Last updated: August 2026 | Reviewed by Nainesh Kotak, B.A. (Hons), LL.B.

If you’ve been receiving long-term disability (LTD) benefits and your insurance company has started sending letters about a “change of definition,” “any occupation,” or an upcoming reassessment, you may be approaching one of the most important stages of your disability claim.

Under many Canadian LTD policies, the definition of disability changes after approximately 24 months of benefits. During the initial period, the question is generally whether you can perform the essential or material duties of your own occupation. After the change of definition, the insurer may apply a broader and more difficult any occupation test.

This change does not necessarily mean your medical condition has improved. It does not mean your claim should never have been approved. The test for continued entitlement has changed – and many legitimate LTD claims are terminated at this stage.

Understanding the difference between own occupation and any occupation, and preparing appropriate medical and vocational evidence before the change occurs, can be critical to protecting your benefits.

What Does “Own Occupation” Mean in a Disability Claim?

Under many LTD policies, the initial disability test focuses on whether your medical condition prevents you from performing the material or essential duties of the occupation you were performing before you became disabled.

The exact wording and duration of this period depend on your insurance policy, but the own-occupation period commonly lasts approximately 24 months.

The important point is that you do not necessarily have to prove that you are incapable of doing any type of work.

For example, a surgeon who develops a serious hand tremor may be unable to safely perform surgery even though they remain capable of performing some other activities.

Similarly, a long-haul truck driver suffering from chronic pain may be unable to tolerate prolonged sitting, driving and the physical demands of the job even though they are not completely incapable of all activity.

During the own-occupation period, the focus is generally on whether your disability prevents you from performing the important duties of your occupation.

What Does “Any Occupation” Mean?

After the own-occupation period ends, many LTD policies apply a broader definition of disability.

The precise wording varies from policy to policy, but continued entitlement may depend on whether you are capable of performing another occupation for which you are reasonably suited by factors such as your education, training and experience.

This does not necessarily mean that an insurer can simply identify any theoretical job that you might be physically capable of performing.

The proposed occupation must satisfy the actual wording of your LTD policy and the applicable legal principles.

This is where many disputes arise.

An insurer may accept that you cannot return to your previous occupation but argue that your medical condition would allow you to perform another type of work.

The central question then becomes whether the alternative occupation identified by the insurer is genuinely suitable for you and whether you can reliably perform its material duties given your medical restrictions and limitations.

What Makes Another Occupation “Suitable”?

The phrase “any occupation” can sound as though you must be incapable of performing every conceivable job before you can continue receiving LTD benefits.

That is generally not how the analysis works.

The starting point is always the wording of your particular insurance policy.

Depending on that wording and the circumstances of the claim, relevant considerations may include:

Your education
Your professional or vocational training
Your previous work experience
Your transferable skills
Your physical restrictions and limitations
Your cognitive and psychological limitations
Your ability to work reliably and consistently
The duties and demands of the proposed occupation
The level of remuneration associated with the proposed occupation, where relevant under the policy and applicable law

A claimant’s ability to perform isolated activities is also different from the ability to sustain competitive employment on a predictable and reliable basis.

For example, being able to use a computer for short periods at home does not necessarily establish that someone can perform full-time sedentary employment.

Likewise, someone with depression, anxiety, PTSD, chronic pain, fibromyalgia, fatigue or cognitive difficulties may be physically capable of sitting at a desk but still be unable to maintain the concentration, pace, attendance, persistence or reliability required in a workplace.

These distinctions can become particularly important at the any-occupation stage.

The 24-Month LTD Transition: Why Claims Are Often Terminated

The change of definition is a predictable milestone in many LTD claims.

Insurers may begin reviewing the file months before the actual change-of-definition date. In some cases, this can begin around month 18 or even earlier.

The transition is important for several reasons:

The definition can change even if your health has not improved. You may have essentially the same medical limitations at month 25 that you had at month 12, but your entitlement is now being assessed under a different contractual test.
The insurer may request updated medical information. Your doctors may be asked to provide additional reports, clinical notes or information about your functional abilities.
The insurer may arrange medical or vocational assessments. These can include independent medical examinations, functional assessments or vocational reviews.
The evidence must address a broader disability test. It is no longer enough to establish that you cannot perform your former occupation. The evidence may need to address why your restrictions also prevent you from performing other occupations for which you might otherwise be reasonably suited.
Claims involving mental health conditions, chronic pain and other conditions without easily measurable findings can receive particular scrutiny. An insurer may argue that although you cannot return to a stressful or physically demanding occupation, you should be capable of performing a different role.

The months leading up to the change of definition can therefore be an important time to review your medical evidence and understand exactly what your insurance policy requires.

How Insurers Apply “Any Occupation” Differently Across Canada

While the underlying policy language is generally consistent nationwide, insurers frequently apply the “any occupation” standard differently depending on the workforce and industry involved.

In Alberta, this transition often affects workers in physically demanding oil and gas, industrial and trades occupations. Insurers may point to sedentary or administrative roles as supposedly suitable alternatives – roles that frequently do not reflect a person’s real training, experience or the realities of the local job market.

In Ontario, similar arguments are commonly applied to professionals and office workers whose conditions are cognitive or psychological rather than physical, where an insurer may argue that a claimant who cannot sustain a demanding role could nonetheless manage a quieter or less senior position.

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. Having litigated LTD claims involving both industrial and professional occupations, our team understands how these arguments tend to surface differently depending on the province and workforce involved — and how to respond to them with the right medical and vocational evidence.

Common Insurer Strategies Around the Change of Definition

Every disability claim is different, but there are several steps insurers commonly take when reviewing entitlement under the any-occupation definition.

These can include:

Independent Medical Examinations

An insurer may require you to attend an examination with a physician or other healthcare professional.

The assessment may focus on whether your medical restrictions prevent you from performing alternative work.

Medical File Reviews

An insurer may have your medical records reviewed by a doctor or other healthcare professional who has not personally examined you.

The reviewing professional may provide an opinion about your functional abilities based on the written medical file.

Vocational Assessments

A vocational consultant may review your education, employment history, transferable skills and medical restrictions and identify occupations that the insurer believes you could perform.

A dispute can arise where the proposed occupations do not adequately reflect your actual training, experience, functional abilities or the requirements of the policy.

Functional Capacity Assessments

Some claimants may be asked to participate in testing designed to measure physical abilities such as sitting, standing, lifting, walking or carrying.

Surveillance and Social Media Review

Insurers may conduct surveillance or review publicly available social media activity.

A short period of observed activity does not necessarily establish an ability to sustain full-time employment, but insurers may nevertheless rely on surveillance when assessing a claim.

What Should You Do Before the Any-Occupation Change?

If you are approaching your change-of-definition date, you do not necessarily have to wait until your benefits are terminated before seeking legal advice.

There are several steps that may help protect your claim.

Find Out Your Exact Change-of-Definition Date

Do not assume that it occurs exactly 24 months after you stopped working.

Review your policy and correspondence from your insurer to determine the applicable date and the precise definition that will apply.

Make Sure Your Medical Evidence Addresses Function

A diagnosis alone may not explain why you are incapable of working.

Your medical evidence should clearly document your restrictions and limitations and, where appropriate, explain how your symptoms affect activities such as:

Sitting and standing
Walking and lifting
Concentration
Memory
Decision-making
Stress tolerance
Pace and persistence
Attendance
Reliability
Interaction with others

The issue is not simply what condition you have. It is how that condition affects your ability to function in a workplace.

Understand Insurer-Requested Assessments

Your LTD policy may require you to participate in medical, functional or vocational assessments.

Before attending, it is important to understand what is being requested, why the assessment is taking place and how the insurer may use the results.

Review Any Occupations Proposed by the Insurer

If a vocational assessment identifies alternative occupations, those jobs should be considered against your actual education, training, experience and functional limitations as well as the specific wording of your policy.

The fact that an occupation exists does not necessarily establish that it is a suitable occupation for you.

Get Legal Advice Before a Denial If You Are Concerned

You do not necessarily have to wait until your benefits have been terminated.

If the insurer is questioning your continued entitlement, requesting significant new assessments or suggesting that you can perform another occupation, obtaining advice before the decision is made may help you understand what evidence is missing from your claim.

What If Your LTD Benefits Have Already Been Terminated?

If your insurer has terminated your LTD benefits at the change-of-definition stage, carefully review the denial letter.

The insurer should explain why it believes you no longer satisfy the policy’s definition of disability.

Common reasons include allegations that:

Your medical evidence does not support ongoing functional impairment
You have the capacity to perform sedentary or less demanding work
A medical consultant believes you can return to work
A vocational assessment has identified alternative occupations
Surveillance or other evidence is inconsistent with your reported limitations
Your treatment or medical documentation does not support continued disability

A denial letter is the insurer’s position. It is not necessarily the final determination of your legal rights.

A disability lawyer can review the policy, medical evidence, vocational evidence and insurer’s reasoning to determine whether the denial can be challenged.

Internal Appeal or Lawsuit?

After an LTD denial, insurers frequently advise claimants that they can submit an internal appeal.

An appeal may be appropriate in some circumstances, but it is not always the best strategy.

The insurer itself decides an internal appeal. Depending on the case, it may be more appropriate to obtain the insurer’s file, develop additional medical or vocational evidence and pursue a legal claim.

It is also important not to assume that participating in an insurer’s internal appeal process stops a legal limitation period from running.

If your LTD benefits have been terminated, obtaining independent legal advice early can help you understand your options and protect important deadlines.

Limitation Periods After an LTD Denial

There are deadlines for starting legal proceedings against a disability insurer.

The applicable limitation period depends on the province, the policy and the circumstances surrounding the denial. In many cases, a limitation period may be approximately two years from a clear denial, but you should never assume that you automatically have two years.

Internal appeals and continued correspondence with an insurer do not necessarily stop the limitation period from running.

If your LTD benefits have been denied or terminated, speak with a disability lawyer promptly about the deadline that applies to your particular claim.

Frequently Asked Questions

Does my medical condition have to improve before my insurer can terminate my LTD benefits?

No. Under policies containing a change of definition, the insurer may reassess your entitlement when the contractual definition of disability changes even if your underlying medical condition has not improved.

That is why someone can qualify for benefits under the own-occupation definition but subsequently be denied under the any-occupation definition.

Does “any occupation” literally mean any job?

Not necessarily.

The precise test depends on your policy. Many policies refer to occupations for which the claimant is reasonably suited based on factors such as education, training and experience.

Whether a particular alternative occupation satisfies the policy definition can become an important issue in an LTD dispute.

Can the insurer say I can perform a desk job even though I have never done one?

An insurer may identify sedentary or administrative occupations as alternatives, but that does not automatically mean those occupations satisfy the policy.

Your education, training, experience, transferable skills, medical restrictions and the actual requirements of the proposed occupation may all be relevant.

Can I work part-time during the own-occupation to any-occupation transition?

It depends on your policy and the circumstances.

A genuine attempt to return to work can sometimes provide useful evidence about your functional limitations. However, work activity can also affect entitlement to benefits or be relied upon by an insurer when assessing your abilities.

It is sensible to obtain advice before making significant changes to your work status while receiving LTD benefits.

What if I have already been approved for CPP Disability?

CPP Disability approval can be important evidence in an LTD claim because CPP applies its own test relating to severe and prolonged disability and substantially gainful employment.

However, CPP Disability approval does not automatically establish entitlement to LTD benefits. Your LTD entitlement is determined under the wording of your insurance policy and the applicable law.

Can an insurer require me to attend an independent medical examination?

Many disability policies contain provisions requiring claimants to participate in reasonable medical examinations or assessments.

The exact obligations depend on your policy. If you have concerns about an insurer-requested examination, obtain advice before refusing to participate.

How long do I have to challenge an any-occupation denial?

Limitation periods vary by province and depend on the circumstances of the claim.

In many cases, the applicable period may be approximately two years from a clear denial, but you should not assume that you have two years. Internal appeals do not necessarily suspend the limitation period.

Does Kotak Law handle LTD claims across Canada?

Kotak Law represents clients in disability insurance disputes throughout Canada.

Nainesh Kotak has practised law in Ontario since 1994 and is also called to the bars of Alberta and British Columbia. The firm can review your circumstances and advise you about representation and the appropriate approach for your province.

Related Long-Term Disability Resources

Learn more about disability insurance claims and denials:

Speak With a Disability Lawyer About the Change of Definition

If you are approaching the own-occupation to any-occupation change, have received a letter questioning your continued eligibility, or have already had your LTD benefits terminated, it is important to understand what your policy actually requires.

Kotak Law can review your LTD policy, the insurer’s correspondence, medical evidence and any vocational assessments and explain your options.

We represent clients in disability insurance disputes throughout Canada, including claims involving depression, anxiety, PTSD, chronic pain, fibromyalgia, cancer and other disabling medical conditions.

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 — the team represents clients throughout Canada in long-term and short-term disability disputes involving major Canadian insurance companies.

Own Occupation vs. Any Occupation: How the Definition Change Affects Your Disability Claim