Applying for Long-Term Disability (LTD) benefits can feel like a lot. You’re already managing health challenges, and the last thing you should have to worry about is an insurance company denying the support you need. Sadly, LTD claim denials happen more often than most people realize, but here’s the good news: a “no” isn’t always the final answer.
At Litco Law, we’re here to make the process a little less stressful and to help Albertans understand their rights. If your long-term disability claim has been denied (or you’re worried it might be), here are the top five reasons it can happen and what you can do next.
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Lack of Medical Evidence
Insurance companies want “proof” that your condition prevents you from working. If your medical file is incomplete, missing specialist reports, or doesn’t clearly explain your limitations, they may deny your LTD claim.
Tip: Some ways to avoid this include keeping copies of all medical records, attending appointments, and asking your doctor to document not just your diagnosis, but how it impacts your daily life and ability to work.
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Missed Deadlines or Incomplete Forms
Insurance companies love their paperwork, and missing a deadline or leaving a section blank can be enough for them to reject your claim.
Tip: Mark your calendar for every deadline, double-check forms before submitting, and don’t hesitate to ask for help if the paperwork feels confusing (because, let’s be real, it usually is).
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The Insurance Company Says You Don’t Meet the Definition of “Disabled”
Most insurance policies use two key definitions of disability:
- Own Occupation: You can’t perform your current job.
- Any Occupation: You can’t perform any job you’re suited for.
Insurers often deny long-term disability claims by arguing that you could technically do some kind of work, even if it’s unrealistic or unsustainable.
Tip: Make sure your medical evidence specifically addresses both your ability to work in your current role and whether you could realistically transition to another type of job.
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Surveillance or Social Media Activity
It sounds unfair, but insurers sometimes use online surveillance of your social media posts against you. A single photo of you smiling at a family BBQ can be used as “proof” you’re not as limited as you say.
Tip: Be mindful of what you post online and keep social media accounts private. Short moments of activity don’t reflect your overall ability to sustain full-time work, but insurance companies may portray it otherwise.
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Pre-Existing Condition Exclusions
Many long-term disability policies have clauses that exclude coverage for conditions you had (or were treated for) before your coverage began. If your insurer believes your disability is linked to a pre-existing condition, they may deny your claim.
Tip: Review your policy carefully and seek legal advice if a pre-existing clause is being used to deny your benefits. Sometimes these denials can be challenged.
What To Do If Your Long-Term Disability Claim Is Denied
A denial can feel final, but it doesn’t have to be. Many people are able to challenge long-term disability claim denials with the right help. At Litco Law, our disability lawyers have decades of experience standing up to insurance companies and helping Albertans get the benefits they deserve.
You don’t have to go through this alone. If your long-term disability claim has been denied, you can reach out to us at any time for a free consultation. We’ll review your situation and explain your options. If for any reason filing a claim against the LTD denial isn’t in your best interest, we’ll tell you that too. Contact us today to speak with our legal team for free.