If you can’t work because of an illness or injury, long term disability (LTD) benefits can provide crucial income support.
In Ontario, most employees have LTD coverage through a workplace group insurance plan, while others purchase private disability insurance.
LTD benefits replace about 60 to 70 per cent of your regular income while you’re unable to work. These payments help you focus on recovery instead of worrying about bills.
At Samfiru Tumarkin LLP, our Ontario long term disability lawyers have helped thousands of clients secure their benefits after unfair denials, delays, or cut-offs.
This guide explains:
- Who qualifies for LTD in Ontario
- How long benefits last
- What happens after two years
- What to do if your claim is denied
📍 Serving clients acrosrs Ontario — from Toronto and Ottawa to London and Windsor — we provide no-win, no-fee legal help for employees denied LTD benefits.
What Is Long Term Disability in Ontario
Long term disability (LTD) is an insurance benefit that replaces part of your income when you can’t work because of a serious medical condition.
There are two main types of coverage in Ontario:
- Group plans: Provided through your employer or union.
- Private plans: Purchased directly from an insurance company.
Most LTD policies:
- Pay 60–70% of your pre-disability income
- Have a 90–120-day waiting period before payments begin
- Continue paying until age 65 if you remain disabled under your policy
LTD vs. Other Ontario Programs
LTD is different from short term disability Ontario, CPP Disability, ODSP, or WSIB. You can sometimes qualify for more than one program — but your insurer may deduct these payments from your LTD benefits.
💡Example: If you receive CPP Disability while on LTD, your insurer will usually subtract that amount from your monthly payment.
Who Qualifies for Long Term Disability in Ontario
To qualify for LTD benefits in Ontario, you must:
- Have active coverage under a group or private disability policy
- Be unable to perform your job due to illness or injury
- Provide medical evidence supporting your condition
Common Conditions That Qualify:
- Mental health conditions such as depression, anxiety, PTSD
- Chronic pain, fibromyalgia, or chronic fatigue syndrome
- Cancer and side effects of treatment
- Neurological disorders such as MS, Parkinson’s, or epilepsy
- Cardiac or autoimmune illnesses, or other long-term physical impairments
You don’t need to be bedridden to qualify.
If your symptoms prevent you from doing the essential duties of your job, you may be eligibile for benefits.
🔎 Read More: What Conditions Qualify for Disability in Canada
Tip: Always ask your doctor to describe your functional limitations — what you can and cannot do — not just your diagnosis. This is the evidence insurers rely on when deciding your claim.
What Does “Totally Disabled” Mean Under an Ontario LTD Policy?
The term “totally disabled” doesn’t mean you’re unable to do anything.
It refers to whether you can perform the essential duties of your job — and, after a certain period, any job suited to your background.
In most Ontario long-term disability policies:
- Own occupation period (first 2 years): You must prove you can’t perform the key tasks of your own job.
- Any occupation period (after 2 years): You must show you can’t perform any occupation that fits your training, education, or experience.
After the two-year mark, many insurers reassess claims and cut off benefits unfairly, even when your condition hasn’t improved.
If that happens, contact a long term disability lawyer in Ontario before appealing directly to your insurance company.
Our team can review your medical evidence, work with your healthcare providers, and ensure your benefits are reinstated or settled fairly.
👉 For a detailed explanation of how insurers define total disability, visit our Total Disability Definition page.
Common Policy Limitations and Waiting Periods
Every long term disability policy in Ontario has rules that affect when and how you can receive benefits. Understanding these limitations can help you avoid surprises when you file your claim.
Common LTD policy rules include:
- Waiting period (elimination period): Most LTD plans have a 90–120 day waiting period after you stop working. This means payments don’t start right away.
- Pre-existing condition clause: If your condition began before you joined the plan (often within the first 12 months of coverage), your insurer may deny your claim.
- Coverage exclusions: Certain conditions, such as injuries from criminal activity or substance use, may not be covered.
- Proof of ongoing disability: You must continue providing updated medical reports to show that you remain unable to work.
💡 Tip: Even if your insurer says your condition is “pre-existing,” you may still qualify for LTD benefits depending on your policy wording and medical evidence. Our Ontario long-term disability lawyers can review your policy and determine your true eligibility.
How to Apply for Long Term Disability in Ontario
Applying for LTD benefits in Ontario involves more than just filling out forms. Insurers require detailed medical evidence to confirm that your condition prevents you from working.
Step-by-Step Guide:
- Confirm you have coverage. Check your workplace benefits plan, union agreement, or private insurance policy.
- Talk to your doctor. Your physician must support your time off work and describe your limitations clearly.
- Complete all claim forms.
- Claimant’s Statement: Filled out by you.
- Employer’s Statement: Completed by your employer.
- Attending Physician’s Statement: Completed by your doctor or specialist.
- Include supporting documents. Attach recent test results, medical notes, and any specialist letters that describe how your condition limits your ability to work.
- Submit everything before the deadline. Most insurers require you to apply within a specific window after your last day at work (often 90 to 120 days).
💡 Tip: Always keep copies of every form you submit. If your doctor’s letter is vague, insurers may delay or deny your claim.
If you’re unsure how to apply or your insurer is asking for extra documentation, contact our long term disability lawyers in Ontario for help before sending in your claim. We can review your application and make sure your forms tell your story clearly.
How Much Do Long Term Disability Benefits Pay in Ontario?
Most long term disability benefits in Ontario replace 60–70% of your gross monthly income, up to a specific cap listed in your policy.
- Example: If you earn $5,000 per month and your LTD plan covers 66.7% of your income, your monthly benefit would be about $3,335 before tax.
Important Notes:
- Some LTD benefits are taxable and others are not. If your employer pays the premiums, your LTD income will likely be taxable.
- LTD payments can be offset by other benefits like CPP Disability, WSIB, or EI Sickness.
- Some policies include a cost-of-living adjustment (COLA) that increases your benefit each year to account for inflation.
💡 Tip: If your insurer lowers your payment after you start receiving CPP Disability or another benefit, ask for a written explanation. You may still be entitled to the full amount under your policy.
How Long Can You Stay on Long Term Disability in Ontario?
Most long term disability benefits in Ontario continue until age 65, as long as you continue to meet your policy’s definition of disability.
Typical Timeline:
- First 2 years (“own occupation”): You must prove that your condition prevents you from doing your regular job.
- After 2 years (“any occupation”): You must show that your condition prevents you from performing any job suited to your education, training, or experience.
Some policies include rehabilitation or gradual return-to-work programs after two years, but participation must be medically supported and approved by the insurer.
💡 Tip: Insurers often stop payments after two years, insisting you can work in “any occupation.” If this happens, contact a long term disability lawyer in Ontario right away. A review by our team can determine whether you’re still entitled to full benefits under your policy.
What Happens After Two Years on LTD in Ontario?
After two years on LTD, your insurance company will reassess your claim. At this point, the definition of disability changes from “own occupation” to “any occupation.”
This is when many Ontarians see their LTD benefits denied or cut off, even if their medical condition hasn’t improved.
Insurers often claim that you can perform some other kind of work — even if it’s unrealistic or far below your skill level.
If your LTD payment are cut off at the two-year mark:
- Don’t panic.
- Don’t appeal directly to the insurer.
- Contact a disability lawyer who understands Ontario insurance law.
At Samfiru Tumarkin LLP, we regularly help people across Ontario reinstate wrongfully terminated benefits or negotiate fair lump-sum settlements.
We know how insurers make these decisions — and how to challenge them effectively.
Why Long Term Disability Claims Get Denied in Ontario
Even strong claims can be wrongfully denied by insurers. Common reasons include:
- Lack of medical evidence or vague doctor’s notes
- Pre-existing condition clauses
- Missed filing deadlines
- Change in definition of disability after 2 years
- Social media or surveillance evidence the insurer misinterprets
- Failure to follow prescribed treatment
If your claim is denied, remember that insurers often reject valid applications simply to reduce payouts.
💡 Tip: An internal “appeal” rarely succeeds — it’s handled by the same company that denied your claim.
Instead, speak to an experienced Ontario long term disability lawyer. We can review your medical file, contact your insurer, and push for the benefits or compensation you’re legally owed. Read our guide on Appeals and LTD Claims.
Can You Be Fired While on Long Term Disability in Ontario?
Your employer can’t fire you simply because you’re on long term disability (LTD) — doing so could breach the Ontario Human Rights Code.
However, there are limited situations where employment may end while you’re still on LTD.
For Example:
- If your medical evidence shows you’re permanently unable to return to work (called “frustration of contract“)
- If your employer restructures or eliminates your position entirely
- If your termination is unrelated to your medical condition (such as company-wife layoffs)
Even then, you may still be owed severance pay in Ontario — sometimes up to 24 months of compensation — and possibly human rights damages if the termination was discriminatory.
💡 Tip: If you’re told your job has been “frustrated” or you’ve been let go while receiving LTD benefits, don’t sign anything before speaking with an employment or disability lawyer.
Our team can review your termination, your policy, and your medical file to determine whether your severance and LTD rights in Ontario were violated.
Returning to Work After Long-Term Disability in Ontario
Many people in Ontario eventually return to work after a period on LTD — either part-time or in a modified role.
If your doctor supports the transition, your insurer may allow a gradual return-to-work plan or rehabilitation program.
Here’s what to know:
- Medical approval is essential. Always get written support from your treating physician before returning.
- Stay in touch with your insurer. Notify them of any schedule or workload changes to avoid accidental claim termination.
- Be honest about your capacity. Overextending yourself too soon can delay recovery and put benefits at risk.
💡 Tip: If you try returning to work and your symptoms worsen, your LTD benefits can often resume. You may not need to start a new claim if your relapse happens soon after returning.
If your insurer refuses to restart your benefits or pressures you to return before you’re ready, our Ontario long-term disability lawyers can step in to protect your rights.
- Read next: Returning to Work After Disability Benefits
Can You Travel While on Long Term Disability in Ontario?
Yes — you can usually travel while on long term disability, but you must follow your policy’s rules and maintain your treatment plan.
Before you go:
- Check your policy for travel restrictions or required approvals.
- Continue medical care or therapy as prescribed.
- Avoid posting photos or updates that could be misinterpreted by your insurer.
Insurance companies sometimes view travel as evidence that you’re not “totally disabled.” Even innocent activities — like sightseeing or attending a family event — can raise red flags if they contradict your reported limitations.
- Example: If you’re on LTD for anxiety and post photos of yourself hiking abroad, your insurer may question your ability to work.
If your benefits are denied or cut off after a trip, contact our firm immediately. We can review your policy, your medical file, and your insurer’s reasoning — and help you get your benefits reinstated quickly.
Real Legal Victories from Our Ontario Disability Lawyers
Our Ontario long-term disability lawyers have helped thousands of people across the province win back the benefits they deserved after unfair denials.
Recent examples:
- 🟢 Sandra Bullock. vs. Sun Life: Benefits reinstated after Sun Life wrongly claimed she could work full-time.
- 🟢 Julie A. vs. OTIP: Teacher’s OTIP LTD benefits restored after surveillance evidence was misinterpreted.
- 🟢 Mitch M. vs. Beneva: Client paralyzed in a car accident successfully challenged a complete denial.
Each success story represents someone who refused to give up — and a team that knew how to hold insurance companies accountable.
Speak to a Long Term Disability Lawyer in Ontario
If your long term disability benefits have been denied, delayed, or cut off, you don’t have to face the insurance company alone.
The long-term disability lawyers in Toronto at Samfiru Tumarkin LLP will handle the entire process — from communicating with your insurer to securing the compensation you’re legally entitled to.
✅ Insider Advantage: Sivan Tumarkin, co-founding partner of Samfiru Tumarkin LLP, previously worked for insurance companies. Today, he uses that knowledge to advocate for disabled individuals across Ontario. He knows insurers’ strategies, and how to level the playing field in your favour.
Why Ontarians Choose Our Firm:
- 👥 Over 50,000 clients helped nationwide
- 💰 Millions recovered in compensation
- ⚖️ No win, no fee — you don’t pay unless we succeed
- ⭐ 2,311 5-star Google reviews across Ontario (4.8 average)
- 🏆 Named Canada’s Best Law Firm by The Globe and Mail
Get a FREE consultation at 1-855-821-5900, fill out a short online form, or email help@disabilityrights.ca.
⛔ Unfortunately, Samfiru Tumarkin LLP does not assist with ODSP or WSIB denials.