Five mistakes to avoid in your LTD application to improve your odds of success

Five mistakes to avoid in your LTD application to improve your odds of success

By Nainesh Kotak

Getting the long-term disability (LTD) benefits you are entitled to can be a challenging process, so starting your claim off on the right track is crucial.

As I approach three decades in legal practice advocating for injured workers, I know as well as anyone that insurers will never make the LTD application process easy for disabled employees.

But in all that time, I’ve also seen too many applicants make life difficult for themselves, derailing their claims at the outset with the same recurring mistakes in their applications.

Although these issues can often be overcome with the help of experienced legal counsel, it’s always upsetting to see the unnecessary stress and income gaps that these errors cause.

If you are having trouble applying for LTD benefits or your insurer has denied your claim for benefits, remember that our lawyers are only a phone call away.

In the meantime, to get your LTD journey started on the best possible foot, here is my list of five mistakes to avoid when completing your benefits application.

1. Bending the truth

I understand the temptation of employees forced off work by an injury or illness to exaggerate their difficulties, but bending the truth of your struggles tends to cause more trouble than it saves.

Credibility is often a key issue in LTD claims, particularly when a claim is denied, and a judge will not look kindly on a party whose truthfulness can be reasonably questioned.

At the same time, there is nothing to gain from underplaying your condition or the effect it has had on your life. The best approach is to be factual and straightforward at all times.

2. Forgetting functionality

As impressive as a long list of medical diagnoses may seem, it’s not enough on its own for an LTD applicant to have their benefits approved. Injured workers must also draw a clear line between these conditions and their impact on their ability to perform their job functions.

Many writers live by the maxim “show, don’t tell” as a way to inject some life into their prose, and LTD applicants have much to gain from the same technique. Rather than listing their medical ailments, applicants will boost their chances of success by describing in detail how each has played out in terms of functionality, both at work and in their day-to-day lives at home.

3. Ignoring your policy documents

When it comes to qualifying for LTD benefits, there is no more important document than your insurance policy. If the policy itself is too dense with legalese for you to comprehend or you simply don’t have a copy, employees with group LTD coverage should, at the very least, have a policy booklet that explains the test they will have to meet to qualify for benefits.

In most cases, for the first two years of a claim, that means injured workers must show that they are totally disabled from performing the essential tasks of their “own occupation” in order to be entitled to benefits.

Although individual policies may differ, at the two-year mark, the test generally switches to a more stringent version that requires claimants to show that they are unable to obtain employment in “any occupation” for which they are currently qualified or could be trained.

The policy booklet will also outline critical deadlines you must meet to qualify for benefits.

4. Keeping your doctor out of the loop

Visiting your doctor is never much fun, but it can’t be avoided if you plan to apply for LTD benefits since medical evidence will be key to the insurer’s determination.

Give your physician as much information as possible about the nature of your job, your health issues and when they arose. It will also be helpful to provide them with the terms of your LTD insurance so that they can be as accurate and detailed as possible when reporting your functional limitations.

Those with multiple disabling conditions should not be afraid to raise all of them with their family doctor or other treatment providers. By detailing your symptoms and explaining how they impact your functionality, your doctor can provide the insurance company with the most comprehensive assessment. Of course, there will be a tendency to concentrate on the medical issue causing the most problems at a particular moment, but it’s not unusual for the prominence of different conditions to shift over time.

5. Disregarding medical advice

Seeing your medical professional is not the end of the story for LTD applicants. If you want to maximize your chances of success, you will also need to follow their advice and treatment recommendations.
As well as helping with recovery and symptom management, sticking to a treatment plan demonstrates to your insurer that you are doing everything you can to get better and stops you from falling foul of policy exclusions that could result in a denial of benefits.


We understand that being denied short-term disability or long-term disability benefits can be devastating. Your time to fight your disability insurance company is limited. Please do not delay in calling a short- and long-term disability claim lawyer at Kotak Personal Injury Law. We have successfully sued numerous disability insurance companies including Manulife, Sunlife, Desjardins, Cigna, Great-West Life, Equitable Life, Empire Life, London Life, Blue Cross, AIG, SSQ, RBC, Industrial Alliance, Canada Life, Fenchurch, OTIP, Teachers Life and more.

Call your trusted long-term disability lawyers at 1-888-GOKOTAK (Toll Free for all of Canada), or (416) 816-1500 (Local Number for Ontario Residents), (403) 319-0071, (587) 414-1010 (Local Numbers for Alberta Residents). Our consultation is free, and we don’t get paid until you do. We represent disabled people throughout Ontario and Alberta, including Toronto, Mississauga, Brampton, Milton, Georgetown, Orangeville, Oakville, Burlington, Hamilton, St.Catharines, Niagara Falls, Stoney Creek, Kitchener/Waterloo, Cambridge, London, Windsor, Markham, Pickering, Oshawa, Peterborough, Keswick, Kingston, Ottawa, Banff, Brooks, Calgary, Edmonton, Fort McMurray, Grande Prairie, Jasper, Lake Louise, Lethbridge, Medicine Hat, Red Deer, Saint Albert and other locations.