Long-Term Disability Lawyer Ontario

Denied or cut off from LTD benefits? Get clear answers and real help. 

When your long-term disability (LTD) benefits are denied, delayed, or suddenly cut off, the impact is immediate. Your income stops. Bills pile up. Your health may worsen. And insurers often make the process feel confusing and overwhelming.

You don’t have to navigate this alone.

At Samfiru Tumarkin LLP, we’re Ontario’s leading disability law firm, helping tens of thousands of Canadians challenge unfair denials and get their benefits reinstated. Our team knows how insurance companies operate — and exactly what to do when they say “no.”

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What Does Long-Term Disability Cover in Ontario?

Long-term disability benefits replace a portion of your income when you can’t work due to an illness or injury. These can include:

• Mental health conditions
• Chronic pain and fatigue
• Neurological disorders
• Cancer and immune-related conditions
• Cardiovascular issues
• Orthopedic injuries
• Post-concussion and traumatic brain injuries

Every policy is different, but most define disability using two key stages:

1. “Own Occupation”

You qualify if you can’t perform the essential duties of your job.

2. “Any Occupation” (Usually After Two Years)

The insurer evaluates whether you can perform any job you’re reasonably suited for.

If an insurer decides you can work — even when your doctor strongly disagrees — your payments can be cut off. This is one of the most common problems we see across Ontario.

Note: Some Ontarians may also qualify for federal income support such as CPP Disability benefits.

Why LTD Claims Are Denied or Cut Off in Ontario

Insurers frequently deny legitimate disability claims using broad or technical arguments. The most common reasons include:

• “Insufficient medical evidence”
• “You can return to modified or part-time work”
• “Your condition does not meet the definition of disability”
• “You’re not following a treatment plan”
• “Surveillance suggests you are more active than reported”
• “Your benefits end at the two-year mark”

A denial doesn’t mean your claim is invalid — it simply means the insurer is challenging your evidence, your diagnosis, or their own policy wording.

And they’re often wrong.

Ontario LTD Claims: What To Do If Your Benefits Are Denied

If your claim is denied, delayed, or cut off:

✅ Don’t file an internal appeal

These almost never work. They’re handled by the same insurer that denied your claim.

✅ Don’t give up on your benefits

Your doctor’s opinion — not the insurance company’s — is what matters.

✅ Get a legal opinion as soon as possible

Most LTD cases resolve through negotiation, not court. Our team can explain your options quickly, in plain language.

Common Conditions That Lead to LTD Claims in Ontario

Insurance companies often underestimate or misunderstand conditions including:

• Depression, anxiety, and other mental health disorders
• Chronic pain and fibromyalgia
• Long COVID and post-viral fatigue
• Concussion and traumatic brain injury
• Crohn’s disease and other gastrointestinal disorders
• Autoimmune diseases
• Migraines and neurological issues
• Orthopedic injuries requiring surgery or ongoing treatment

If your doctor supports your disability, the insurer must consider that evidence.

How the Two-Year Definition Change Works

In most Ontario LTD policies, the definition of disability changes at the 24-month mark. This is when many people are suddenly cut off.

Insurers often argue that:

• you can work in “alternative occupations,”
• you’re able to take on lighter duties, or
• your condition has improved “enough” to return.

These decisions are frequently incorrect. We challenge them every day across the province.

Surveillance and Social Media: What Insurers Look For

Insurers often use video surveillance or social media to take activities out of context — such as carrying groceries, attending a family event, or going for a short walk.

These brief moments don’t reflect:

• your medical limitations,
• your recovery needs, or
• your ability to sustain work.

We help ensure surveillance is interpreted properly and does not undermine your claim.

🔎 To learn more about the major insurers in the province, explore our List of Insurance Companies in Ontario.

Who We Help Across Ontario

We assist individuals throughout the province, including:

Wherever you live, our disability lawyers can help you understand your rights and the next steps in your claim.