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Long Term Disability Alberta: Your Complete Guide to Benefits and Denied Claims

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Long-term disability (LTD) benefits provide crucial financial protection for Albertans who cannot work due to a serious illness, injury, or medical condition. When your health prevents you from performing your job for an extended period, LTD benefits replace a significant portion of your income so you can focus on recovery—not financial survival.

Yet, every year, many Albertans have their long-term disability claims delayed, reduced, or unfairly denied by insurance companies. These denials often happen when people are dealing with depression, chronic pain, autoimmune conditions, cancer treatment, PTSD, or the aftermath of serious injuries. If your LTD benefits have been denied, you are not alone—and you have legal rights.

At Kotak Law, we represent clients across Alberta—including Calgary, Edmonton, Red Deer, Lethbridge, Fort McMurray, Medicine Hat, Airdrie, and rural communities—helping them obtain the disability benefits they deserve.

This comprehensive guide explains how long-term disability works in Alberta, what qualifies, why claims get denied, and how Kotak Law can help you fight back.

What Are Long-Term Disability Benefits in Alberta?

Long-term disability benefits provide income replacement when a medical condition prevents you from working for an extended period—usually after short-term disability or EI sickness benefits have ended.

Most LTD plans pay between:

  • 60% to 70% of your regular income,
  • subject to policy limits and offsets.

You may receive benefits through:

  1. Employer Group LTD Plans

The most common source of coverage in Alberta.

  1. Union Disability Plans

Often include enhanced benefits.

  1. Private LTD Policies

Individually purchased plans for added protection.

LTD policies are designed to support you long term—sometimes for years, and in some cases until age 65, depending on your plan.

Understanding the Own Occupation” vs. Any Occupation” Tests

A crucial part of LTD eligibility lies in the changing definitions of disability over time.

  1. Own Occupation” Period (Usually First 24 Months)

To qualify, you must prove you are unable to perform the essential duties of your own job.

Most claims are approved or denied at this stage.

  1. Any Occupation” Period (After 24 Months)

After two years, you must show you cannot perform any job for which you are reasonably suited based on:

  • education
  • experience
  • training
  • health limitations

Insurers often use this transition to terminate benefits, even when you are truly unable to work.

Conditions That Commonly Qualify for LTD Benefits in Alberta

LTD benefits cover a wide range of serious or chronic medical conditions, including:

Mental Health Conditions

  • Major depression
  • Generalized anxiety disorder
  • PTSD
  • Bipolar disorder
  • Severe stress-related illnesses

Mental health disabilities are among the most frequently denied claims in Alberta.

Chronic Pain & Musculoskeletal Conditions

  • Fibromyalgia
  • Chronic back or neck pain
  • Failed back surgery
  • Complex Regional Pain Syndrome
  • Severe osteoarthritis

Neurological Conditions

  • Migraines
  • Concussion / post-concussion syndrome
  • MS (Multiple Sclerosis)
  • Parkinson’s disease
  • Neuropathy

Autoimmune & Inflammatory Disorders

  • Lupus
  • Rheumatoid arthritis
  • Crohn’s disease
  • Ulcerative colitis

Cardiac & Respiratory Conditions

  • Heart disease
  • Long COVID
  • COPD
  • Severe asthma

Cancer & Treatment Side Effects

Many people qualify during and after cancer treatment due to symptoms like fatigue, neuropathy, cognitive fog, and immune suppression.

If your symptoms prevent you from working safely and consistently, you may qualify for LTD—even if the diagnosis is not visible or not easily measured by a test.

Why Long-Term Disability Claims Are Denied in Alberta

Insurance companies deny valid claims every day. These denials can be devastating, but many are legally challengeable.

Common denial reasons include:

  1. The insurer claims you can do modified work

Even when your doctor disagrees.

  1. Insufficient medical evidence”

Often used even when medical records clearly show disability.

  1. The insurers medical consultant disagrees

Internal doctors who never examine you may override your treating physician.

  1. Surveillance or social media posts

Insurers may misinterpret ordinary activities.

  1. They argue your condition is subjective”

Especially common in mental health, pain, and fatigue-based conditions.

  1. Pre-existing condition exclusions

Frequently misapplied.

  1. Termination during the any occupation” changeover

A major tactic used by insurers to cut people off after 24 months.

A denial does NOT mean you do not qualify. It means it’s time to get legal help.

Should You Appeal Internally? Why Internal Appeals Fail

Most denial letters encourage you to file an internal appeal, but this process is controlled by the same insurer that denied your claim.

Internal appeals:

  • rarely succeed
  • rely on the same medical reviewers
  • delay your case
  • risk missing Alberta’s two-year limitation period
  • are used strategically by insurers

Kotak Law usually recommends avoiding internal appeals unless we advise otherwise after reviewing your file.

The fastest, safest approach is to speak with a disability lawyer immediately.

How Kotak Law Helps With LTD Denials in Alberta

Kotak Law is one of Canada’s leading disability law firms. We aggressively pursue insurers to get Alberta clients the benefits they deserve.

We help by:

  • Reviewing your denial letter and policy
  • Gathering and strengthening medical evidence
  • Communicating directly with the insurer
  • Protecting you from surveillance tactics
  • Negotiating for full compensation
  • Filing a lawsuit when necessary
  • Ensuring your claim meets all limitation deadlines

Our Promise: No Win, No Fee — Maximum Contingency Fee 33% + GST

You pay nothing unless we win.
No upfront costs.
No hourly fees.
Complete transparency.

Can You Be Cut Off LTD Benefits in Alberta?

Yes—and insurers often terminate benefits even when your condition hasn’t improved. This frequently happens:

  • at the 24-month “any occupation” mark
  • after a medical consultant review
  • after surveillance
  • if there are gaps in treatment (even for reasons beyond your control)

If your benefits have been stopped, contact Kotak Law immediately.

What to Do If Your Long-Term Disability Benefits Are Denied or Terminated

Follow these steps:

  1. Contact Kotak Law immediately

Do not rely solely on the insurer’s appeal process.

  1. Continue medical treatment

Gaps in treatment can harm your case.

  1. Avoid social media posts

Even innocent photos can be misinterpreted.

  1. Keep a record of symptoms

A journal is excellent supporting evidence.

  1. Do not return to work unless your doctor approves

Forced or premature return-to-work attempts often fail.

We guide you through every step.

How Long Do You Have to Sue in Alberta? The Limitation Period

In Alberta, the limitation period is typically:

2 years from the date the insurer first clearly denies your claim.

If you miss this deadline, you may lose your right to benefits permanently.

If you’re unsure about your timelines, contact us immediately.

Contact Kotak Law — Alberta Long-Term Disability Lawyers

If your long-term disability claim has been denied or terminated, you do not need to take on the insurance company alone. Kotak Law is a nationally recognized disability law firm with extensive experience representing clients throughout Alberta.

We fight for your rights—so you can focus on your health.

Call Toll-Free: 1-888-GO-KOTAK

Email: info@kotaklaw.com
Visit: www.kotaklaw.com

No Win, No Fee. Maximum contingency fee 33% + GST.
Kotak Law — Albertas trusted long-term disability lawyers.