Your Long-Term Disability Was Denied or Cut Off. Now What?
You stopped working because you could not do your job, your long-term disability claim was approved, and then a letter arrives saying the benefits are ending. Or the claim was denied from the start. Either way it lands like a verdict. It is not one. A denial is an insurer’s position, and that position can be challenged.
Long-term disability is a contract claim, which makes it different from a car accident or a slip and fall.
Why claims get cut off at month 24
Most policies change the test for disability after about two years. In the first period you only have to show you cannot do your own job. After that, many policies switch to a stricter test: you have to show you cannot do any job that suits your education, training and experience.
That change of definition is where a large share of denials happen. The medical picture has not improved, but the bar has moved, and the insurer takes the position that you could do some other work. Meeting the new test takes evidence aimed squarely at it.
The deadline people misunderstand
Insurers offer an internal appeal, and many people spend months going back and forth on it. Here is the trap: an internal appeal does not stop the legal limitation clock. You generally have two years to start a lawsuit, and that clock can keep running while you are politely appealing. People lose the right to sue this way without realizing it.
Use the internal appeal if it helps, but never assume it protects your deadline. It usually does not.
CPP disability is a separate question
A Canada Pension Plan disability benefit is decided under its own rules and is not the same as your private or group long-term disability claim. The two can interact, since many policies reduce their payment by the CPP amount, but a denial of one does not decide the other. Each is worth pursuing on its own terms.
- ·An LTD denial is a contract dispute with the insurer, not a final answer.
- ·Many claims are cut off when the test changes from your own job to any job, often around 24 months.
- ·An internal appeal does not pause the roughly two-year deadline to sue.
- ·CPP disability is decided separately and is worth pursuing alongside your policy claim.
This article is general information, not legal advice, and every case turns on its own facts. If you have been injured, and especially in a matter involving long-term disability, Shah & Shah Lawyers offers a free consultation.