Depression and LTD: Why Mental Health Claims Get Denied

Mental health is the #1 cause of disability claims in Ontario

Over one-third of all disability leaves in Ontario are mental health related, and mental health conditions drive approximately 70% of total disability costs for employers. Depression, anxiety, PTSD, and burnout are legitimate, documented medical conditions.

So why do insurers deny mental health claims?

Because they can frame them as "subjective." Unlike a broken bone that shows on an X-ray, depression is documented through clinical assessment, patient history, and functional observation. Insurers exploit this by claiming there's "no objective evidence" of disability.

The 24-month mental health limitation

Many LTD policies contain a clause that limits benefits for mental health conditions to 24 months. After two years, the insurer terminates benefits — even if you're still disabled. However, this limitation can sometimes be challenged.

How we prove mental health disability

Building a strong mental health disability case requires: comprehensive treatment records, functional assessments showing how depression affects your ability to work, documentation of failed treatment attempts, evidence of how the condition affects daily activities, and independent medical opinions.

Having good days doesn't mean you're not disabled

Insurers love to argue that if you had a good day — went to a family dinner, posted a smiling photo — you're not really depressed. Courts see through this. Disability isn't about being incapacitated 24/7. It's about whether you can reliably and consistently perform the demands of employment.

The diagnosis is clear. The denial is the problem.

If your insurer denied your mental health claim, it doesn't mean you're not disabled. It means the insurer decided it was cheaper to say no. Depression doesn't show up on an X-ray. That doesn't make it any less disabling, and the law recognizes that.