Sun Life Long-Term Disability Claims: What You Need to Know

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

If Sun Life has denied your long-term disability claim, terminated benefits you were already receiving, or told you that you no longer meet the definition of disability, you may have options to challenge that decision.

Sun Life is also the insurer administering the federal government’s Disability Insurance (DI) Plan — the mandatory long-term disability plan for most unionized federal public service employees. If you work for the federal government and your LTD is being managed through Sun Life, some of the plan’s claims and appeal procedures follow federal plan rules that differ slightly from a typical private employer’s group policy.

Sun Life is one of Canada’s largest providers of group and individual long-term disability (LTD) insurance. The outcome of a Sun Life disability claim depends on the wording of your particular policy, the medical and functional evidence, and how Sun Life has assessed your ability to work.

This guide explains how Sun Life LTD claims generally work, why benefits may be denied or terminated, and what you can do if you disagree with Sun Life’s decision.

How Sun Life Long-Term Disability Coverage Works

Sun Life provides long-term disability coverage through employer group benefit plans as well as individual disability insurance policies.

The terms of LTD coverage can vary significantly from one policy to another. The definition of disability, waiting period, benefit amount, offsets, exclusions, rehabilitation requirements and duration of benefits are determined by the particular policy or plan.

Elimination period. LTD policies generally include a waiting period, often called an elimination period, before benefits become payable. The length of this period varies by policy and should be confirmed from your plan documents. During this period, you may have access to short-term disability benefits, Employment Insurance sickness benefits or other sources of income.

Benefit amount. LTD benefits are generally calculated as a percentage of your pre-disability earnings, subject to the terms and maximum monthly benefit contained in your policy.

Rehabilitation and partial disability provisions. Some policies contain provisions dealing with rehabilitation, gradual return to work, partial disability or reduced earnings. These provisions vary by policy and should be reviewed carefully before making significant changes to your employment or work schedule.

Applying for Sun Life Long-Term Disability Benefits

A Sun Life LTD application will generally require information from you, your medical providers and, for group disability plans, your employer.

The application should provide a clear picture not only of your diagnosis, but of the symptoms, restrictions and limitations that prevent you from performing the important duties of your occupation.

Your medical providers should be given accurate information about the actual demands of your job. A diagnosis alone does not necessarily establish disability under an insurance policy.

Keep copies of everything submitted to Sun Life, as well as correspondence, medical forms and requests for additional information.

Why Sun Life May Deny or Terminate Long-Term Disability Benefits

Every disability claim is different. Some of the reasons an insurer may rely upon when denying or terminating LTD benefits include:

Insufficient medical evidence — Sun Life may take the position that the medical documentation does not establish restrictions or limitations severe enough to prevent you from working.
The change from “own occupation” to “any occupation” — many LTD policies change their definition of disability after a specified period, often around the two-year point. Claims may be reassessed at this stage, and some claimants have their benefits terminated even though they do not believe their medical condition or functional abilities have improved. Learn more about the own occupation to any occupation transition.
Incomplete or missing documentation — Sun Life may request updated medical or other information when assessing continuing entitlement to benefits.
Pre-existing condition exclusions — some policies contain exclusions relating to medical conditions that existed before coverage became effective. Whether an exclusion applies depends on the wording of the particular policy and the medical circumstances.
Treatment or rehabilitation concerns — the insurer may take the position that recommended treatment, rehabilitation or return-to-work efforts have not been followed.
Independent medical examinations or medical file reviews — Sun Life may rely on medical consultants or assessments that reach conclusions different from those of your treating doctors.
Vocational assessments — particularly after a change in the definition of disability, Sun Life may identify other occupations it believes you are capable of performing.
Surveillance or social media — an insurer may rely on observed activities or publicly available social media when assessing whether a claimant’s activities are consistent with reported restrictions and limitations.

A denial letter reflects Sun Life’s position. It does not necessarily determine your legal entitlement to LTD benefits.

If your benefits have been denied or terminated, the reasons given by Sun Life should be compared carefully with your policy wording, medical evidence, occupational duties and actual functional limitations.

Sun Life LTD Claims Involving Depression, Anxiety and Other Mental Health Conditions

Mental health conditions can prevent a person from working even though there may be no diagnostic imaging, laboratory test or other objective measurement demonstrating the severity of the condition.

Claims involving depression, anxiety, PTSD and other psychological conditions can therefore depend heavily on the quality and consistency of the medical and functional evidence.

Medical records should document more than a diagnosis. They should address symptoms, treatment, medication, functional restrictions and the ways in which the condition interferes with the claimant’s ability to reliably and consistently perform their occupational duties.

Sun Life LTD Claims Involving Chronic Pain and Fibromyalgia

Chronic pain and fibromyalgia can also present challenges in disability claims because the severity of symptoms and resulting functional limitations may not be fully demonstrated by imaging or other diagnostic testing.

The important issue is often not simply whether a condition has been diagnosed, but how pain, fatigue, sleep disturbance, medication side effects and other symptoms affect the person’s ability to function consistently and reliably in the workplace.

What to Do If Sun Life Has Denied or Terminated Your LTD Claim

A denial or termination of LTD benefits can have significant financial consequences. The steps you take after receiving the decision can also affect your legal rights.

1. Review the denial letter carefully

Identify exactly why Sun Life says you no longer qualify for benefits.

The insurer may dispute the severity of your restrictions and limitations, your ability to perform your own occupation, your ability to perform another occupation or another requirement contained in the policy.

2. Weigh an internal appeal against your legal options carefully

Sun Life’s internal appeal is reviewed by Sun Life itself, so it functions as a request to reconsider its own decision rather than an independent review. If you’re a federal public service employee, the DI Plan has its own layered appeal structure through a joint labour-management board, which is a different process from a typical private-sector group policy appeal — worth confirming which applies to you. Either way, time spent on an internal appeal doesn’t necessarily pause the legal limitation clock, so understanding your deadline is worth doing before choosing a path.

3. Preserve the evidence

Keep your denial letter, policy and benefits booklet, correspondence with Sun Life, medical records, employment information and copies of everything submitted to the insurer.

If Sun Life says your medical evidence is insufficient, the answer is not necessarily simply to obtain more records. The evidence should address the particular issues in dispute and explain how your symptoms translate into functional restrictions and limitations.

4. Determine the applicable limitation period

Do not assume that you have a particular amount of time to commence a lawsuit.

Limitation periods can depend on the province, policy wording and circumstances surrounding the denial or termination.

Most importantly, do not assume that an internal appeal extends or suspends your limitation period.

5. Speak with a disability lawyer

A lawyer experienced in LTD claims can review the policy, Sun Life’s denial letter, your medical evidence and the insurer’s stated reasons for denying or terminating benefits.

Getting legal advice early allows you to make an informed decision about whether additional evidence should be provided, whether an internal appeal serves a useful strategic purpose or whether a legal claim should be commenced.

How a Disability Lawyer Can Help With a Sun Life LTD Denial

At Kotak Law, our review of a denied or terminated Sun Life LTD claim may include:

the definition of disability contained in your policy
Sun Life’s reasons for denying or terminating benefits
your medical records and treating doctors’ opinions
medical, functional or other assessments relied upon by Sun Life
vocational evidence and proposed alternative occupations
the transition from the “own occupation” to “any occupation” definition
applicable limitation periods
whether further medical evidence should be obtained
whether an internal appeal serves a useful purpose
whether a legal claim should be commenced

Frequently Asked Questions About Sun Life LTD Claims

Does it matter that I’m a federal government employee for my Sun Life claim?

Yes, potentially. Federal public service employees are typically covered under the Disability Insurance (DI) Plan administered by Sun Life, which has its own claims and appeal structure separate from Sun Life’s standard private-employer group policies.

Can Sun Life require me to attend an independent medical examination?

Many disability insurance policies contain provisions allowing an insurer to request reasonable medical examinations or assessments.

Your obligations depend on the wording of your particular policy. If you have concerns about an examination Sun Life has requested, consider obtaining legal advice before refusing to participate.

Does Sun Life’s “any occupation” definition mean I have to be unable to do any job at all?

Not necessarily.

The wording depends on the particular policy, but an “any occupation” definition generally considers occupations for which you are reasonably suited based on factors such as education, training and experience. It does not necessarily mean literally every job that exists. Read our full explanation of the own occupation to any occupation transition.

What if Sun Life says there is no objective medical evidence supporting my disability?

Not every disabling medical condition can be measured through diagnostic imaging or laboratory testing.

Conditions involving chronic pain, fibromyalgia and mental health can produce significant functional limitations despite limited objective findings.

Can I work part-time while receiving Sun Life LTD benefits?

This depends on your particular policy and circumstances.

Some policies contain provisions dealing with partial disability, rehabilitation or reduced earnings. A genuine return-to-work attempt can sometimes provide useful evidence about functional capacity, but working may also affect how Sun Life assesses your entitlement.

Does Kotak Law handle Sun Life LTD disputes across Canada?

Kotak Law represents clients in long-term disability matters throughout Canada, subject to applicable provincial law society requirements. 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

Speak With a Disability Lawyer About Your Sun Life Claim

Kotak Law can review your policy, medical evidence, and Sun Life’s reasons for its decision, and explain your options.

Free consultation. Disability cases are handled on a contingency-fee basis.

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.

Read the full team bio →