Navigating a long term disability claim in Canada can feel overwhelming, especially when your financial security and health are on the line. One of the most important factors in the success of your claim is the strength and clarity of your objective medical evidence.

This guide will help you understand what objective evidence is, why it matters, and how to gather and present it so you have the best chance to get approval from your insurance company.

Introduction to Objective Medical Evidence

Objective medical evidence is the foundation of any successful long term disability claim. It refers to concrete, measurable data—like test results, medical imaging, and clinical findings—that can be independently verified. This type of medical evidence is important because insurance companies rely on it to determine whether your condition meets the definition of disability in your policy.

Key points about objective medical evidence:

• It includes X-rays, MRIs, CT scans, blood tests, and physical exam findings.

• It provides clear, factual support for your symptoms and limitations.

• A medical professional’s opinion, when backed by objective findings, carries significant weight with insurers.

• Insurance companies often require this evidence to approve claims, especially for long term disability benefits.

Why is objective evidence so important?

Insurance companies use objective evidence to reduce uncertainty and prevent fraud. Without it, they may argue your symptoms are exaggerated or not severe enough, leading to a denial or termination of your benefits.

Understanding Subjective Evidence

While objective evidence is measurable, subjective evidence is based on your personal experience and self-reporting. This includes symptoms like pain, fatigue, or mental health struggles—things that can’t always be seen on a scan or measured in a lab.

Challenges with subjective evidence:

• Difficult to prove independently.

• Insurance companies are more likely to deny claims based solely on subjective complaints.

• Chronic pain and mental health conditions often rely heavily on subjective evidence, making these claims more complex.

However, subjective evidence still matters:

• Your testimony, detailed symptom diaries, and consistent reports to your doctor help establish credibility.

• Physician support and thorough documentation can bridge the gap between subjective symptoms and objective findings.

• Expert testimony from specialists can help explain how subjective symptoms impact your ability to work.

Tip: Always be honest and consistent when describing your symptoms to both your doctor and the insurance company.

Quick Reference: Objective Evidence vs. Subjective Evidence

Gathering Medical Evidence for Your Claim

Building a strong long term disability claim means collecting as much objective medical evidence as possible, while also documenting your subjective experience.

Steps to gather effective medical evidence:

• Undergo all recommended medical tests and assessments (imaging, bloodwork, physical exams).

• Keep copies of all test results, doctor’s notes, and treatment plans.

• Ask your doctor to provide detailed reports explaining how your condition limits your work activities—not just your diagnosis.

• Follow your treatment plan and attend all appointments. Gaps in care can be used against you.

• Be honest with your healthcare providers so your records accurately reflect your symptoms and limitations.

Checklist: Essential Medical Evidence for Your LTD Claim

• Diagnosis from a qualified healthcare professional

• Test results (X-rays, MRIs, blood tests, etc.)

• Detailed physician notes and progress reports

• Treatment plans and evidence of adherence

• Specialist referrals and opinions (if applicable)

• Symptom diary or personal statement

• Employer letters (if available) describing work limitations

Organize your records: Keep everything in one place and make copies for your lawyer and the insurance company.

Dealing with the Insurance Company

Insurance companies are known for their strict approach to long term disability claims. Understanding their requirements and being prepared with strong objective medical evidence is your best defense.

What insurance companies look for:

• Clear, consistent, and comprehensive medical documentation.

• Evidence that directly links your condition to your inability to perform your job duties.

• Adherence to treatment and cooperation with requested assessments.

Common reasons for claim denial:

• Insufficient or inconsistent medical evidence.

• Lack of objective proof for subjective symptoms.

• Failure to follow the insurer’s procedures or provide requested information on time.

If your claim is denied:

• Don’t panic. A denial is not the end of the road.

• Review the denial letter carefully to understand the reason.

• Gather additional evidence or seek expert opinions to address the insurer’s concerns.

• Consult a disability lawyer to help you appeal the decision and protect your rights.

Long Term Disability Claims: What You Need to Know

A successful long term disability claim hinges on your ability to prove that your condition prevents you from working, using both objective and subjective evidence.

Key requirements for LTD claims:

• Meet your policy’s definition of disability (often “unable to perform the essential duties of your own occupation” for the first two years, then “any occupation” after that).

• Provide ongoing proof of disability, including regular medical updates.

• Be prepared for the insurance company to request an independent medical examination (IME).

Role of your medical professional:

• Your doctor’s support is critical. Their detailed reports and willingness to advocate for you can make or break your claim.

• If your doctor disagrees with the insurer’s specialist, get a second opinion from another qualified specialist.

Tip: Always review any IME reports for accuracy and consult your own doctor if you disagree with the findings.

The Importance of Expert Testimony

In complicated or disputed cases, expert testimony can be the deciding factor.

How expert testimony helps:

• Provides an independent assessment of your condition.

• Explains how your symptoms (even subjective ones) impact your ability to work.

• Counters the insurance company’s own experts or IME reports.

A lawyer can help:

• Identify and retain the right experts for your case.

• Ensure expert reports are clear, thorough, and persuasive.

• Present complex medical information in a way that is easy for insurers and courts to understand.

Surveillance & Your Claim

Insurance companies may use surveillance—both online and in-person—to try to discredit your claim.

What to know about surveillance:

• Insurers may monitor your social media, hire private investigators, or record your activities in public.

• Surveillance evidence is often taken out of context and may not accurately reflect your ability to work.

• Be honest and consistent in all your statements and activities. Inconsistencies can harm your credibility.

Protect yourself:

• Follow your doctor’s advice and document everything.

• Avoid posting about your activities or health online.

• If you suspect you’re being surveilled, consult your lawyer for guidance.

Seeking Professional Help

The disability claim process is complex and insurance companies have significant resources on their side. Don’t try to navigate this alone—especially if your claim has been denied.

How a lawyer can help:

• Review your policy and denial letter to identify weaknesses in your case.

• Gather and organize all necessary objective medical evidence.

• Communicate and negotiate with the insurance company on your behalf.

• Appeal denied claims and represent you in court if necessary.

Remember: Some disability lawyers in Canada offer free consultations and work on a contingency basis—you don’t pay unless you win your case.

Summary Checklist: Building a Strong LTD Claim

• Collect all objective medical evidence (test results, imaging, exam notes)

• Document your subjective symptoms thoroughly and consistently

• Ensure your doctor provides detailed reports on how your condition limits your ability to work

• Adhere to your treatment plan and attend all appointments

• Respond promptly to all insurance company requests

• Be mindful of surveillance and your online presence

• Seek legal advice if your claim is denied or if you feel overwhelmed

Remember: Your disability benefits are not a handout—they are a right you’ve earned and paid into for many years. If you’re facing challenges with your insurance company, you don’t have to fight alone. Reach out to a trusted disability lawyer and get the support you deserve.

Conclusion & Next Steps

Objective evidence is the backbone of any successful long term disability claim in Canada. By understanding what counts as objective medical evidence, gathering thorough documentation, and getting professional support, you can improve your chances of approval—even if your insurance company challenges your claim.

Your next steps:

• Stay organized and keep detailed records.

• Be honest and consistent in your reports and daily activities.

• Work closely with your medical professionals to ensure your documentation is complete and credible.

• Don’t hesitate to consult a disability lawyer if you’re struggling with the process or facing a denial.

With the right preparation and support, you can ensure your rights are protected and your claim receives the fair consideration it deserves.