Last updated: August 2026 | Reviewed by Nainesh Kotak, B.A. (Hons), LL.B.
Making a Successful Long-Term Disability Claim for Chronic Pain
If you’ve been suffering from recurring pain for a lengthy period — pain from an injury that should have healed months or years ago, or pain that’s disrupting your life emotionally and physically — and it’s preventing you from performing your job, you may qualify for LTD benefits.
What Is Chronic Pain?
According to Health Canada, nearly 8 million Canadians — about one in five people — live with chronic pain, a condition that significantly affects both physical and mental health. People suffering from chronic pain report among the lowest quality of life of any long-term condition. In simple terms, chronic pain is pain that persists far longer than would reasonably be expected — months or years — and it may affect a specific part of the body or multiple areas at once.
Common causes include cancer, nerve damage, endometriosis, psychogenic (psychosomatic) pain, fibromyalgia, and injuries from accidents such as motor vehicle collisions or falls. Sometimes the original injury has healed and the pain persists regardless; sometimes the specific source is never identified. According to Mayo Clinic research, the most common forms include back and neck pain, headaches, joint pain, nerve-related pain, and pain associated with cancer or fibromyalgia.
The effects of chronic pain often extend well beyond the physical experience of pain itself. Sleep disruption is common, leading to fatigue and reduced energy, which in turn can contribute to depression — further reducing a person’s ability to function at work or in daily life. Many chronic pain sufferers also experience heightened anxiety related to their pain and concerns about their ability to continue performing as they once did.
Claiming Long-Term Disability Benefits for Chronic Pain
LTD coverage provides income replacement for people unable to work due to illness or injury, including chronic pain. Under most policies, a claimant qualifies for the first two years if they’re unable to perform the essential tasks of their current occupation due to their pain. After two years, most policies require the claimant to show they’re unable to perform any job for which they may be reasonably qualified by education, training, or experience.
Why Chronic Pain LTD Claims Are Often Denied
Chronic pain claims tend to face a particular set of recurring insurer arguments, including:
- Normal or inconclusive imaging — an insurer may point to unremarkable scan or test results as evidence that the pain isn’t as severe as reported, even though chronic pain frequently has no visible source.
- Lack of “objective” support for subjective pain — insurers often take the position that self-reported pain isn’t sufficient on its own, despite pain itself being inherently subjective for every patient.
- Surveillance showing brief activity — a short video of a claimant doing light activity on a good day is sometimes used to suggest broader functional capacity than actually exists.
- Insurer-retained doctors suggesting greater capacity — a file review or independent medical exam may reach a different conclusion than your treating physician.
- Treatment plateau or “maximum medical recovery” — an insurer may argue that once treatment has plateaued, ongoing disability is no longer supported, even if pain and limitations persist.
- Allegations that sedentary work is possible — insurers frequently argue a claimant could perform a desk job, without adequately accounting for how pain, medication side effects, and fatigue affect sustained concentration and reliability.
Building a Credible Chronic Pain Claim
The key to a successful chronic pain claim generally comes down to credibility. When pain is closely tied to a known injury or diagnosis, objective evidence — X-rays, imaging, test results — can support the claim alongside an established medical link between the diagnosis and the reported pain. But when chronic pain isn’t tied to a clear point of origin, or persists longer than would typically be expected, the evidence often rests largely on the claimant’s own description of their symptoms — making credibility especially important.
Establishing credibility generally means seeking medical attention for both the physical and psychological effects of chronic pain, obtaining a professional diagnosis, and making a genuine, consistent effort to follow recommended treatment, including prescribed medication. Chronic pain can be difficult to treat, but a consistent pattern of trying to improve strengthens a claimant’s credibility even where treatment hasn’t fully resolved the pain.
Because chronic pain is inherently subjective, a physician’s assessment of its severity often depends heavily on how consistently and credibly the patient describes their symptoms over time.
How a Disability Lawyer Can Help With a Chronic Pain LTD Claim
At Kotak Law, our review of a denied or terminated chronic pain LTD claim may include:
- the consistency of your symptom reporting across your entire treatment history
- evidence from pain specialists, not just your family physician
- functional capacity evidence, and whether the insurer conflated isolated activity with sustained, reliable work capacity
- your treatment history, including any treatments that were tried and failed
- how medication side effects factor into your overall ability to function
- the insurer’s stated reasons for denying or terminating your claim
- the transition from the “own occupation” to “any occupation” definition
- applicable limitation periods
- whether a legal claim should be commenced
Frequently Asked Questions About Chronic Pain LTD Claims
Can I get LTD benefits for chronic pain without a clear diagnosis?
Yes, though it can be more challenging. Chronic pain without a clear identifiable cause is still recognized as a genuine, potentially disabling condition — the claim typically relies more heavily on consistent medical documentation and the claimant’s credibility.
What happens to my claim after two years?
Most policies shift from an “own occupation” to an “any occupation” standard around the two-year mark, requiring you to show you can’t perform any job you’d reasonably be suited for. Read more about how this transition works.
Will my insurer question my credibility?
Often, yes — particularly where there’s no clear objective source for the pain. Consistent treatment history and documentation of your genuine efforts to improve can help support your credibility.
Is chronic pain the same as fibromyalgia?
No, though fibromyalgia is one recognized cause of chronic pain. Learn more about fibromyalgia disability claims specifically.
Does Kotak Law handle chronic pain LTD claims across Canada?
Kotak Law represents clients in long-term disability matters throughout Canada. Nainesh Kotak has practised law in Ontario since 1994 and is also called to the bars of Alberta and British Columbia, with the firm continuing to expand its bar admissions across Canada.
Related Long-Term Disability Resources
- Own Occupation vs. Any Occupation in LTD Claims
- Fibromyalgia Disability Claims
- Depression and Anxiety Disability Claims
- CPP Disability Benefits
Speak With a Disability Lawyer About Your Claim
Although proving a largely “invisible” injury like chronic pain presents real challenges, it’s a genuine, recognized condition capable of resulting in long-term or even permanent disability. If your LTD claim for chronic pain was denied or unfairly terminated, Kotak Law can help resolve the legal and evidentiary issues standing in your way.
Free consultation. Disability cases are handled on a contingency-fee basis.
Speak With a Disability Lawyer →
About Nainesh Kotak and Rajiv Haté
Nainesh Kotak, B.A. (Hons), LL.B., has practised law in Ontario since 1994 and is also called to the bars of Alberta and British Columbia. Nainesh and his colleague Rajiv Haté are both recognized by the Canadian Lexpert Directory as leading lawyers in long-term disability law.
Nainesh is a Past Chair of the Long-Term Disability Section of the Ontario Trial Lawyers Association (OTLA) and currently serves as Vice President of OTLA.
Together with the firm’s disability lawyers — including Kaity Yang and Avinaash (Avi) Laljie — Nainesh and Rajiv represent clients throughout Canada in long-term and short-term disability disputes involving major Canadian insurance companies.
