Medical evidence is one of the most important parts of a long-term disability claim.
The insurance company needs more than proof that you have an illness or injury. It needs medical information explaining how your condition affects you and why you can’t perform your job.
A short doctor’s note that simply says “unable to work” can leave important questions unanswered. A stronger report explains your symptoms, treatment, limitations and how those limitations interfere with your ability to work.
If you are just starting your claim, see our guide to applying for long-term disability benefits.
On This Page:
- What Medical Evidence Do You Need?
- What Should a Doctor’s Report Say?
- Is a Doctor’s Note Enough?
- Who Can Provide Medical Evidence?
- Walk-In Clinics and LTD Forms
- How Often Are Updates Needed?
- If Your Doctor Won’t Support You
- If the Insurer Says Evidence Is Missing
What Medical Evidence Do You Need for Long-Term Disability?
The medical evidence needed will depend on your condition and your claim.
It can include:
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Reports from your family doctor
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Specialist reports
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Clinical notes and records
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Diagnostic test results
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Psychological or psychiatric reports
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Treatment or rehabilitation records
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Information about medication and important side effects
You don’t need every type of document listed above. The important point is that the medical evidence clearly supports why your health prevents you from working.
For a broader list of documents to save during your claim, use our long-term disability claim checklist.
What Should a Doctor’s LTD Report Include?
A useful medical report should connect your health problems to your ability to work.
Where appropriate, it should explain:
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Your condition or diagnosis: What medical problem is being treated?
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Your symptoms: What are you experiencing?
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Your treatment: What treatment, medication or therapy are you receiving?
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Your limitations: What activities are difficult or not medically appropriate?
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Your ability to work: Why do those limitations prevent you from performing the important duties of your job?
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Your outlook: Is improvement expected, and is there a reasonable estimate for when your ability to work should be reassessed?
The report should reflect your treating professional’s actual medical opinion. You should never ask a doctor to exaggerate your condition or write something they don’t believe is medically accurate.
Is a Doctor’s Note Saying You Can’t Work Enough for LTD?
Often, no. A short note saying only that you are “unable to work” can be too vague for an LTD claim.
The insurer wants to understand why you can’t work.
For example, your medical evidence might explain that your condition causes:
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Severe pain when sitting or standing
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Fatigue that prevents you from maintaining a full workday
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Difficulty concentrating or remembering information
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Panic, anxiety or other symptoms that interfere with workplace functioning
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Medication side effects that affect alertness or stamina
That information gives the insurer a clearer picture of what your condition actually prevents you from doing.
Who Can Provide Medical Evidence for an LTD Claim?
Your medical evidence can come from the health professionals who are treating the condition that prevents you from working.
Depending on your situation, that can include:
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Your family doctor
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A medical specialist
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A psychiatrist
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A psychologist
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A physiotherapist or occupational therapist
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Another treating professional with relevant information about your condition and limitations
Different professionals can provide different pieces of the picture. For example, a specialist can explain a diagnosis while a physiotherapist can provide useful evidence about physical limitations.
The insurer can still require its specific medical form to be completed by a doctor or another type of professional identified in the policy or claim forms.
Can a Walk-In Clinic Fill Out Disability Forms?
A walk-in clinic doctor can potentially provide medical information or complete disability paperwork, but whether they can properly support your LTD claim depends on your situation.
A doctor who has treated you over time will usually know more about:
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Your medical history
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How your symptoms have changed
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Treatment you have already tried
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How your condition affects your ability to function
A walk-in doctor who has only seen you once may not have enough information to give a detailed opinion about a long-term disability.
If you don’t have a family doctor, explain that to the insurer and continue seeking appropriate medical care. Keep records of your appointments, referrals and efforts to obtain ongoing treatment.
How Much Do Doctors Charge to Fill Out Disability Forms?
There isn’t one standard fee for completing LTD paperwork or preparing a medical report.
The cost can depend on the doctor or clinic, how detailed the form is, how much of your medical file must be reviewed and whether a separate report is required.
Ask the doctor or clinic about the fee before requesting the report. You should also check your benefits plan or ask the insurer whether it will cover any of the cost.
How Often Do You Need to Provide Updated Medical Reports?
How often you need updated medical information depends on your condition, your policy and what the insurer reasonably needs to assess your continued disability.
There is no standard schedule for every LTD claim.
For a condition that is changing or where recovery is expected, an insurer can ask for updates more frequently, sometimes every few months. For a long-standing or more stable condition, updates might be requested every six months, once a year or sometimes even less often.
The important point is to respond to reasonable requests and keep your medical evidence current enough to show why you continue to qualify for benefits.
If the insurer suddenly starts asking for extensive updates, new forms or assessments, read our guide on what to do when your LTD benefits are under review.
Can the LTD Insurer Ask for Your Medical Records?
Yes. An insurer needs medical information to assess whether you qualify for LTD benefits and whether those benefits should continue.
It can ask for records that are relevant to your disability claim, including information from your treating doctors and specialists.
Read any authorization carefully before signing it so you understand what information can be collected and from whom.
If a request seems extremely broad or unrelated to your claim, ask the insurer why it needs the information before simply ignoring the request.
What if Your Doctor Doesn’t Support Your LTD Claim?
Start by having a clear conversation with your doctor about your symptoms and the actual demands of your job.
Your doctor might understand your diagnosis but not fully understand what your work requires or why particular symptoms make those duties difficult.
Explain:
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Your regular job duties
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Which duties you are struggling with
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What happens when you try to perform them
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Whether your symptoms worsen with activity
If your doctor still believes you are medically able to work, you shouldn’t ask them to provide an opinion they don’t support.
If you believe important medical issues are being missed, you can discuss whether another appropriate medical assessment, referral or treating professional is needed.
What Should a Psychological or Psychiatric Disability Report Explain?
For a mental health LTD claim, the insurer needs to understand how your condition affects your ability to function at work.
Depending on the condition, the report can address problems with:
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Concentration and memory
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Stress tolerance
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Decision-making
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Interaction with other people
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Attendance and reliability
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Ability to maintain a regular work schedule
As with a physical condition, the report should focus on what your symptoms prevent you from doing—not simply the name of the diagnosis.
What if the Insurer Says There Isn’t Enough Medical Evidence?
Find out exactly what the insurer says is missing.
Ask whether it needs:
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A specific medical form
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Updated clinical records
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A clearer explanation of your limitations
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Information from a specialist
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Details about your treatment or expected recovery
Give that request to your treating professional rather than simply asking for another general note saying you can’t work.
If your claim has already been denied despite supportive medical evidence, don’t assume the insurer’s decision is final.
Read what to do when your long-term disability claim is denied.
Frequently Asked Questions About LTD Medical Evidence
Does LTD Ask for Medical Reports?
Yes. Medical information is normally required to assess an LTD application, and the insurer can ask for updated information while benefits are being paid.
Can Your Doctor Write a Letter for Disability?
Yes. A treating doctor can provide a letter or report explaining your medical condition, treatment, limitations and why you are unable to work. The insurer can also require its own medical forms to be completed.
Do Doctors Have to Fill Out Disability Paperwork?
A doctor can be asked to complete LTD paperwork, but whether they are able or willing to provide a particular report depends on the circumstances. If a required form isn’t being completed, find out why and address the problem before an insurer deadline passes.
Can a Walk-In Doctor Fill Out LTD Forms?
Potentially. However, a doctor who doesn’t know your medical history might not have enough information to give a detailed opinion about a long-term disability. Ongoing treatment is usually more helpful for showing how your condition affects you over time.
How Often Does LTD Need Medical Updates?
There is no single schedule. The frequency depends on your condition, policy and claim. Some insurers request updates every few months, while more stable claims can go six months, a year or longer between requests.
What if I Don’t Have a Family Doctor?
Continue seeking appropriate medical care and tell the insurer about the situation. A walk-in clinic, specialist or another appropriate treating professional can still provide medical information, depending on your circumstances.
Get Help With Medical Evidence for an LTD Claim
Strong medical evidence doesn’t need to be complicated. It needs to clearly explain what your condition prevents you from doing and why you can’t work.
If the insurer says your medical information isn’t enough, keeps requesting more documentation or has denied your claim despite support from your doctors, get legal advice.
Samfiru Tumarkin LLP helps people with long-term disability claims throughout Canada, excluding Quebec. Our long-term disability lawyers can push back against the insurance company and get you what you’re owed.