When a serious injury or illness prevents you from working, the financial and emotional stress can feel overwhelming. Long term disability is designed to replace part of your income, helping you focus on recovery without worrying about bills. However, insurance companies often deny valid claims, leaving you frustrated and uncertain. At MG Law, we’re here to help you navigate this complex process with compassion and expertise.
With over a decade of experience in Ottawa, we’ve helped many people secure the long term disability benefits they deserve. We also guide clients through the Canada Disability Benefit (CDB), a government program that provides additional monthly support. This blog explains long term disability in Ontario, what to do if your claim is denied, and how the CDB can help, empowering you to reclaim financial stability.
What are Long Term Disability Benefits in Ontario?
Long term disability benefits replaces a certain percentage (based on your policy) of your income if a medical condition prevents you from working. They act as a safety net, covering essentials like groceries and rent while you recover or adapt to a permanent condition. These benefits may come from:
- Employer group insurance plans
- Private insurance policies
- Union or association coverage
When Do Benefits Start?
Long term disability benefits typically begin after a waiting period of 90 to 120 days. During this time, you may use sick leave, short-term disability, or Employment Insurance (EI) benefits.
What Conditions Qualify?
You may qualify if a condition significantly limits your ability to work. Examples include:
- Cancer, heart attack, or stroke
- Chronic pain or autoimmune diseases
- Severe mental health conditions, such as depression or anxiety
Eligibility depends on how your condition affects your job duties, not just the diagnosis.
Key Policy Terms: “Own Occupation” vs. “Any Occupation”
This distinction is one of the most important and often misunderstood elements of long term disability coverage in Ontario.
- Own Occupation: For the first 24 months of receiving long term disability benefits, eligibility is typically based on whether you can perform the duties of your own job.
- Any Occupation: After 24 months, most policies shift the definition to whether you can perform any job for which you’re reasonably qualified based on your education, training, and experience.
This change in definition is often where disputes arise, and many insurers use it to deny or terminate benefits, even if your condition hasn’t improved. MG Law’s long term disability lawyers have extensive experience challenging these denials.
How Long Do Benefits Last?
Benefits may continue until age 65 or until you can return to work, depending on your policy. Reviewing your policy with a long term disability lawyer ensures you understand its terms.
How to Qualify for Long Term Disability Benefits
Qualifying for long term disability benefits in Ontario can be challenging due to strict insurance company requirements. Here’s what you’ll need:
- Prove Your Disability: Show your condition prevents you from working. For the first 24 months, this means your own job; after that, any suitable job.
- Submit Strong Medical Evidence: This can include:
- Doctor’s reports detailing your symptoms, treatments, and prognosis
- Test results (e.g., MRIs, blood work)
- Specialist opinions (e.g., from neurologists or psychiatrists)
- Assessments showing how your condition affects daily tasks or mental health
- Complete the Waiting Period: Use short-term benefits (e.g., sick leave, EI) during the 90- to 120-day waiting period before long term disability starts.
MG Law’s long term disability lawyers work with you and your doctors to build a clear, persuasive case that meets your insurer’s criteria, reducing the risk of denial.
What to Do if Your Long Term Disability Claim is Denied
A denied long term disability claim can feel devastating, but you have options. Strict deadlines (sometimes as short as six months, depending on your policy) apply, so act quickly. Here’s how to proceed:
- Review the Denial Letter: The letter explains why your claim was denied, citing policy clauses or missing evidence. MG Law can analyze it to identify weaknesses in the insurer’s reasoning.
- Gather More Evidence: Strengthen your claim by:
- Requesting detailed medical records or specialist reports.
- Considering a Functional Abilities Evaluation (a test to measure your physical or mental limitations).
- Documenting how your condition affects your job and daily life.
- Consider an Internal Appeal: Some policies allow an appeal to the insurer, but this can delay legal action and rarely succeeds. MG Law’s long term disability lawyers can advise if this is worth pursuing.
- File a Lawsuit: A lawsuit can lead to reinstated benefits, back pay, or a settlement. MG Law handles the entire process, from evidence collection to court representation.
Introducing the Canada Disability Benefit (CDB): Extra Support
The Canada Disability Benefit (CDB), passed in June 2023 and officially launched in June 2025, provides up to $200 per month to low-income Canadians with disabilities (ages 18-64). It complements long term disability benefits, helping cover living costs.
Who is Eligible for the Canada Disability Benefit?
To qualify for the CDB, you must:
- Be a Canadian resident.
- Be between 18 and 64 years old.
- Have an approved Disability Tax Credit (DTC) certificate.
- Meet income thresholds set by the federal government.
The Disability Tax Credit is the primary gateway to the CDB. To apply for the DTC, your doctor must attest that you have a severe and prolonged disability that markedly restricts your ability to carry out basic life activities.
More information about the DTC can be found here.
How Do I Apply?
Below is a concise guide to the application process and requirements.
Applying for Yourself
If you received a letter from Service Canada, you’ll need:
- Your 6-digit application code (found in the upper right-hand corner of the letter).
- Your Social Insurance Number (SIN), available on your SIN card, confirmation letter, or tax documents.
- Your legal status in Canada.
- (Optional) Direct deposit information (branch, institution, and account numbers) for faster, reliable payments.
If you didn’t receive a letter, provide:
- Your SIN.
- Your mailing address.
- Your legal status in Canada.
- (Optional) Your net income (line 23600 from your notice of assessment) to speed up processing.
- (Optional) Direct deposit information.
Applying as a Legal Representative
A legal representative, such as a guardian, trustee, or power of attorney, applies on behalf of the applicant. If the applicant received a Service Canada letter, provide:
- The applicant’s 6-digit application code
- The applicant’s SIN
- The applicant’s legal status in Canada
- Proof of your legal authority (e.g., court order, guardianship certificate, or power of attorney)
- A copy of your non-expired government-issued ID (e.g., driver’s license, passport, or birth certificate)
- Your mailing address
- (Optional) Direct deposit information for you or the applicant
If no letter was received, include the above plus:
- The applicant’s mailing address
- (Optional) The applicant’s net income
For Organizational Representatives
If acting professionally within an organization, provide:
- The organization’s mailing address
- A document confirming your role (e.g., employment contract or organizational correspondence)
- (Optional) The organization’s business number (e.g., CRA or provincial/territorial business number)
Application Methods
- Online: The fastest method, recommended for efficiency.
- By Phone: Contact Service Canada via telephone, TTY, or video relay service (VRS) with a sign language interpreter
- In Person: Visit a Service Canada office
- By Mail: Complete the appropriate application form (individual or legal representative), then mail it to Service Canada Centre, CDB Processing Centre, P.O. Box 60, Boucherville, QC J4B 5E6, or drop it off at a Service Canada office
Ensure Accuracy
Double-check your application for errors or missing information. Contact Service Canada immediately to correct any errors.
Why the CDB Matters—Even If You Already Receive Long Term Disability Benefits
The CBD is designed to complement, not conflict with, other forms of assistance. This means:
- You do not need to stop long term disability to apply for the CDB.
- The CDB can help cover the gap between long term disability payments and actual living costs.
- It provides another layer of financial resilience in case your claim is ever reduced or denied.
For lower-income Canadians, the CDB can help restore a measure of independence and dignity.
Why Choose MG Law for Your Long Term Disability Claim?
When your claim is denied, you need a trusted partner to fight for you. MG Law offers:
- Experience: Over 15 years helping people in Ontario win long term disability claims, from applications to lawsuits.
- Compassion: We listen to your story, explain each step in plain language, and keep you informed.
- Multilingual Support: Services in English, French, Arabic, Mandarin, Russian, Spanish, and more.
- Results: We’ve secured settlements and reinstated benefits for clients, restoring their financial security.
We collaborate with medical experts to strengthen your case and guide you from start to finish, so you can focus on your health.
Take Action Today
A disability that prevents you from working is challenging enough without the added stress of a denied claim. You deserve the financial support you’re entitled to, and MG Law is here to help you get it. Whether you’re applying for long term disability benefits, appealing a denial, or exploring the CDB, our experienced team in Ottawa is ready to guide you with empathy and determination.
Don’t wait—strict deadlines may apply. Contact MG Law today for a free consultation to discuss your long term disability claim or Canada Disability Benefit eligibility. Let us help you reclaim your financial stability and peace of mind.
