People with disabilities (whether with physical or psychological conditions) often face immense challenges. The emotional and financial consequences, ranging from the inability to return to work and a significant decline in quality of life to the endless costs of supporting themselves and their families, can prove to be an overwhelming burden. Long term disability (LTD) insurance can provide essential financial support when an illness or injury prevents you from working, but obtaining the LTD benefits is not always straightforward. Insurance companies may deny or terminate legitimate claims, leaving you to navigate a complex process while dealing with the realities of your disability.
If your long term disability claim has been denied, delayed, or terminated, a long term disability lawyer in Toronto can help you protect your rights. At Campisi Law, we’ve seen clients who have their claims denied and we helped them challenge the insurance company’s decision and secure the LTD benefits they needed to support themselves.
Long-term disability (LTD) benefits can be complex, and unfortunately, even valid claims are often denied. Simple oversights, like missing a medical appointment, missing a deadline, or submitting incomplete paperwork, can put your benefits at risk.
Some common reasons an LTD claim may be denied include:
Insufficient medical evidence
Failure to meet the policy’s definition of disability
Incomplete or inconsistent documentation
Missed deadlines or appointments
Failure to cooperate with the insurer
Surveillance or other evidence
Pre-existing condition or policy exclusions
At Campisi Law, we understand how overwhelming the process can be. Our team is here to guide you through your appeal with clarity and care. We have in-depth knowledge of long-term disability claims and the strategies insurers use to deny them. From gathering essential documentation to meeting strict deadlines, our Toronto LTD lawyers take care of the details, so you can focus on your health and recovery.
Eligibility for LTD benefits in Ontario depends on the terms of your specific insurance policy. However, many LTD policies provide coverage for a wide range of physical and psychological conditions, including:
Musculoskeletal conditions, such as chronic back, neck, joint, or spinal disorders
Neurological conditions, including multiple sclerosis, epilepsy, and other nervous system disorders
Mental health conditions, such as depression, anxiety, PTSD, and other psychological conditions
Chronic illnesses, including fibromyalgia, chronic fatigue syndrome, and other debilitating conditions
Serious injuries, including traumatic brain injuries and spinal cord injuries
Cancer and other serious diseases that significantly affect your ability to work
If your LTD claim has been denied, don’t assume you’re not entitled to benefits. Our Toronto long term disability lawyer can challenge the insurer’s decision, present evidence supporting your claim, and help you pursue the benefits you deserve.
Our lawyers use their extensive knowledge of long-term disability claims to help you successfully navigate the appeals process. They offer:
At Campisi Law, we approach every long-term disability claim with integrity and compassion. Our team is led by Joseph Campisi, a professor of insurance law and PhD holder in the field, whose knowledge of how insurance policies operate helps inform our approach to complex LTD claims. We understand the stress and uncertainty that can follow a denied or terminated claim, and we’re committed to providing the knowledgeable legal guidance and personal support you need throughout the process.
What sets your experience with Campisi apart?
Our multilingual team speaks more than 20 languages, making it easier for individuals from all backgrounds to access the legal support they need.
You are at the heart of everything we do. We focus on helping you secure the long term disability benefits you deserve while ensuring you feel heard, respected, and supported throughout the claims process.
Campisi Law is widely respected for its deep understanding of long-term disability claims and commitment to ethical, knowledgeable representation.
We’ve helped many clients successfully appeal denied disability claims and access the benefits they’re entitled to, because results matter when your well-being is on the line.
Many employers provide some form of LTD coverage as part of their benefits package, although there can be significant variations in the terms of the policy. It is important to understand how your policy defines “disability”, the extent of your potential coverage, your rights and obligations, and the procedural steps you need to follow, including the appeals or complaints process if your claim is denied.
Typically, LTD coverage begins after 3 months of continuous disability during which you have been unable to work at your usual employment. Generally, it is not automatic, and you must apply for LTD coverage. Because of the complexities of the application process, many injury victims seek legal assistance at this stage, before submitting the initial application.
Even with expert assistance, most LTD claims are denied. Insurance companies are run for profit. They want to spend as little as possible and will use any means available to deny your legitimate LTD claim. Many claims are denied over technicalities like missed doctor’s appointments or treatment sessions, or for missing medical evidence in your file. Missed deadlines for filing or providing information also trigger automatic denials and happen frequently, even when you are not aware of the deadline.
If your claim has been denied for a technical reason, you will have the right to appeal the denial with your insurance company. The procedures will be set out in your LTD policy. Usually, you have 30 or 60 days to start an appeal in this manner. Depending on the circumstances and your health, you can argue your own appeal. Be advised, however, that most of the time these appeals are a formality, and the denial is upheld.
Frequently, your insurer will demand additional medical evidence beyond your medical records to determine whether you qualify for LTD coverage. They are entitled to send you for medical assessments for this purpose. These assessors are not on your side and typically try to minimize or distort the impact of your injuries or will find other ways to disqualify you. You should think carefully before agreeing to attend one of these assessments, as they can be very damaging to your chances. If you have not already done so, it is a good idea to discuss your options with an experienced LTD lawyer at this point.
A denial of your long-term disability (LTD) claim can feel overwhelming, but it doesn’t mean the end of your claim. Taking the right steps can protect both your health and your legal rights.
Here’s what to do next:
When an LTD claim has been denied, you can either start the appeal process with your LTD provider or start a lawsuit, depending on the reason for the denial. If you have missed deadlines or appointments, but have reasonable explanations, it might be best to appeal the denial. You would do this to preserve the relationship with your disability insurer and get your LTD benefits started or reinstated. The LTD policy will set out the limitation to appeal (usually 30 or 60 days) and other requirements.
If the insurer accepts your explanation, an appeal will get the needed money in your bank account as quickly as possible. However, even in straightforward cases, insurance companies will try to avoid paying, particularly if you do not have a lawyer.
Often, if an insurance company thinks you might win the appeal, they will try to settle your claim on a full and final basis. Usually, however, they will only offer a small portion of the potential benefits. We have successfully taken on major insurance companies in Ontario, including Manulife, Sun Life, Canada Life, and other insurers, and we will work with you to maximize your potential settlement offer.
We'll review your case or a denial letter to help you understand whether you may be entitled to long-term disability benefits and what options are available to you.
We'll provide a clear plan for moving forward, whether you’re preparing an LTD claim, challenging a denied claim, or seeking to reinstate benefits that have been terminated.
You'll leave with actionable advice and clear direction, whether we can take your case or not.
Available seven days a week. We’ll meet you wherever works best: in person, online, or by phone.
Find us here: Ajax, Aurora, Barrie, Belleville, Bowmanville, Burlington, Caledon, Downtown, Guelph, Halton Hills, Hamilton, Kingston, Kitchener-Waterloo, Markham, Mississauga, Newmarket, Oakville, Oshawa, Peterborough, Pickering, Toronto, Vaughan, Woodbridge.
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