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What Does Ontario Long-Term Disability Insurance Cover?


You cannot plan for unexpected events like illness and injury. Such events can disrupt your life without a moment’s notice, leaving you to deal with not only the physical and emotional implications of your illness or injury, but also the financial burden.

Unfortunately, an illness or injury does not prevent bills from coming in every month.

Consider the following statistics: a typical 30-year-old is four times more likely to become disabled before the age of 65 than he or she is of dying. 1 in 6 Canadians will be disabled for three months before the age of 50.

Ontario Long-term Disability Insurance (LTD) is designed to replace lost income in the event of a serious illness or injury.

Long-Term Disability Insurance is designed for those with “total disability.” Total disability is usually defined as sickness or injury that prevents you from being able to perform the most essential job duties at your regular job. After two years the test usually changes to whether you are impaired from performing any occupation for which you are reasonably qualified based on your training, education or experience. Total disability also means that you are under the regular care of a doctor.

There are exclusions to Ontario’s long-term disability coverage that can prevent you from receiving benefits. For example, if your injury was self-inflicted (regardless of whether or not it was a result of mental illness), you cannot qualify. Normal pregnancy or childbirth is another example. If your injury was the result of civil disobedience, had criminal intent, or occurred during a period of imprisonment, benefits may not be payable.

On many occasions, people who are totally disabled and cannot work still have their claim for long-term disability benefits refused by the insurance company for a variety of reasons. This decision may be based on internal reviews by physicians who are on the insurance company’s payroll and do not have your best interests in mind.

If you have been injured or disabled and have had your LTD benefits refused, contact the LTD lawyers at SG Injury Law. We will evaluate your case and provide you with options regarding making a claim for your denied benefits. For more information, please contact us today.