Long-Term Disability Lawyers Ottawa
Denied or Delayed LTD Benefits? We’re Here to Help.
Trusted Ottawa Long-Term Disability Lawyers
When an illness or injury stops you from working, your long-term disability benefits are supposed to be there to catch you. When the insurer says no, it can feel like the floor has dropped out beneath you. The long-term disability lawyers at LMS Personal Injury Lawyers help Ottawa residents challenge denied, delayed, and terminated claims and fight to get the benefits they have already paid for.
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Understanding Long-Term Disability Claims in Ottawa
Many people in Ontario carry some form of long-term disability (LTD) coverage. Whether it comes through a group benefits plan at work or a policy you purchased yourself, LTD insurance is something you buy hoping you will never have to use it.
But none of us can predict the future. At any moment, an injury, a serious illness, or a debilitating mental health condition can change everything. A person whose life has been upended this way must often rely on the very disability policy they have been paying into for years just to keep their household running.
So what happens when the insurance company decides not to honour that policy and denies your claim? It is worth remembering that insurers are profit-driven businesses. They do not profit when they pay a long-term disability claim, and that reality creates a strong incentive to look for reasons to deny, delay, or cut off benefits. Understanding how to push back is exactly what our team does.
Why Insurance Companies Deny Long-Term Disability Claims
Denials are far more common than most policyholders expect, and they are rarely the final word. Knowing why a claim was refused is the first step to overturning it. Some of the reasons insurers give most often include:
- “Insufficient medical evidence.” The insurer claims your file does not prove you are disabled, even when your own doctors disagree.
- The definition of “disability” in your policy. Many denials hinge on policy wording rather than how sick or injured you actually are.
- Surveillance and social media. Insurers sometimes use video or online posts, often taken out of context, to argue you are more capable than you claim.
- Independent medical examinations. A report from a doctor the insurer selected and paid for may contradict your treating physicians.
- Missed deadlines or paperwork gaps. A late form or an incomplete application can become a reason for refusal.
- Pre-existing condition arguments. The insurer may allege your condition existed before your coverage began.
A denial letter is not a verdict. It is the insurer’s opening position, and it can be challenged.
The “Own Occupation” vs. “Any Occupation” Trap
One of the most important and least understood features of LTD policies is the change in definition that happens partway through a claim. For an initial period, often the first two years, most policies pay benefits if you cannot perform the essential duties of your own occupation. After that window, the test usually shifts to whether you can perform any occupation for which you are reasonably suited by education, training, or experience.
This “change of definition” is one of the most common moments for benefits to be terminated, even when nothing about your health has improved. Insurers frequently cut people off at exactly this transition. Our long-term disability claim lawyers in Ottawa know how to anticipate this shift, document your limitations against the correct standard, and challenge a termination that relies on it.
Conditions That Commonly Lead to LTD Claims
Long-term disability is not limited to any single type of condition. We help clients whose ability to work has been compromised by a wide range of physical and psychological conditions, including chronic pain and fibromyalgia, serious back and spinal injuries, cancer and the effects of treatment, cardiovascular conditions, neurological disorders such as multiple sclerosis, the lasting effects of a traumatic brain injury, and mental health conditions, including depression, anxiety, and post-traumatic stress disorder. Invisible and hard-to-measure conditions are often met with the most skepticism from insurers, which is precisely where strong legal advocacy matters most.
How Our Ottawa Long-Term Disability Lawyers Help
The long-term disability lawyers at LMS Personal Injury Lawyers Ottawa are experienced at helping clients fight back against insurers who have wrongly denied their claims, and at securing a fair and just result. Our approach generally moves through a few stages, and we tailor it to where your claim stands.
We begin by reviewing your policy and your denial in detail, because the specific wording of your plan often determines the strategy. From there, we help you appeal the denial of your benefits, assembling the medical and vocational evidence needed to meet your policy’s definition of disability. If the insurer still refuses to do the right thing, we are fully prepared to commence a lawsuit against the company and pursue your benefits through the courts.
Many denied claims are resolved through negotiation or a lump-sum settlement once the insurer realizes the claimant has serious representation. Whether your case settles or proceeds to litigation, our goal is the same: the benefits and compensation you are entitled to.
Don’t Wait — Deadlines Apply to Disability Claims
Time is not on your side after a denial. Disputes over long-term disability benefits are generally subject to a two-year limitation period in Ontario, but the date that the clock starts can be earlier and more complicated than people assume, and group policies may contain their own internal appeal timelines as well. Acting quickly protects your legal options and gives us the best chance to preserve evidence and build your case. If your benefits have been denied or terminated, the safest step is to speak with a lawyer right away rather than relying solely on the insurer’s internal appeal process, which is not the same as protecting your legal rights.
Contact Our Ottawa Long-Term Disability Lawyers Today
You paid your premiums. You held up your end. If your insurer will not hold up their end, we are ready to help. Call us today to arrange a free consultation with our Ottawa long-term disability lawyers, so we can get to work pursuing the best result possible for you. Remember, there are no fees unless we settle or win your case.
Frequently Asked Questions
My LTD claim was denied. Is it too late to do anything?
Almost certainly not. A denial is the insurer’s position, not a final ruling, and denied claims are challenged successfully all the time. The important thing is to act promptly, because limitation periods and policy appeal deadlines can apply.
Should I use my insurer's internal appeal process?
You can, but be cautious. An internal appeal is run by the same company that denied you, and pursuing it does not necessarily pause the legal limitation clock. It is wise to get legal advice before relying on the insurer’s appeal process alone.
Can I claim long-term disability for a mental health condition?
Yes. Conditions such as depression, anxiety, PTSD, and chronic stress are legitimate bases for LTD benefits. These claims are often met with extra scrutiny because the symptoms are not visible on an X-ray, which is exactly why thorough medical documentation and experienced representation are so valuable.
What does it cost to hire a long-term disability lawyer?
We work on a contingency basis, which means there are no fees unless we win or settle your claim. Our fee comes as a percentage of what we recover for you, and we will explain everything clearly before you decide to proceed.
What if my benefits were approved at first and then cut off?
Termination of an active claim is very common, particularly at the “change of definition” point around the two-year mark. A cut-off can be challenged the same way an initial denial can, and the fact that the insurer once approved you can actually strengthen your position.
Meet Our Ottawa Lawyers
Russ Molot
Russ Molot brings a client-first approach to personal injury, family law, and disability claims. Fluent in English and French, Russ takes the complexity out of the legal process for Ottawa residents at some of the most stressful moments of their lives.
David Capra
David Capra has represented Ottawa accident victims for over two decades, handling motor vehicle accidents, medical malpractice cases, and slip-and-fall claims. He is known for his thorough case preparation and his commitment to pursuing maximum compensation for every client he takes on.