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Denied Disability Claim: How We Can Help
Process
Our appeal process is a structured legal strategy. We begin with a comprehensive file review, analyzing your medical evidence, the insurer's denial letter, and the specific policy language. Our team then builds a compelling case, which often involves commissioning independent medical-legal reports to counter the insurer's assessment. We meticulously prepare submissions that address the legal tests for disability—such as proving you are unable to perform the essential duties of your own occupation or any occupation. We leverage procedural rules and case law to advocate for you, whether through mandatory internal appeals, filing a lawsuit, or pursuing arbitration. A significant portion of denied claims are successfully overturned through this rigorous, evidence-based approach.
At a Glance
| Parameter | Reference Value |
|---|---|
| Typical Appeal Timeline | 12-24 months |
| Standard Limitation Period | 2 years from denial |
| Internal Appeal Deadline | 30-180 days (policy dependent) |
| Common Case Types | LTD, CPP, Group Insurance |
Local Considerations — Canada
Disability law practice varies across Canada's provinces and territories, primarily due to differing insurance regulations and court procedures. In Ontario, the majority of long-term disability litigation proceeds under provincial contract law, while in other regions, federal standards may apply to certain plans. The economic drivers in major hubs like Toronto, Vancouver, and Calgary—including finance, tech, and resources—create distinct patterns in claim types and insurer tactics. Our national firm adapts by maintaining expertise in both provincial superior court rules and federal administrative tribunals, such as the Social Security Tribunal for CPP Disability appeals. This ensures tailored advocacy whether your claim originates in a major urban center or a remote community.
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Standards & Compliance
- Insurance Act (Provincial)
- Income Tax Act (Federal)
- PIPEDA (Federal Privacy Law)
- Provincial Limitations Acts
Frequently Asked Questions
What is the first step after my disability claim is denied?
The critical first step is to review the denial letter and your policy for the appeal deadline. Contact our legal team immediately for a case assessment. We will secure your file from the insurer and begin analyzing the grounds for denial to formulate your appeal strategy before time expires.
What are the most common reasons for a disability claim denial?
Insurers commonly deny claims citing insufficient medical evidence, surveillance findings alleging activity, opinions from their hired doctors that you can work, or interpretations that your condition does not meet the policy's specific definition of 'total disability.' Each requires a distinct legal and evidentiary rebuttal.
How long does the appeal process for a denied claim usually take?
The timeline varies significantly. An internal appeal with the insurer may take 3-6 months. If litigation is necessary, the process through discovery, mediation, and potentially trial in provincial court typically ranges from 12 to 24 months, depending on complexity and court schedules.
How much does it cost to appeal a denied disability claim in Canada?
Legal fees depend on case complexity, the stage of appeal (internal vs. litigation), and the need for expert reports. Many cases are handled on a contingency fee basis, where legal fees are a percentage of the recovered benefits, reducing upfront cost. We provide a clear fee agreement after an initial case assessment.