Managing an illness or injury that leaves you unable to work is incredibly difficult and more common than you think. If you’ve been paying disability insurance premiums and the insurance company you counted on to be there in your time of need has denied your claim, you likely feel lost.

You need those benefits to focus on rehabilitating and rebuilding your life.

If your long term disability (LTD) claim has been denied, don’t give up hope. In Ontario, about 60 percent of legitimate disability claims are rejected by insurance companies each year. Insurance companies are notoriously tight-fisted and denying claims is how they make money.

Often, an LTD applicant will receive a letter telling them their claim has been denied. It also invites them to appeal the decision. But Samantha Share, Lawyer and Assisting Managing Director at Share Lawyers, an Ontario-based law firm specializing in disability law says, “This appeal invitation is done primarily to appease the applicant and rarely results in a change in the decision. In the meantime, you have no money coming in.”

The LTD appeals process can be long and frustrating. This is why you should have an experienced long term disability lawyer get involved at this stage rather than risking damaging your chances for future success.

What to Do Immediately After Your LTD Claim Is Denied

1. Review the Denial Letter Carefully
2. Request the Full Claim File
3. Gather Additional Medical Documentation & Supporting Evidence
4. Speak with a Disability Lawyer About Your Next Steps

Common Reasons for Disability Claim Denials

Many insurance companies look for reasons to deny long-term disability claims in Ontario. Some of the most common reasons are:

• Filing a claim or appeal late

Insurance policies often stipulate a timeline under which to submit a claim, beginning from the point you first became disabled, but this timeline isn’t always clear.

• You are not “totally disabled”

This is another common reason that a claim gets denied. Your insurance company feels you are not disabled enough and are capable of doing your job. They are overriding your doctor’s opinion and forming their own views on your medical situation. This is not right and if your doctor is supporting your disability leave, then your insurance company should be supporting you as well. If they are not willing to, then we can help.

• Insufficient medical evidence

The insurance company may not accept your doctor’s assessment of your disability, especially in cases where your condition cannot be verified through diagnostic imaging or a blood test. This is often the case with mental health claims and chronic pain claims, that cannot be proven through testing.

If you’re given this reason, consider calling a long term disability lawyer in Toronto or use this free online tool to determine how an experienced disability lawyer can help, because challenging a denied disability claim balances the playing field.

• Your medical condition is contested by the insurer

Your insurance company may have initially supported your claim and paid your benefits, but their goal is to get you to return to work as soon as possible. The quicker you go back, the less they have to pay. They will push you to go back to work, and even provide you with a rehabilitation plan that you may not be ready for. If you are unable to work, and your claim has been cut off before you’re ready to return to work, contact us right away to learn the options that exist to fight for your disability benefits.

• Pre-existing condition

If your insurance company denies your disability claim stating that your medical condition is pre-existing, they may not be disputing whether you are disabled, but rather stating that the medical issue that is causing you to stop working existed prior to your disability insurance coverage came into effect.

A pre-existing exclusion under your policy only applies if you have been covered under the policy for a limited period of time (commonly in the first year you have benefits in place). This kind of denial requires a proper review of your medical records to determine if they were right to have denied you. It’s best to speak to one of our long term disability lawyers in Toronto to see if it is possible to fight their decision.

• Surveillance

Insurance companies conduct surveillance by monitoring social media sites as well as hiring private investigators to look into your activities. If your insurance company has conducted surveillance on you and is using that information to deny your claim, it does not mean that they have caught you in a lie.

Sometimes they jump to conclusions without making further inquiries to check for accuracy. Though they may try to use any information they can find to prove you are capable of doing your job, they are not necessarily right in their assessment. Talk to our team of disability lawyers to see how you can fight their decision to deny your disability claim.

Why You Should Fight a Denied Long Term Disability Claim

After receiving a denial letter, you may feel like giving up.

The fact is you have been paying premiums directly or indirectly and this long term disability insurance was meant to protect you in case you’re unable to work. If you throw in the towel now, you could be giving up the money that you are entitled to receive.

Appeal vs Lawsuit: What’s the Best Path?

When your LTD claim is denied, choosing between an internal appeal and a lawsuit can be confusing. We guide you through your options, clearly explaining why filing a lawsuit—with our help—is often the stronger path to getting you the benefits you deserve.

Key point: Unlike appeals, lawsuits are reviewed by independent parties rather than the same people who denied your claim. Lawsuits often lead to faster, fairer compensation for your denied LTD benefits.

Mistakes to Avoid After a Denied LTD Claim

• Ignoring the Denial: Don’t assume it will resolve itself. You must act quickly.
• Missing Deadlines: There are contractual and legal time limits for claims and lawsuits (as little as 1 year depending on your policy, with a maximum of 2 years in most provinces).
• Appealing Without Legal Advice: Direct appeals are rarely effective; seek a legal review first.
• Exaggerating Symptoms: Always be truthful. Insurance companies closely scrutinize descriptions and may conduct surveillance.
• Withdrawing from Treatment: Not following medical advice or skipping appointments can seriously hurt your case.
• Posting on Social Media: Online photos or updates can be misinterpreted and used against your claim.

By following these steps, you can maximize your chances of getting your disability benefits and protect your financial future.

How a Long Term Disability Lawyer Can Help

• Take Over All Communication with Your Insurance Company: Once you hire Share Lawyers, you no longer have to deal with stressful phone calls, letters, or emails—they handle every conversation, so you can step back and focus on your health
• Read and Explain Your Denial Letter: You don’t have to figure out confusing insurance language or deadlines. Share Lawyers reads your denial letter, explains exactly what it means, and makes sure nothing is missed.
• Gather All Medical Evidence for Your Case: They collect all the necessary reports and documents from doctors and your workplace, so you’re not left chasing paperwork on your own
• Build and Settle Your Case: You don’t have to figure out the legal process or negotiate with the insurance company—Share Lawyers works to settle your case, often through mediation, so you can get benefits without having to go to court

With these steps off your plate, you can focus on what matters most: your health and well-being.

Your Long Term Disability Denied? Contact a Disability Lawyer

When your disability claim is denied, it can feel like you have been failed by your insurance company. We understand and we want to help you.

At Share Lawyers, we stand up for people and take the fight to the insurance companies. We’re well-versed in their tactics and have a track record of over 9,000 successful cases. In fact, most of our cases are settled before ever going to court because insurance companies know we mean business.

Don’t let your insurance company win. Reach out and have one of our staff guide you through a free consultation, and pay nothing until your case is won.