Recognized leaders in the complexities of long term disability cases.
What is Long-Term Disability?
Long-term disability means you are unable to work for an extended period due to a serious illness, injury, or medical condition. It isn’t about how you feel but whether the condition affects your ability to perform the essential duties of your job, even if you want to work and are trying to return.
Even if your limitations aren’t visible, such as chronic pain, neurological issues, or mental health challenges, you may still have a valid disability claim.
Long-term disability insurance replaces a portion of your income when this happens. Most people have this coverage through an employer's benefits plan, though some purchase individual policies directly from insurers.
To qualify for benefits, your condition must meet the specific definition of “total disability” in your policy. Many policies first assess whether you can perform the duties of your own occupation. After a set period, they may apply an “any occupation” standard, meaning insurers evaluate whether you are capable of any job based on your education, training, and experience.
Understanding how your policy defines these terms can directly affect the decisions you make about your claim.
Long-Term Disability Eligibility.
Qualifying for long-term disability benefits depends on the wording of your policy. While every plan is different, approval generally requires demonstrating that:
- your medical condition meets the policy’s definition of “disability.”
- your condition is not excluded under the policy (for example, pre-existing condition clauses or other listed exclusions).
- your disability prevents you from performing the essential duties of your occupation, particularly during the initial benefit period.
- If the policy shifts to an “any occupation” definition, your condition prevents you from working in a role that matches your education, training, or experience.
- you have satisfied the required waiting period before benefits become payable.
Insurance policies are detailed documents. Small differences in wording can alter how eligibility is evaluated. Understanding how your policy applies to your situation is an important first step.
You may receive a denial letter filled with policy language that is difficult to interpret. Insurers may rely on file reviews or independent medical assessments that conflict with your treating physician’s opinion. In some cases, insurers conduct surveillance or rely on internal assessments that differ from your doctor’s findings. Claims may also be delayed while additional documentation is requested or reassessed.
Disability Claims We Handle.
Long-term disability is not limited to visible injuries. If your condition prevents you from performing the essential duties of your occupation, you may qualify for benefits, even if your diagnosis is not readily apparent.
We assist clients with claims involving:
- Long-Term Disability Denials
- Long-Haul COVID Claims
- Fibromyalgia & Chronic Pain
- Mental Health Conditions
- Post-Cancer Disability
- Neurological Conditions
- Cardiac Conditions
- Diabetes and Related Complications
- Physical Injury
Insurance companies often scrutinize claims involving chronic pain, mental health conditions, and fatigue-related disorders particularly closely. These cases require strong medical evidence and a clear understanding of how policies are interpreted.
Before You Decide What to Do Next, Get Clear Advice.
Tell us what happened. We will review your situation and explain where you stand - clearly and honestly.
Long-Term Disability Process.
Whether you’re applying for LTD, preparing for an “any occupation” review, or dealing with a denial, the steps below outline the typical process and how we help at each stage.
Important: Before filing an internal appeal, seek advice. The insurer that denied your claim handles the appeal.
- Review the policy and paperwork (forms, medical, and employer documents).
- Clarify your options (appeal vs legal action, deadlines, next steps).
- Build the evidence (medical support, functional limits, vocational impact).
- Pursue resolution (insurer negotiations or litigation, if needed).
You do not have to manage insurer correspondence, deadlines, or complex policy terms on your own. We deal directly with the insurer and handle the process while you focus on your health - and there are no upfront legal fees.
Long Term Disability Lawyers.
At Gluckstein Lawyers, we meet clients during one of the most challenging periods of their lives. When illness or injury disrupts your ability to work, the uncertainty can feel overwhelming. You deserve clear guidance and reliable support.
Our long-term disability team draws on decades of experience in serious personal injury and insurance litigation. We understand how disability policies are interpreted, how insurers assess claims, and how to respond when benefits are denied, reduced, or terminated.
The lawyers in this group have extensive courtroom and appellate experience, have served as lead counsel in complex cases across Ontario, and have represented clients before the Superior Court of Justice, the Court of Appeal, and administrative tribunals. That depth of experience informs every LTD claim we handle.
Our work is measured and strategic, focused on ensuring you understand your rights and on pursuing the benefits available under your policy.
Testimonials.
It is an honour to represent our clients and their families to help them come to a resolution, and we are grateful to have played a part. It is their stories of resiliency that inspire us to continue advocating on behalf of injured victims. Here are their stories, and we hope they inspire you.
Frequently Asked Questions.
What is Surveillance in Long-Term Disability Insurance?
Surveillance in the context of Long-Term Disability (LTD) insurance refers to the practice where insurance companies may conduct covert monitoring and observation of claimants to investigate the validity of their disability claims. This surveillance is typically carried out by professional investigators who gather visual evidence, such as photographs or videos, to assess the claimant's activities and functional limitations. Here are key points to understand about surveillance in LTD insurance:
- Purpose: The primary purpose of surveillance is to verify the extent of a claimant's disability and ensure that the reported limitations align with their actual activities. Insurance companies use surveillance as a tool to prevent fraud, confirm the accuracy of claims, and protect the integrity of the LTD system.
- Activities Monitored: Surveillance may involve monitoring various aspects of a claimant's daily life, including physical movements, interactions with others, engagement in recreational activities, and participation in events that could indicate the level of disability.
- Covert Nature: Surveillance is typically conducted covertly, meaning that the claimant is not aware that they are being monitored. This approach aims to capture the claimant's behavior and activities in their natural state without influencing their actions.
- Legal Compliance: Surveillance activities must comply with legal regulations and privacy laws to ensure that the rights of the claimant are respected. Investigators must adhere to ethical standards and obtain evidence lawfully.
- Impact on Claims: The results of surveillance can influence the outcome of an LTD claim. If the surveillance footage contradicts the claimant's reported limitations or suggests misrepresentation of disability, the insurance company may use this information to deny or terminate benefits.
- Frequency: Surveillance is not conducted continuously for all claimants but is often employed selectively based on specific factors, red flags, or suspicions raised during the claims process.
- Balancing Privacy and Investigation: While surveillance is a legitimate tool for insurance companies to verify claims, it raises concerns about privacy invasion and the potential misinterpretation of normal activities as evidence of fraud. Claimants have the right to challenge surveillance findings if they believe their disability status has been misrepresented.
Understanding the role of surveillance in LTD insurance can help claimants navigate the claims process effectively, ensure transparency in their interactions with the insurance company, and seek legal advice if they have concerns about the handling of surveillance activities in relation to their disability claim.
If surveillance has affected your claim, our team can review what happened and help you respond. You don't pay us anything upfront, we only get paid if we win your case. Concerned about how surveillance affected your claim? Bring your questions to a free consultation with our team.
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