Long-Term Disability Denials

Who this helps

Employees and self-employed people whose long-term disability benefits were denied, cut off or delayed under a group plan through work or an individual policy.

Why claims are denied

• The insurer says the medical evidence does not show you cannot work
• The definition of disability changes, often after two years, from your own job to any reasonable job
• Surveillance or social media is used to question your limitations
• Missed deadlines or incomplete forms
• Pre-existing condition clauses

Appeal or sue

Many policies offer internal appeals. An appeal can help, but it can also use up time, and limitation periods may continue to run. A lawsuit is often the stronger route because it allows full disclosure of the insurer's file. We review the policy and the denial letter and advise which route fits your situation.

Deadlines

Limitation periods for disability claims are generally two years, but when the clock starts can depend on the policy wording and the denial. Do not wait for an internal appeal to finish before getting advice.

Other benefits that interact

Long-term disability benefits are often reduced by other income such as CPP disability benefits or accident benefits. We look at the whole picture so offsets are applied correctly.

Documents to bring

• Your policy or group benefits booklet
• The denial or termination letter
• Your claim forms and correspondence
• Medical records and your doctors' contact information
• Job description and recent pay stubs

Fees

Consultations are free. Disability claims are usually handled on a contingency fee. Read how fees work.