Disability/Personal Injury

Denied long-term disability for mental health issues: Your rights


In Canada, long-term disability (LTD) claims for mental health issues make up the lion’s share of claims filed each year.

Despite mental disorders, such as depression and anxiety, being recognized as conditions that can affect your ability to do your job, many insurance companies still turn down legitimate claims.

By refusing to provide you with disability benefits, insurers are able to bolster their bottom line.

Not only does this prevent you from accessing crucial financial support, but it can add to the mental and emotional distress you are already dealing with before applying for disability benefits.

If you are struggling with a mental health issue, and your LTD claim was denied, don’t lose hope.

An experienced disability lawyer at Samfiru Tumarkin LLP can help you review your legal options.

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What is an “invisible illness”?

In Canada, invisible illnesses are mental (sometimes physical) conditions that exist, but lack visible or quantifiable medical evidence to prove their existence.

Since it can be difficult to prove that an individual is suffering from depression, anxiety, or another mental health issue, insurance companies often use this as an excuse to deny LTD claims.

  • Example: A woman in Vancouver filed a long-term disability claim for depression. A few days later, her insurance company informed her over the phone that her claim had been denied. When she asked her insurer why they wouldn’t provide her with disability benefits, the representative said depression is subjective and that her self-report of her condition was insufficient.

Regardless of the reason that your insurance company gives you for turning down your LTD claim, it’s important to remember that their decision isn’t final.

You have a right to ask questions and learn more about why you were denied disability benefits.

An experienced disability lawyer at Samfiru Tumarkin LLP knows the right questions to ask and how to determine if the insurance company made mistakes when turning down your claim.

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My insurer denied my claim, should I get the decision in writing?

It’s very important that you ask your insurance company for a denial letter. This document will explain why your LTD claim for mental health issues was turned down.

It should also cover:

  • How to appeal the insurer’s decision
  • The two-year time limit within which you can pursue a claim for compensation

Instead of sending you a denial letter, some insurance companies will try to tell you over the phone why you were denied or cut off disability benefits.

If this happens to you, don’t let your insurer end the call before confirming that they will also provide you with their decision in writing.

WATCH: Disability lawyer James Fireman explains three major mistakes people make when their LTD claim is denied on an episode of the Disability Law Show.

Once you receive the denial letter, gather any other relevant documents (i.e. your policy, application forms, etc.) and contact an experienced disability lawyer at Samfiru Tumarkin LLP.

We can review your situation, assess your legal options, and help you secure the compensation you deserve.

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Before filing my claim, do I need supporting medical information from my doctor?

The short answer is yes. When filing an LTD claim, you have to submit a variety of forms to the insurance company, including a physician statement.

If your doctor says you can’t work because of a mental health issue, such as depression or anxiety, you should qualify for long-term disability benefits.

However, even with support from a medical professional, some insurers will argue that claimants aren’t following the proper treatment plan for their disability and turn down or prematurely close LTD claims.

  • Example: A man in Toronto told his doctor that he couldn’t work because he was struggling with severe anxiety. His physician told him to take a specific medication daily and to rest. After six months of being on long-term disability, his insurance company reached out to get an update on his treatment and to see if he was participating in counselling. The man explained that he was resting and taking the medication that his doctor prescribed. A few days later, he was informed that his disability benefits had been cut off. When he asked his insurer why he no longer had access to his LTD benefits, he was told it was because he wasn’t participating in counselling for his anxiety.

It’s a good idea to ask your doctor to provide you with referrals to as many treatment providers and specialists as possible.

The more medical documentation you can provide, the higher the likelihood that your LTD claim will be approved.

• Doctor and Treating Health Professional Reports
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My long-term disability claim was denied, should I appeal?

If you are struggling with a mental health issue, and your LTD claim is denied, you are better off filing a legal claim instead of appealing.

The appeals process is typically handled by the same insurance company that refused to provide you with disability benefits in the first place.

There is no limit on the amount of times you can appeal. Insurers use this process to run out the clock on your ability to file a legal claim to get the compensation you are owed.

You have a two-year window to take legal action after your LTD claim is denied. Once the two years are up, the insurance company doesn’t have to pay your disability benefits and you can’t file a legal claim.

• Disability Law Show: Why you shouldn’t appeal a denied LTD claim
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What should I do if I already appealed?

If you appealed the insurance company’s decision to turn down your long-term disability claim, and were unsuccessful, you may still have options.

As long as it hasn’t been two years since your LTD claim was denied, an experienced disability lawyer at Samfiru Tumarkin LLP can review your situation and help you secure the compensation that you are entitled to.

How we can help

If your long-term disability claim is denied, or you are cut off from your disability benefits, contact the experienced disability law team at Samfiru Tumarkin LLP.

We know the law and regularly resolve LTD, life insurance, and mortgage insurance claim denials across Canada (excluding Quebec).

Several of our lawyers previously worked for insurance companies, which means we know how they operate, why they make certain decisions, and how to enforce your rights.

We have helped thousands of clients, including Julie Austin and Sandra Bullock, hold insurers accountable after their claims were denied or cut off prematurely.

Our disability lawyers provide free consultations and we don’t get paid unless we secure the compensation that you are legally entitled to.

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