Your long-term disability policy is one of the most important documents in an LTD claim.

It sets out when you qualify for benefits, how much you can receive, what medical information the insurer can request and when payments can end.

If your LTD coverage comes through work, you might only have a benefits booklet or online summary. If you are applying for benefits, already receiving them or dealing with a denial, ask for the documents that contain the actual terms that apply to your coverage.

💡 Don’t rely only on what an insurer or employer tells you the policy says. Ask for the applicable policy wording and read the terms that affect your claim.

On This Page:

What Is a Long-Term Disability Policy?

An LTD policy contains the rules that determine whether and when long-term disability benefits are payable.

If you have coverage through work, your LTD insurance can be part of a group benefits plan. The documents describing your coverage can include a master policy, insurance certificate, benefits booklet, amendments and other plan documents.

If you bought disability insurance yourself, your individual insurance contract contains the terms of your coverage.

These documents matter because LTD plans aren’t all the same. The wording that applies to someone else’s claim might be different from yours.

How Do You Get a Copy of Your LTD Policy?

If your LTD coverage is provided through work, start by asking:

  • Your employer or human resources department

  • Your benefits or plan administrator

  • The insurance company

Ask in writing for the documents that set out the LTD coverage that applies to you, including the policy or certificate and any amendments that affect your benefits.

If you purchased an individual disability policy, contact the insurance company or the broker who arranged the coverage.

What Should You Ask For?

You can ask for:

  • The LTD policy or insurance contract that applies to your coverage

  • Your insurance certificate or benefits booklet

  • Any amendments or changes to the LTD coverage

  • The LTD claim forms, if you are preparing an application

If you are applying for benefits, our How to Apply for Long-Term Disability guide explains the rest of the application process.

Is a Benefits Booklet the Same as the LTD Policy?

Not always.

A benefits booklet or online summary can be useful because it explains your LTD coverage in a simpler format. But it might not contain every term that applies to your claim.

If an important issue arises, ask for the documents containing the complete wording that applies to your LTD coverage.

This is especially important if the insurer is relying on a specific clause to:

  • Deny your application

  • Reduce your monthly benefits

  • Require a medical examination

  • Change the test for disability

  • Cut off benefits

⚠️ If an insurer tells you that “the policy says” something important, ask it to identify the exact wording it is relying on.

What Should You Look for in an LTD Policy?

An LTD policy can be long and difficult to read. You don’t need to understand every page at once.

Start with the sections that affect the main issues in your claim.

Definition of Disability

Find the definition of “total disability” or similar wording. This explains what you need to show to qualify for benefits.

Many policies use an own occupation test initially and later change to an any occupation test. Read our guide to own occupation vs. any occupation disability.

Waiting or Elimination Period

This tells you how long you generally need to be disabled before LTD payments can begin.

Benefit Amount

Check how your monthly LTD benefit is calculated and whether the policy sets a maximum payment.

Other Income and Deductions

Look for rules allowing the insurer to reduce LTD because of other income or benefits.

These provisions can become particularly important if you receive a severance package while on long-term disability.

Pre-Existing Conditions

The policy can limit coverage for certain medical conditions based on treatment and timing before your insurance took effect.

See our guide to pre-existing conditions and long-term disability.

Medical Information and Examinations

The policy can explain what medical evidence you need to provide and when the insurer can require an independent medical examination.

Change of Definition

Check whether the definition of disability changes after a certain period.

Learn more about the LTD change of definition.

Recurrent Disability

This section explains what happens if you return to work and later become unable to work again because the same or a related condition returns.

See our guide to recurrent disability.

Exclusions and Limitations

Read any section that limits when benefits are payable or how long certain claims can be paid.

Don’t assume an exclusion applies simply because the insurer refers to it. The wording still has to fit the facts of your claim.

When Should You Get Your LTD Policy?

Ideally, get the applicable policy documents as early as possible.

They are particularly important when:

You shouldn’t have to guess what rules the insurer is applying to your claim.

What if You Can’t Get a Copy of the LTD Policy?

If you ask for your LTD documents and only receive a summary—or receive nothing—follow up in writing.

Ask the employer, plan administrator or insurer to confirm:

  • Which LTD policy or plan applies to you

  • The date your coverage took effect

  • Which document contains the terms being applied to your claim

  • Where you can obtain a copy of that document

Keep copies of your requests and responses.

If the insurer is relying on policy wording to deny or stop benefits but you still haven’t been given the relevant terms, speak with a disability lawyer.

When Should a Disability Lawyer Review Your LTD Policy?

You don’t necessarily need a lawyer simply because you received an LTD policy.

Legal advice becomes particularly useful when:

  • You don’t understand a clause the insurer is relying on

  • The insurer says your condition is excluded

  • The definition of disability is changing

  • The insurer is deducting money from your LTD payments

  • Your benefits are being reviewed or are about to end

  • Your LTD claim has been denied

A disability lawyer can compare what the insurer is saying with what the policy actually requires.

If your claim has already been refused, read what to do when your long-term disability claim is denied.

Frequently Asked Questions About LTD Policies

How Do I Get a Copy of My Long-Term Disability Policy?

If your LTD coverage comes through work, ask your employer, benefits administrator or insurance company for the documents containing the LTD terms that apply to you. If you bought the policy yourself, contact the insurer or broker.

Is My Benefits Booklet My LTD Policy?

Not necessarily. A booklet can summarize your coverage, but other policy, certificate or plan documents can contain additional terms. Ask what documents contain the complete wording that applies to your LTD coverage.

Why Do I Need My LTD Policy?

The policy explains when you qualify, how benefits are calculated, what medical information can be required and what exclusions or limitations can affect your claim.

What if the Insurer Says My Policy Excludes My Claim?

Ask for the exact policy wording it relies on. An exclusion must actually apply to your circumstances before it can be used to deny benefits.

What if My Employer Only Gives Me a Benefits Summary?

Ask which policy, certificate or other plan document contains the complete LTD terms that apply to you and request a copy of the relevant documents.

Get Help Understanding Your LTD Policy

Your long-term disability policy determines the rules the insurance company must follow when assessing your claim.

If the insurer is relying on wording you don’t understand, refusing to provide the relevant documents or using the policy to deny or cut off benefits, get legal advice.

Samfiru Tumarkin LLP helps people with long-term disability claims throughout Canada, excluding Quebec. Our long-term disability lawyers can respond to the insurance company and get you what you’re owed.

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Having Trouble Understanding Your LTD Policy?

The wording of your policy can determine whether benefits are approved, continued or denied.

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