If you’re seeking long term disability benefits for an episodic disability - one where your symptoms come and go - you must be able to provide detailed, consistent documents as proof to support your claim. Here’s how to document fluctuating and episodic disabilities for your LTD claim, prove your eligibility, and protect your financial security.

What Are Fluctuating and Episodic Disabilities?

Fluctuating and episodic disabilities are medical conditions where symptoms can intensify or ease unpredictably. You might feel relatively well one day and completely unable to function the next. Examples range from autoimmune and neurological illnesses to mental health and chronic pain conditions.

Some key features of the disability dynamic for these conditions include:

• Unpredictable relapses and remission.
  

• Good days and bad days that disrupt daily life and work.
  

• Functional limitations that are not always visible or measurable through standard tests

The Episodic Disabilities List

The episodic disabilities list includes many conditions recognized across Canada and by the World Health Organization. Here are some common episodic disability examples:

(This list is not exhaustive—the episodic disabilities network identifies many lifelong episodic disabilities affecting both physical and mental health).

Why These Conditions Are Often Denied in LTD Claims

Insurance companies deny many long term disability benefits claims involving episodic disability for several reasons:

• Lack of objective medical evidence: If your symptoms are invisible or don’t show up on imaging/tests, your claim may be questioned.
  

• Symptom variability: The fact that you have some better days is often held against you, even though recovery is inconsistent.
  

• Documentation gaps: Missed doctor appointments, inconsistent treatment records, or missing symptom journals make it harder to prove disability.
  

• Biases around mental illness and chronic pain: Insurance companies frequently dispute these diagnoses, citing “insufficient evidence” or calling them “manageable”.

Key Steps to Document Episodic and Fluctuating Disabilities

Step 1 – Keep a Daily Symptom Journal

A daily symptom journal is vital for anyone with a fluctuating or episodic disability. Document the following each day:

• Your symptoms, severity, time of day, and triggers. Include good days, too - showing that your symptoms vary from day to day is important.
  

• Impact on work tasks, home life, and social interactions. Note any work absences, late arrivals, and missed deadlines.
  

• Activities missed or stopped due to illness.
  

• Medications or treatments taken, and any side effects.
  

• Any attempts at returning to work and the results.
  

Make sure you share your symptom journal at every medical visit so it becomes part of your medical record.

Step 2 – Obtain Objective Medical Evidence

While episodic disabilities can be difficult to capture on tests, you can strengthen your disability benefits claim with:

• Consistent doctor and specialist appointments.
  

• Diagnostic test results (as available).
  

• Functional Capacity Evaluations (FCE): These tests provide an objective measure of your physical or cognitive abilities, even when symptoms aren’t always present.
  

• Narrative reports from medical professionals linking your symptoms to work limitations.
  

• Neuropsychological assessment, if relevant (for cognitive or mental illness impacts).

Step 3 – Use Third-Party Statements

Insurance providers value third-party statements showing how your symptoms affect real life and work. Gather:

• Statements from family, friends, and co-workers about missed work, visible symptoms, mood changes, or functional impairments.
  

• Employer performance reviews, attendance records, and notes about accommodations or modified duties due to your disability.
  

• Reports from vocational experts explaining why your symptoms prevent any job with your education, training, or experience.

Step 4 – Coordinate Doctor's Notes With Symptom Patterns

• Keep every physician up to date with your symptom journal.
  

• Ask doctors to document fluctuating patterns, not just a single exam.
  

• Ensure that your file describes the true impact on your ability to perform job duties.
  

• Have doctors note why treatments are following an “episodic” pattern (missed appointments, variable response, etc.).
  

• Request your doctors respond to any insurer requests for more information, especially if you’re sent for an IME.

Understanding the Duty to Mitigate with Episodic Conditions

Most LTD policies require you to attempt reasonable treatments and “mitigation strategies” to help manage your condition.

If you are experiencing episodic disabilities:

• Follow all reasonable medical advice.
  

• Try recommended therapies and attend all scheduled appointments.
  

• Document any side effects, failed attempts, or reasons you cannot pursue certain treatments (ask your doctor to note this!).
  

• Communicate honestly about relapses and recoveries.

How to Strengthen Your Claim Before Submitting

To maximize approval for your LTD claim for an episodic disability:

• Build a comprehensive history of consistent treatment and follow-ups with all providers.
  

• Submit your detailed symptom journal, third-party statements, and all employer records.
  

• Obtain supporting statements from multiple specialists, not just your family doctor.
  

• Address any “gaps” in your records with explanations (travel, specialist wait lists, illness preventing appointments, etc.).
  

• Consider an FCE or neuropsychological evaluation to illustrate hidden limitations.
  

• If you are facing the Change of Definition (when the insurance company moves you from being able to do your “own occupation” to “any occupation”), be ready to show why your disability dynamic prevents any suitable work—even when episodic.

What to Do If Your LTD Claim for an Episodic Disability Was Denied

If your LTD claim for an episodic disability is denied:

• Do not give up.

• Don’t rely on the appeals process - your case is often reviewed by the same people who denied your claim in the first place.

• Contact a disability lawyer to evaluate your case and determine the best approach.

Case Study: Terry’s Story

Terry lives with Crohn’s disease, a classic episodic disability. His symptoms weren’t constant, and his insurance company argued he could still work because he didn’t have flare-ups every day. Terry documented every symptom, kept up with specialists, and had his family and employer provide statements on how his random “good days” didn’t mean he was able to do sustained work. Share Lawyers took on Terry’s case, gathered all necessary documentation, and successfully helped him secure his long term disability benefits. His story shows that—when thoroughly documented—even insurance denials can be overcome.

Summary

If you live with a fluctuating or episodic disability and are pursuing long term disability benefits, your best chance at success is detailed, honest, and ongoing documentation. Keep thorough records—a symptom diary, medical appointment notes, tests, and third-party statements. Work closely with your doctors, follow their recommendations, and ensure your file shows the true disability dynamic of your daily life.

If your claim is denied, reach out to an experienced disability lawyer. With the right approach, you can overcome insurance company skepticism and get the disability benefits you need to focus on your health.

If you need tailored advice or support documenting your episodic disability for your LTD claim, don’t hesitate tocontact our team at Share Lawyers—we’re here to guide and strengthen your case every step of the way.