Introduction
Filing for disability benefits — whether under a short-term disability (STD) or long-term disability (LTD) plan — can be stressful and confusing. A single error or delay can lead to denial or cancellation of benefits. Insurance companies look for inconsistencies and missing information, often using them to justify cutting off payments.
In this post, we outline four common mistakes that can undermine your disability claim, why they matter, and how to avoid them. Following these steps can make the difference between approval and denial.
Mistake #1: Failing to Follow or Document Your Medical Treatment
Why it matters
Your medical evidence is the foundation of your claim. Insurers expect consistent proof that you’re under appropriate treatment and that your condition genuinely limits your ability to work. Gaps or inconsistent records can make them question your credibility.
What to do instead
– Attend all appointments and follow treatment plans exactly as prescribed.
– Keep copies of medical reports, test results, and treatment summaries.
– Maintain a simple symptom journal noting pain, fatigue, and how your condition affects daily tasks.
– Ask your doctor to clearly connect your diagnosis and your work limitations.
– Notify your insurer and lawyer promptly if treatment plans change.
Mistake #2: Ignoring Your Policy’s Definition of Disability
Why it matters
Every policy defines “disability” differently. Many LTD plans pay benefits for the first 24 months if you cannot perform your own occupation, then switch to an any occupation definition. If your evidence doesn’t address the correct test, your claim may be denied.
What to do instead
– Obtain a full copy of your insurance policy or benefits booklet.
– Review the definitions, exclusions, and waiting periods carefully.
– Align your doctor’s reports and your own descriptions with the policy language (e.g., “own occupation” vs “any occupation”).
– Ask a disability lawyer to interpret unclear wording or exclusions.
Mistake #3: Providing Inconsistent or Incomplete Information
Why it matters
Even small inconsistencies — such as dates, activity levels, or descriptions — can harm your credibility. Insurers compare your forms, doctor’s notes, and even your social-media activity for contradictions.
What to do instead
– Be honest and complete on all claim forms.
– Keep copies of everything you submit.
– Review your social-media presence; remove or hide anything that might be misunderstood.
– If your condition changes, update your insurer and medical team in writing.
Mistake #4: Waiting Too Long — or Trusting the Insurance Company’s “Internal Appeal”
Why it matters
Many claimants assume the insurer’s internal appeal process is the proper way to challenge a denial. In reality, internal appeals are reviewed by the same insurer that already denied you. They rarely succeed and often delay your ability to take stronger legal action, sometimes until it’s too late.
What to do instead
– Do not rely on the insurer’s internal appeal process. It is designed to protect their interests, not yours.
– Contact Kotak Law immediately after receiving a denial letter. A lawyer can review your case, preserve limitation periods, and advise on whether to file a lawsuit or negotiate directly.
– Keep copies of all correspondence, forms, and your denial letter — these are vital pieces of evidence.
– Act quickly. Ontario and other provinces have strict limitation deadlines, and missing them may end your right to compensation.
Remember: The insurance company profits by denying claims. Kotak Law ensures your appeal is handled strategically and independently — not left in the insurer’s hands.
Quick Checklist
| Action | Why it Matters |
|---|---|
| Get a full copy of your disability policy | Know exactly how “disability” is defined |
| Follow and document all medical treatment | Shows credibility and continuous care |
| Keep a daily symptom / function journal | Reinforces your functional limitations |
| Complete all forms consistently | Avoids contradictions insurers exploit |
| Avoid social-media contradictions | Prevents insurers from misrepresenting your activities |
| Contact a disability lawyer after any denial | Protects your rights and ensures timely action |
Helpful Resources from Kotak Law
– Five Mistakes to Avoid in Your LTD Application: https://www.kotaklaw.com/five-mistakes-to-avoid-in-your-ltd-application-to-improve-your-odds-of-success/
– Understanding the LTD Appeal Process and Why Legal Support Matters: https://www.kotaklaw.com/understanding-the-ltd-appeal-process-and-why-legal-support-matters/
– What to Do If Your Long-Term Disability Claim Is Denied in Ontario: https://www.kotaklaw.com/what-to-do-if-your-long-term-disability-claim-is-denied-in-ontario/
– Own Occupation vs Any Occupation Explained: https://www.kotaklaw.com/gainfully-employed-unpacking-the-meaning-and-criteria-in-long-term-disability-cases/
Talk to a Disability Lawyer — Not the Insurance Company
If your long-term or short-term disability claim has been denied or terminated, do not waste time on the insurer’s internal appeal. Contact the experienced team at Kotak Law right away. We’ve helped thousands of Canadians recover the benefits they deserve.
Book a Free Case Review: https://www.kotaklaw.com/describe-your-claim/
Call: (416) 816-1500 or 1-888-GOKOTAK
Email: https://www.kotaklaw.com/contact/
