Disability claim denials for benefits provided by your employer or private long term disability claims are alarmingly common in Canada—but a denial is not the end. If your claim is rejected due to insufficient medical evidence, policy definitions, mistakes, or other reasons, you have legal options and ways to fight back for the disability benefits you deserve.

Common Reasons LTD Claims Are Rejected – And How to Fight Back

When your long term disability claims are denied, it can feel overwhelming and unfair. Insurance companies often prioritize their profits and use technicalities to avoid paying valid claims. Understanding why term disability denials happen—and knowing what to do next—puts you in a stronger position to fight for your rights.

Why Do Long Term Disability Benefits Get Denied?

Disability insurers frequently reject claims for technical, medical, or administrative reasons. Their aim is to minimize payouts—regardless of how much you need those benefits. Here are the most common reasons your disability insurance claim might be denied:

Common Reasons LTD Claims Are Denied

1. Insufficient Medical Evidence

One of the top causes of disability claim denials is insufficient or unclear medical documentation. Insurance companies demand detailed proof that your condition seriously limits your ability to work. If your file lacks clear medical records, lab results, or detailed doctor’s notes showing how your symptoms prevent you from working, your claim can be quickly rejected.

Tip: Keep organized, up-to-date medical records, including test results, treatment notes, and symptom diaries. Regularly update your doctor on your condition and functional challenges at work.

2. Lack of Objective Medical Documentation

Insurers often want to see concrete evidence—like imaging, blood work, or specialist evaluations—showing you genuinely cannot perform your job. Many “invisible” illnesses (e.g., chronic pain, mental health challenges, MS) are difficult to prove with lab tests alone, making claims easier for insurers to dispute.

Tip: Ask your treating physicians to provide clear, objective findings where possible, and don’t hesitate to follow up for specialist reports.

3. Incomplete or Inaccurate Information

Errors or omissions on your application, employer forms, or medical documentation can trigger denials. Even small mistakes—like leaving out important symptoms or providing conflicting answers—make insurers suspicious and may result in the loss of critical income support.

Checklist: Avoid These Application Pitfalls

• Double-check that claim forms are complete and consistent.
  

• Correct any mismatches between your claim form, employer, and doctor’s portions.
  

• Provide ample details describing how your condition impairs your ability to work.

4. Insufficient Support from Your Own Doctor

If your treating doctor does not provide clear, written support for your claim—or if their report seems vague—your claim is at risk. Some physicians may be reluctant to participate in the claims process due to time constraints, lack of familiarity, or personal biases.

If this happens:

• Ask your doctor directly if they are comfortable supporting your application.
  

• Request a letter spelling out your diagnoses, restrictions, and prognosis in practical terms.
  

• Consider seeking a second opinion or seeing a specialist who can offer additional medical evidence.

5. Surveillance or Social Media Evidence

Insurance companies may conduct covert surveillance or scour your social media for images and posts that appear inconsistent with your claim. Even innocent moments—a photo of you smiling or standing—can be misconstrued and used as grounds for a disability claim denial.

Remember: Surveillance often lacks context and doesn’t account for good days/bad days, accommodations, or the invisible efforts disabled individuals make to participate in rare events. If you’re targeted, seek legal help right away.

6. You Don’t Meet the Policy’s Definition of Disability

Every policy defines “disability” differently—some use “own occupation” for the first 24 months (meaning you can’t perform your current job), and then shift to “any occupation” (meaning you can’t perform any suitable work). If your insurer decides you don’t fit their definition, they’ll deny your LTD benefits—often without a fair review.

Watch out: At the 2-year mark, many policies re-evaluate your ability to work. If you receive a “change of definition” letter, seek legal advice immediately.

7. The Insurance Company Thinks You Can Work

Often, insurers will have their doctor review your file (sometimes without meeting you) and decide you’re capable of returning to work, even if your actual doctor disagrees. Their focus may be on activities you can do—ignoring symptoms that prevent sustained, reliable workplace performance.

Action: Obtain detailed, ongoing medical reports countering the insurer’s doctor’s opinion. Emphasize your actual ability (or inability) to do the full scope of your job, not just isolated tasks.

Bill's Story: Denied After Surveillance

Bill had been living with multiple sclerosis for years, fighting through extreme fatigue, nerve pain, and balance issues. After taking a year off work on disability, he was stunned to learn his insurer had denied his claim. Their “evidence”? Social media photos showing him at his daughter’s wedding—smiling and walking her down the aisle.

What those images didn’t reveal was the wider context: Bill spent most of that day resting in his hotel room, saving his strength to take part in essential moments. His daughter had chosen a venue with an attached hotel so he could lay down between events, and his mobility aids were out of frame in the cropped pictures that were posted.

The denial hit hard. Bill felt deep shame at being accused of dishonesty, and panic set in as the financial consequences became clear.

That’s when Bill contacted Share Lawyers. Together, they gathered comprehensive medical evidence, documented his daily struggles, and presented expert testimony explaining how those fleeting wedding moments didn’t reflect his actual day-to-day disability. The legal team challenged the insurer’s narrative, clarified the context of the photos, and secured the reinstatement of Bill’s benefits.

What to Do If Your LTD Claim Is Denied

Receiving a denial is discouraging—but you have legal options. Take these essential next steps:

Review your Denial Letter

This information will help you understand the insurance company’s reasons for denial and guide your response.

Don’t File an Internal Appeal Without Legal Advice

While insurance companies suggest an “appeal,” these are usually reviewed by the same people who denied your claim. Appealing without experienced advice almost never results in a different outcome.

Instead: Connect with an LTD lawyer as soon as possible—don’t delay or rely solely on the appeal process. Insurers count on people “appealing” while legal deadlines run out.

Contact an LTD Lawyer Early — Legal Timelines Are Short

There are strict deadlines for challenging a denial. Missing them can forfeit your right to take legal action, leaving you without recourse. An LTD lawyer can quickly assess your claim, file legal action within the limitation period, and level the playing field against powerful insurers.

Gather Updated Medical and Occupational Evidence

• Return to your doctors and ask for additional reports, updates, or referrals to specialists.
  

• Collect occupational assessments or functional capacity evaluations if possible.
  

• Build a thorough file illustrating how your symptoms, even if intermittent, significantly limit your work ability.

How an LTD Lawyer Can Help When Your Disability Claim Is Denied

At Share Lawyers, we specialize in representing Canadians facing disability claim denials. Our lawyers will help:

• Navigate the complex legal landscape and all insurance policy requirements.
  

• Gather and interpret medical records and evidence, filling in any gaps.
  

• Handle all communications with insurance companies so you can focus on your health.
  

• Stand up to unfair surveillance tactics and misinterpretations of your activities.
  

• Advocate for the full, fair value of your disability benefits.
  

Most clients who engage legal support see their claims resolved—often before court—because insurers know you’re serious and supported.

Quick Reference: Common LTD Denial Reasons & How to Respond

Essential Checklist: Protect Your Disability Claim

• Keep all medical appointments and follow treatment plans.
  

• Document symptoms and work limitations in a journal.
  

• Gather comprehensive, ongoing medical records.
  

• Review your disability insurance policy for definitions and deadlines.
  

• Be careful about what you post on social media.
  

• Get professional legal advice as soon as possible—don’t wait.

Final Thoughts

Long term disability claim denials are discouraging, but they do not have to be the last word. If you’ve received a denial, don’t give up. There are proven strategies and legal options to secure the disability benefits you’re entitled to. Get experienced help—ideally right away. The sooner you act, the better your chances of getting the result you need.

If you’re ready to fight back or need guidance, contact Share Lawyers for a free consultation. We only get paid if you win—so your future is our priority from day one.