Long-Term Disability Denied in Canada: What to Do Next

If your long-term disability (LTD) claim was denied, you’re not alone — and the decision is not final.

Insurance companies deny valid claims every day, often based on how your file is reviewed rather than your actual ability to work. In many cases, these decisions can be challenged — and overturned.

What you do next can make a major difference.

This guide explains:

• why long-term disability claims are denied in Canada
• what those denial reasons really mean
• what to do immediately after your claim is denied
• why internal appeals often don’t work
• how long you have to take action
• how a long-term disability lawyer can help

What to Do Immediately After Your Long-Term Disability Is Denied

If your long-term disability was denied or your benefits were cut off, take these steps right away:

• Do NOT appeal immediately — this can weaken your position
• Do NOT accept the insurer’s decision as final
• Request a copy of your full claim file and policy
• Focus on medical evidence that clearly explains your limitations
• Speak with a disability lawyer before taking action

⚠️ Important: Don’t Delay After an LTD Denial

If you’ve received a letter saying your long-term disability claim was denied, timing matters.

Many people assume that filing an internal appeal protects their rights. In reality, legal deadlines still apply, and delays can affect your ability to challenge the decision.

Getting clear advice early can make a major difference in protecting your claim.

What Counts as a Long-Term Disability Denial?

A long-term disability denial doesn’t just mean your initial application was refused.

In Canada, a denial can include situations where:

• Your initial LTD claim was denied
• Benefits were approved but later cut off
• The insurer says you no longer meet the definition of disability
• Benefits stopped after the two-year “any occupation” change
• The insurer claims you can work in another job
• Surveillance or insurer medical exams are used to justify termination
• Benefits stopped due to paperwork or compliance issues

Common Reasons LTD Claims Are Denied

Insurance companies rely heavily on policy wording and internal file reviews when deciding LTD claims.

Some of the most common reasons include:

“You Are Not Totally Disabled”

Many LTD policies require that you can’t perform the essential duties of your job.

This does not mean you must be completely unable to perform all activities.

Insurers sometimes interpret this definition very narrowly.

Insufficient Medical Evidence

claims are frequently denied due to “insufficient evidence,” particularly for conditions that are difficult to measure with a single test.

This often reflects how medical evidence is written, not whether the disability exists.

The Insurer Disagrees With Your Physician

Insurance companies often rely on:

• In-house medical consultants
• Paper file reviews
• Insurer-arranged Independent Medical Examinations (IMEs)

These opinions may conflict with the conclusions of your treating doctors.

Surveillance or Activity Reports

Insurance companies sometimes rely on short surveillance clips or isolated activities to suggest that you can work.

Surveillance in long-term disability claims does not automatically justify a denial. These observations are often taken out of context and may not reflect your true limitations.

The Two-Year “Any Occupation” Change

Many LTD policies change definitions after two years.

Initially, you may qualify if you can’t perform your own occupation.

After two years, the insurer may deny benefits if they believe you can perform any occupation.

What Happens After a Long-Term Disability Claim Is Denied?

After a disability claim denial, insurers typically provide a letter explaining their decision.

This letter may:

• Outline reasons for the denial
• Provide an opportunity for internal appeal
• Set deadlines for submitting additional information

However, internal appeals are not always the best strategy.

Should You Appeal a Long-Term Disability Denial?

Most insurers encourage claimants to pursue internal appeals.

However, internal appeals can present challenges:

• The insurer reviews its own decision
• There is no neutral decision-maker
• Appeals can delay legal claims
• Important deadlines may still apply

Before pursuing an appeal, it is often important to understand all available options.

How Long Do You Have to Challenge an LTD Denial?

In many provinces, you have two years from the date of denial to start a legal claim.

If this deadline passes, your claim may be permanently barred.

LTD Denials After Short-Term Disability

It’s common for insurers to approve short-term disability benefits, then deny long-term disability.

This may happen because:

• A different adjuster reviews the claim
• The LTD definition of disability is stricter
• Updated medical evidence is required
• Insurers raise pre-existing conditions exclusions

Conditions Frequently Affected by Disability Claim Denials

Long-term disability claims are often denied for conditions such as:

• Chronic pain
• Mental health conditions
• Fibromyalgia
• Migraine
• Concussions and brain injuries
• Fatigue-related illnesses
• Long COVID

Many disabling conditions do not appear clearly on scans or tests. That does not automatically disqualify a claim.

How a Long-Term Disability Lawyer Can Help

A disability lawyer can:

• Take over all communication with the insurer
• Organize medical evidence
• Challenge flawed insurer reports
• Respond to surveillance allegations
• Protect limitation deadlines
• Negotiate a fair settlement

Speak to a Long-Term Disability Lawyer in Canada

If your long-term disability claim was denied or your benefits were cut off, getting clear legal advice early can make a real difference.

At Samfiru Tumarkin LLP, our team has helped tens of thousands of Canadians challenge disability claim denials and recover compensation.

• ✅ No upfront fees
• ✅ No obligation to proceed
• ✅ Clear, practical guidance