Manulife Long-Term Disability in Canada: 2025 Guide to Benefits, Denials and Legal Help

Manulife Long-Term Disability Coverage

Manulife is one of Canada’s largest providers of long-term disability insurance, offering coverage through employer group benefit plans as well as individual policies. This monthly benefit is designed to help maintain financial stability when you’re unable to work due to illness or injury. Coverage typically begins after a waiting period (often 3-6 months) during which short-term disability or employment insurance may provide income.

To qualify for Manulife long-term disability benefits, you must meet the definition of disability outlined in your specific policy. Most policies define disability in two distinct phases:

• Own Occupation Period: For the first two years of LTD benefits, you generally must be unable to perform the duties of your own occupation. This means if you cannot perform your specific job, you may qualify for benefits even if you could theoretically work in a different capacity.
• Any Occupation Period: After two years, the definition typically changes to require that you be unable to perform any occupation for which you are reasonably suited by education, training, or experience.

Some policies impose maximum benefit periods for specific diagnoses, while others provide coverage until age 65 if you continue to meet the disability definition.

Application Process for Manulife Disability Insurance

Applying for Manulife disability insurance begins with notification to your employer’s HR department or directly to Manulife if you have an individual policy. You’ll need to complete several forms:

• Employee Statement: Personal information with details about your condition, and how it affects your ability to work.
• Attending Physician Statement: Your doctor must complete this form, documenting your diagnosis, treatment plan, functional limitations, and prognosis.
• Employer Statement: Your employer provides information about your job duties and workplace accommodations attempted before your disability leave.

Once submitted, a Manulife case manager will review your file, possibly request additional information, and may contact your healthcare providers directly. They may also arrange an independent medical examination (IME). Be prepared for this process to take several weeks to months, depending on the complexity of your case.

Manulife Long-Term Disability Payment Schedule

If approved, your Manulife long-term disability payment schedule typically involves monthly payments issued directly to your bank account. The amount you receive is calculated based on your pre-disability earnings and the benefit percentage specified in your policy.

LTD benefits are typically taxable if your employer paid the premiums, while benefits from personally paid policies are generally tax-free. Manulife will issue appropriate tax forms annually if your benefits are taxable.

Manulife Long-Term Disability Benefits: What Happens After 2 Years?

Approximately 3-4 months before the two-year mark, Manulife typically initiates a comprehensive review of your claim. This review process includes:

• Requests for updated medical information from all treating practitioners
• Possible referral for an independent medical examination
• Functional capacity evaluations to measure your physical abilities
• Transferable skills analysis to identify potential occupations you might be able to perform
• Surveillance to observe your activities outside medical appointments

During this assessment period, your case manager will compare your documented limitations against the requirements of various occupations. They’re looking specifically for evidence that you could perform some type of work, even if it’s part-time, lower-paying, or completely unrelated to your previous career.

If Manulife approves your claim beyond the two-year mark, you’ll continue receiving benefits as long as you meet the “any occupation” definition. But if Manulife determines you could earn 60-70% of your pre-disability income (the exact threshold varies by policy), they may terminate your benefits even if such jobs aren’t actually available in your geographic area or you haven’t worked in that field before.

Common Reasons for Manulife Financial Disability Claims Denials

Manulife financial disability claims are denied with alarming frequency, even when claimants are legitimately unable to work. The underlying reality is that, as an insurance company, Manulife has a financial incentive to deny claims. While they are obligated to assess claims fairly under their contract and Canadian insurance law, the gray areas in disability assessment leave considerable room for interpretation, often to the detriment of legitimate claimants. These are the primary reasons Manulife denies long-term disability claims:

Insufficient Medical Evidence

The most frequent basis for denial is Manulife’s assertion that there is inadequate medical documentation to support your disability. This may occur when:

• Your medical records lack specific functional limitations
• There are gaps in your treatment history
• Specialists’ reports are missing or outdated
• Objective test results (like MRIs or bloodwork) don’t align with subjective complaints
• Your doctor’s chart notes don’t consistently document your symptoms

Definition of Disability Not Met

Manulife often claims that your condition, while present, doesn’t prevent you from working. They may argue that your limitations are not severe enough to satisfy the policy definition, particularly for conditions with symptoms that fluctuate or aren’t easily measurable through diagnostic testing.

Pre-Existing Condition Exclusions

Many Manulife policies contain exclusions for conditions that existed before your coverage began. If you sought treatment for similar symptoms during the look-back period (typically 3-12 months before coverage), Manulife may deny your claim even if your condition significantly worsened after coverage began.

Policy Exclusions and Limitations

Some conditions have specific benefit limitations built into the policy. For example, many Manulife policies limit benefits for mental health conditions, substance abuse disorders, or self-reported symptoms (like pain or fatigue) to 12-24 months, even if these conditions prevent work indefinitely.

Surveillance Evidence

Manulife regularly employs surveillance to observe claimants engaged in activities that appear inconsistent with their reported limitations. A few hours of video showing you shopping, driving, or performing household tasks can be used to deny or terminate your claim, even if these activities cause you pain or require days of recovery afterward.

Social Media Investigations

Your public social media posts may be scrutinized for evidence contradicting your disability claims. Photos of social events, travel, or physical activities—even if rare exceptions to your normal limitations—can be used against you.

Missed Deadlines or Procedural Errors

Technical issues, such as submitting forms after deadlines, failing to attend scheduled medical examinations, or not providing requested information promptly, can result in denial regardless of your medical condition’s severity.

Non-Compliance with Treatment

Manulife expects you to follow recommended treatments. If you decline certain medications due to side effects, miss appointments, or choose alternative therapies over conventional treatment, they may deny benefits, citing failure to mitigate your disability.

Contradictory Medical Opinions

If Manulife’s medical consultants or independent examiners provide opinions that contradict your treating physicians, they often give these opinions greater weight than those of doctors who have treated you for years.

Self-Reported Conditions

Conditions without clear objective findings, like fibromyalgia, chronic fatigue syndrome, chronic pain, or certain mental health disorders, face heightened scrutiny. Manulife may dismiss these claims as merely subjective or lacking medical foundation, despite their genuine impact.

Return to Work Attempts

Unsuccessful attempts to return to work may be used against you. Manulife might argue that your ability to try working, even briefly, demonstrates capacity for some form of employment, ignoring that the attempt proved your inability to sustain work.

Appealing Denied Manulife Disability Insurance Claims

Receiving a denial letter for your Manulife disability insurance claim can be devastating, particularly when you’re genuinely unable to work. However, a denial is not the final word. You have options to challenge this decision. The appeal process for Manulife long-term disability generally follows these stages:

Internal Appeal

Most Manulife policies provide for at least one level of internal appeal, which is handled within the company but by different personnel than those who made the initial decision. This process typically involves:

• Submitting a formal appeal letter stating why you believe the denial was incorrect
• Providing new or additional medical evidence supporting your disability
• Addressing each specific reason cited in the denial letter
• Including supportive letters from treating healthcare providers

The internal appeal is your opportunity to correct misunderstandings or provide missing information. However, success rates for internal appeals are relatively low, as Manulife is essentially reviewing its own decision. While you should pursue this option, prepare for the possibility that you’ll need to take further action.

Legal Action

For many denied claimants, litigation becomes necessary. In Canada, you can sue your insurer for:

• Breach of contract (failing to provide benefits as promised in the policy)
• Bad faith (if the insurer handled your claim unfairly or unreasonably)
• Punitive damages (in cases of particularly egregious conduct)

It’s important to note that most disability insurance policies are governed by provincial limitation periods—typically two years from the date of denial. Failing to commence legal action within this timeframe may permanently bar your claim, regardless of its merit.

Get Help from an Experienced Long-Term Disability Lawyer

Manulife long-term disability claims are deliberately complex, the policies are filled with exceptions and limitations, and the insurer has teams of adjusters, medical consultants, and lawyers working to minimize payouts. This imbalance of power and expertise puts individual claimants at a distinct disadvantage.

An experienced disability lawyer can:

• Frame your claim in legally advantageous terms.
• Work with your healthcare providers to ensure reports address all elements.
• Ensures all time-sensitive requirements are met promptly.
• Contest mischaracterizations in surveillance and social media and provide proper context for any observed activities.

The sooner you involve legal counsel, the stronger your position becomes. Many claimants contact a lawyer only after multiple appeals have failed, having unknowingly made statements or omissions that weaken their case. A lawyer involved from the application stage or immediately after an initial denial can help you avoid these pitfalls. Contact Matthews Abogado Long-Term Disability Lawyers to discuss your situation and learn how we can help protect your rights against one of Canada’s largest insurance companies.

FAQ

What Medical Conditions Qualify for Manulife Long-Term Disability Insurance?

Manulife long-term disability insurance covers a wide range of medical conditions that prevent you from working, including:

• • physical disabilities (cancer, heart disease, multiple sclerosis, severe injuries)
  • mental health disorders (depression, anxiety, PTSD)
  • chronic pain conditions (fibromyalgia, arthritis)

• neurological disorders

The key factor isn’t the specific diagnosis but rather how your condition impacts your ability to perform your job duties.

How Much Do Manulife Long-Term Disability Benefits Pay Monthly?

Long-term disability Manulife benefits typically pay between 60 and 70% of your pre-disability gross income, up to the maximum monthly benefit specified in your policy. The exact percentage and maximum amount depend on your LTD Manulife policy terms. This monthly payment may be reduced by other income sources, including CPP disability benefits, Workers’ Compensation, automobile insurance benefits, and any part-time work earnings.

Can Manulife Terminate My LTD Benefits If I Work Part-Time?

Most Manulife disability insurance policies include provisions for partial disability that allow you to work part-time while still receiving adjusted benefits. However, if your part-time earnings exceed the threshold specified in your policy, Manulife may reduce or terminate your benefits.

What is the Difference Between “Own Occupation” and “Any Occupation” in Manulife Disability Policies?

Under the “own occupation” definition, which typically applies during the first two years of benefits, you qualify for Manulife disability insurance if you cannot perform the essential duties of your specific job. After two years, most LTD Manulife policies transition to the stricter “any occupation” definition, requiring that you be unable to work in any occupation for which you’re reasonably suited by education, training, or experience.

When Should I Hire a Lawyer for My Manulife Disability Claim?

You should consider hiring a long-term disability lawyer for your Manulife claim in several situations:

• Immediately after receiving a denial letter
• When approaching the critical two-year mark when Manulife transitions from “own occupation” to “any occupation”
• If Manulife requests an independent medical examination
• When they conduct surveillance
• If they’ve reduced your benefits due to other income sources
• When they’ve imposed limitations based on mental health or self-reported conditions

Early legal representation often results in better outcomes for Manulife financial disability claims, as lawyers can help structure your application properly, gather appropriate medical evidence, and ensure deadlines are met.

What Happens If I Return to Work and Then Become Disabled Again?

If you return to work after receiving long-term disability Manulife benefits and then become disabled again, the policy’s recurrent disability provision determines what happens next. For disabilities related to the same or connected conditions that occur within 6 months (timeframe varies by policy) of returning to work, Manulife typically restarts your benefits without a new elimination period, and you continue under the same claim. However, if you’ve been back at work beyond the recurrent disability timeframe (usually 6 months), Manulife will treat this as a new claim requiring a new elimination period and updated medical documentation.