For many Ontarians receiving long-term disability (LTD) benefits, the two-year mark represents a pivotal moment in their claim. Most LTD policies include a change in the definition of disability after two years, which can affect your eligibility for continued benefits.
During the first two years of receiving LTD benefits, most policies evaluate disability based on your ability to perform the duties of your own occupation. This means that if your condition prevents you from doing the job you held before becoming disabled, you're likely to qualify for benefits.
However, after two years, the definition of disability often changes to reflect your ability to perform any occupation for which you are reasonably suited. This broader definition can lead to disputes, as insurers may argue that you're capable of performing other types of work, even if they are outside your previous field or expertise.
To prepare for this transition, it's important to stay proactive. Continue seeking regular medical treatment and ensure your healthcare providers maintain detailed records of your condition and its impact on your daily life. If your insurer requests an independent medical examination (IME) or vocational assessment, cooperate fully while ensuring that your own medical team remains aware of any changes to your health.
If your benefits are terminated either before or after the two-year mark, you have the right to appeal or seek legal advice. Many claimants successfully reinstate their benefits by providing additional evidence or challenging the insurer's interpretation of "any occupation."
Understanding this critical transition period and preparing accordingly can help ensure you continue receiving the support you need.
Long Term Disability Lawyer
Dealing with an LTD claim can feel overwhelming, particularly if you're already managing the challenges of a disability. Consulting with an experienced long-term disability lawyer can help you navigate the process, avoid common mistakes, and ensure you receive the benefits you deserve. A disability lawyer can review your policy, gather additional evidence, communicate with your insurer on your behalf, and build your case to ensure you receive a fair result.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
