SEP | September 25, 2025 | Personal Injury

Long-term disability (LTD) benefits are a financial lifeline for Ontario residents who cannot work due to serious illness or injury. Many workers have access to these benefits through their employer’s group insurance plan, while others purchase private disability insurance policies for protection.

When clients consult our firm about disability matters, they frequently ask about the duration of LTD benefits in Ontario. The answer isn’t straightforward, as benefit periods depend on several factors, including policy terms, the nature of your disability, and your ability to return to work in some capacity. In general, LTD benefits extend until the age of 65, but can be shortened for various reasons, including returning to work.

Key Takeaways

  • Long-term disability benefits in Ontario typically continue until age 65, though benefits can end earlier if you recover or become able to work in a suitable occupation.
  • The transition from “own occupation” to “any occupation” status is the point where many claims are denied, requiring comprehensive medical evidence to prove you cannot work in any suitable occupation based on your education, training, and experience.
  • Ontario employers have a legal duty to accommodate returning employees with disabilities, which may include modified duties, flexible schedules, or workspace adjustments to facilitate a gradual return to work.

Table of Contents

Long-Term Disability in Ontario

Long-term disability insurance in Ontario provides income replacement for employees who are unable to work due to medical conditions that persist beyond the short-term disability period. These benefits typically replace between 60% and 70% of your regular income, though the exact percentage varies by policy.

Most LTD coverage in Ontario follows a two-phase structure. During the first phase, usually lasting 24 months, you qualify for benefits under what’s called the “own occupation” definition of disability. This means you receive long-term disability Ontario pay if your medical condition prevents you from performing the duties of your specific job.

After this two-year period, the definition of disability typically changes to an “any occupation” standard. Under this more stringent criterion, you continue receiving benefits only if you’re unable to work in any occupation for which you’re reasonably suited based on your education, training, and experience. Many long-term disability claims in Ontario face termination at this stage, even when claimants remain unable to return to their previous positions.

For those who continue to qualify under the “any occupation” definition, most LTD policies in Ontario provide benefits until one of these events occurs:

  • You recover sufficiently to return to suitable employment
  • You reach age 65 (the standard termination age for most policies)
  • You fail to participate in recommended treatment programs
  • You pass away

What Qualifies for Long-Term Disability in Ontario?

To qualify for long-term disability in Ontario, you must demonstrate that your medical condition prevents you from working according to the definition in your policy. Insurance providers require substantial medical evidence to support your claim.

Both physical and psychological conditions can qualify for long-term disability benefits in Ontario, including:

  • Chronic pain conditions (fibromyalgia, chronic fatigue syndrome)
  • Musculoskeletal disorders (severe arthritis, degenerative disc disease)
  • Cardiovascular conditions (heart failure, recent heart attack)
  • Neurological disorders (multiple sclerosis, Parkinson’s disease)
  • Serious mental health conditions (major depression, bipolar disorder, PTSD)
  • Cancer and related treatments
  • Post-surgical recovery with complications
  • Autoimmune diseases (lupus, rheumatoid arthritis)
  • Severe diabetes with complications
  • Vision or hearing loss
  • Stroke and post-stroke deficits

For an LTD claim to succeed in Ontario, you generally need:

  • Formal diagnosis from qualified medical practitioners
  • Clinical evidence supporting your diagnosis (test results, imaging)
  • Detailed documentation of functional limitations
  • Treatment records showing compliance with recommended therapies
  • Specialist reports or assessments
  • Documentation of failed treatment attempts, where applicable

The threshold for qualifying becomes more challenging after the initial “own occupation” period. When the “any occupation” standard applies, the insurance company will consider whether there are other jobs you could reasonably perform despite your limitations. Insurance companies often deny claims when they believe workplace accommodations could allow for continued employment or when they judge the medical evidence insufficient to establish total disability.

Length of Long-Term Disability in Ontario

The duration of long-term disability benefits in Ontario depends primarily on your specific insurance policy terms and your ongoing medical condition.

Standard benefit periods typically extend until age 65, which aligns with the traditional retirement age. However, several factors can cause your long-term disability benefits to end before reaching age 65:

  • Medical improvement allowing return to suitable work
  • Failure to provide requested medical updates
  • Non-compliance with recommended treatments
  • Reaching the maximum benefit period specified in your policy
  • Evidence of activities inconsistent with claimed limitations
  • Death of the claimant

The length of your disability benefits can be significantly impacted by providing proper medical documentation and adhering to your insurer’s requirements. Regular attendance at medical appointments and following prescribed treatments are essential for maintaining eligibility throughout the maximum benefit period.

Returning to Work After Long-Term Disability in Ontario

Most insurance companies prefer to see claimants return to work when medically appropriate, as this reduces their financial obligations. However, this process must be guided by medical evidence and realistic assessments of your capabilities.

Under Ontario’s Human Rights Code, employers have a duty to accommodate employees with disabilities to the point of undue hardship. These accommodations might include:

  • Ergonomic workstation modifications
  • Flexible work schedules
  • Redistribution of certain job duties
  • Assistive technology or devices
  • Remote work options
  • Physical workplace modifications

When returning to work, clearly communicate your functional limitations to your employer, supported by relevant medical documentation. Having your treating physician outline specific restrictions helps ensure that you receive appropriate accommodations.

When contemplating a return to work after long-term disability:

  • Consult with your healthcare providers to confirm you’re medically ready
  • Review your insurance policy to understand how work affects your benefits
  • Communicate with your insurer before beginning any work (even volunteer positions)
  • Document all accommodations requested and implemented
  • Keep detailed records of your hours, duties, and any symptoms that develop
  • Consider seeking legal advice if your employer fails to accommodate your return

Many claimants fear losing their benefits if they attempt to return to work. However, most Ontario LTD policies have provisions to protect you during trial work periods. If you return to work and later experience a recurrence of your disability, most Ontario policies allow you to resume benefits without serving another waiting period, provided the recurrence happens within a specified timeframe.

Don’t let insurance companies dictate your financial future. If you’re dealing with a long-term disability claim in Ontario, contact Findlay Personal Injury Lawyers for a free consultation.

FAQs About Being on Long-Term Disability in Ontario

Can You Work While on Long-Term Disability in Ontario?

Yes, you can work while receiving long-term disability benefits in Ontario, but with important limitations that depend on your specific insurance policy terms. Most LTD policies permit some form of work activity while maintaining partial or full benefits, though this arrangement requires careful navigation.

Working during the “own occupation” period (typically first 24 months) is generally more permissible than during the “any occupation” period, as demonstrating capacity for some work could undermine your claim that you cannot work in any suitable occupation.

Before accepting any employment while on long-term disability in Ontario, carefully review your policy or consult with a lawyer specializing in disability claims. Some forms of work (or even volunteer positions) could jeopardize your benefits if not properly disclosed and approved by your insurer.

What Happens If My Long-Term Disability Claim Is Denied After the “Own Occupation” Period?

If your long-term disability claim is denied after the transition from the “own occupation” to the “any occupation” period, you have several options to challenge this decision. When your insurer denies continued benefits, they will send a letter explaining their decision. Your immediate steps should include:

  1. Review the denial letter. Understand the specific reasons for denial and note any deadlines for appeals.
  2. Request your claim file. You have the right to obtain your complete file from the insurer, including all medical reports, assessments, and internal notes they used to make their decision.
  3. Discuss the denial with your treating physicians to determine if they support your continued disability claim and are willing to provide additional documentation.
  4. Consider an internal appeal process where you can submit additional evidence and arguments against their decision.
  5. If your internal appeal is unsuccessful, consult with a lawyer who specializes in long-term disability claims in Ontario.

Success in challenging a denial after the “own occupation” period typically hinges on proving that, despite your education, training, and experience, you remain unable to perform any suitable occupation due to your medical condition. This often requires stronger medical evidence than what was needed during the initial benefit period.

Do Long-Term Disability Benefits in Ontario Continue After Age 65?

In most cases, long-term disability benefits in Ontario do not continue after age 65, aligning with the traditional retirement age. If you’re approaching age 65 while receiving long-term disability in Ontario, review your specific policy terms and prepare financially for this transition. The termination of LTD benefits at 65 is generally not considered age discrimination under Ontario law, as it reflects the standard presumption about retirement age.