Applying for long-term disability (LTD) benefits in Ontario can feel overwhelming—but breaking it down step by step helps. Hiring a lawyer early on who specializes in LTD claims is key.
- Understand Eligibility Criteria
Before applying, verify if your plan even offers LTD coverage. Many employers provide LTD insurance through private insurers. Eligibility typically depends on factors like your employer’s group plan, how long you’ve been employed, your waiting or elimination period (often 90–180 days), and the specific definition of “disability” set by your insurer.
- Notify Your Employer and Insurer
As soon as you think you might qualify, notify your employer and the insurer to begin the claim process. Your HR or benefits coordinator can provide you with the necessary paperwork. You’ll likely need to complete forms detailing your personal information, job duties, income, and, of course, the nature of your disability.
- Obtain Medical Documentation
Your doctor or specialist will need to provide at least a detailed medical report. The insurance company may ask for additional documents or “proof” of your disability. Your doctor or specialist will need to set out their diagnosis, history of your condition, treatment plans, prognosis, and how the disability impacts your ability to work. Detailed, objective medical information is absolutely essential for a successful claim.
- Submit the Claim Form
Once you’ve gathered all documentation, including claim forms and supporting medical records, you can submit your claim. Late or incomplete submissions can delay processing or even lead to denial.
- Follow Up and Cooperate
After submission, it is critical to stay in touch with the insurer and promptly respond to any requests. They may ask for additional medical information, diagnostics, or other assessments. You will also likely be asked to submit periodic updates as your condition evolves.
- Review the Decision
Insurers typically respond within a few weeks. If your claim is approved, you’ll begin receiving LTD payments. If denied, it is best to review the reason with an LTD lawyer and see what next steps might best advance your claim.
- Maintain Communication
Once on LTD, continue staying in touch with the insurer, providing any medical updates, functional capacity forms, or return-to-work plans as required. This ensures uninterrupted benefits and supports any transition back to work when appropriate.
By understanding the process, gathering thorough medical documentation, and staying proactive, you’ll be best positioned to secure long-term disability benefits in Ontario.
