD policies (often the first 24 months)
• Easier standard to meet

What Is “Any Occupation” Disability?

After a set period (usually 24 months), most LTD policies switch to an any occupation definition.

Under any occupation, you must prove that you can’t perform:

• Any job for which you are reasonably suited by education, training, or experience.

This is where many Ontario LTD claims are reduced, questioned, or terminated.

Insurers often argue:

• You can do sedentary or lighter work
• You could retrain for another role
• Your condition doesn’t prevent all employment

The 24-Month Change: Why LTD Claims Are Often Denied

The transition from own occupation to any occupation is not automatic approval — it’s a re-evaluation.

Insurance companies may:

• Order new medical exams
• Rely on paper reviews by insurer-paid doctors
• Focus on what you might be able to do, not what you realistically can do
• Ignore pain, fatigue, or mental health limitations

Many people are denied at this stage even though their condition hasn’t improved.

Does “Any Occupation” Mean Any Job at All?

No — and this is where insurers often overreach.

Under the total disability definition used in most Ontario LTD policies, you are not required to prove that you are incapable of all work in a theoretical sense.

Courts in Ontario have confirmed that:

• The job must be realistic
• It must align with your skills, background, and experience
• It must be work you can perform consistently and reliable
• It must exist in the real labour market

Mental Health & Chronic Conditions Under Any Occupation

Conditions like:

• Depression
• Anxiety
• PTSD
• Chronic pain
• Fibromyalgia
• Long COVID
• Migraines

are frequently challenged under the any occupation test — especially when symptoms fluctuate.

Insurers often rely on outdated assumptions about “sedentary work,” ignoring:

• Cognitive fatigue
• Concentration limits
• Stress intolerance
• Medication side effects

These cases require strong medical and vocational evidence.

Can You Work Part-Time and Still Qualify?

Sometimes — but it depends on your policy and circumstances.

Attempting work without proper guidance can:

• Be used against you
• Trigger a premature benefits cutoff
• Be mischaracterized as “capacity for employment”

Before trying any return-to-work or modified duties, it’s critical to understand how insurers interpret any occupation.

When “Any Occupation” Is Used to Wrongly Cut Off Benefits

If your LTD benefits were:

• Reduced
• Terminated
• Denied after 24 months

you may have legal options.

Many Ontario LTD denials occur because insurers:

• Misapply the policy definition
• Ignore medical evidence
• Rely on flawed vocational assessments

How a Disability Lawyer Can Help

Disputes over own occupation vs any occupation are legal — not medical — issues.

At Samfiru Tumarkin LLP, our disability lawyers:

• Review the exact wording of your LTD policy
• Challenge unfair insurer interpretations
• Work with your doctors to strengthen evidence
• Push back against improper benefit terminations

Key Takeaway for Ontario LTD Claimants

• Own occupation focuses on your job
• Any occupation focuses on realistic employability
• The switch often happens at 24 months
• Denials at this stage are common — and frequently wrong

If your LTD benefits are being questioned, reduced, or cut off under an any occupation definition, understanding your rights early can make all the difference.