Understanding Long-Term Disability Benefits in Canada
Long-term disability (LTD) benefits provide monthly income replacement when illness or injury prevents you from working. These benefits are typically paid through group insurance policies offered by your employer or private disability policies purchased individually. LTD coverage usually replaces 60–70 percent of your regular income after the short-term disability (STD) period ends.
Kotak Law represents individuals whose LTD claims have been denied, terminated, or delayed by their insurance companies anywhere in Ontario or Alberta.
Who Qualifies for LTD Benefits?
Eligibility depends on policy language, but common requirements include:
1. A medically verified illness or injury that prevents you from performing your own occupation during the first 24 months of coverage.
2. After 24 months, proof that you cannot perform any occupation suited to your education and experience.
3. Ongoing medical documentation showing you remain unable to work.
4. Timely submission of forms — employee statement, employer statement, and attending-physician report.
Even if you meet all criteria, insurers often deny claims for reasons such as:
– “Insufficient medical evidence”
– “Failure to attend an independent medical exam (IME)”
– “Condition not covered under policy”
– “You can perform sedentary work”
– “Surveillance suggests ability to work”
Common Tactics Insurers Use to Deny Claims
Insurers employ several strategies to limit payouts:
– Internal “appeals” designed to delay payment without independent review.
– Selective interpretation of medical records.
– Repeated requests for redundant documentation.
– Surveillance and social-media monitoring to dispute disability evidence.
– Pressure to return to work early.
Tip: Insurer appeals are often ineffective. Contact a disability lawyer immediately after a denial to preserve your rights and strengthen your claim.
Building a Strong LTD Claim
1. Detailed Medical Evidence
Your medical documentation should identify the diagnosis and functional limitations, link your symptoms directly to inability to perform job duties, and include reports from specialists (psychiatrists, orthopedists, neurologists, etc.).
2. Consistent Treatment History
Maintain regular follow-ups and keep treatment records up to date.
3. Accurate Employment Records
Provide your job description, duties, and performance expectations to support the “own occupation” test.
If Your LTD Claim Is Denied
Step 1 — Do Not Rely on Internal Appeals
Internal appeals are managed by the same insurer that denied your claim. They rarely succeed and can delay your right to sue.
Step 2 — Consult Kotak Law
Our lawyers will review your denial letter and policy wording, gather supporting medical and employment evidence, negotiate directly with the insurer or file a court action if necessary, and ensure deadlines (usually two years from denial) are not missed.
Step 3 — Litigate When Needed
Most LTD claims settle before trial once the insurer realizes your lawyer is prepared to proceed to court. At Kotak Law, we work on a contingency-fee basis — you pay nothing unless we recover money for you.
How Kotak Law Helps
Kotak Law has successfully represented clients across Ontario and Alberta in LTD disputes involving depression, anxiety, PTSD, and other mental-health disabilities; chronic pain, fibromyalgia, and autoimmune disorders; as well as cancer, cardiac, and neurological conditions. We understand the complex intersection between medical evidence and insurance law, and we fight to secure the full benefits our clients deserve.
Frequently Asked Questions
Q. How long do LTD benefits last?
Until age 65 in most policies, or until you can return to suitable work.
Q. Can I apply for CPP-D and LTD at the same time?
Yes — CPP-D benefits may reduce your LTD amount but strengthen your overall claim.
Q. What if my employer terminated me while I was on disability?
This can violate employment standards; Kotak Law can address both the disability and employment aspects.
Contact Kotak Law Today
If your long-term disability claim has been denied or terminated, don’t navigate the insurer’s appeal process alone. Let Kotak Law protect your rights, gather evidence, and pursue the full benefits you’re owed.
Call Toll-Free: 1-888-GO-KOTAK (1-888-465-6825)
Email: info@kotaklaw.com
Offices: Toronto, Mississauga | Calgary | Serving All of Ontario and Alberta
