Long-Term Disability Appeals
Your Claim Was Denied. That Doesn't Mean They Were Right.
Insurance companies deny legitimate disability claims in Ontario every day — not because people aren't disabled, but because denials save them money. That letter you received isn't a medical opinion. It's a cost-saving exercise. And you don't have to accept it.
In Ontario, you generally have 2 years from the date of denial to take legal action. Worth knowing where you stand.
If You're Reading This After a Denial
You're not crazy. You're not exaggerating. And you're not out of options.
You worked for years. You paid your premiums every month. Then you got sick — really sick — and the one thing that was supposed to protect you said no.
"We have determined that you do not meet the definition of total disability under your policy."
If you're anything like most people who get that letter, you're feeling some combination of shock, anger, and — underneath all of it — a quiet voice asking: maybe I'm not really disabled enough.
That voice isn't yours. It's the insurance company's. They put it there — through the denial, through the "insufficient evidence" language, through making you justify your pain to people who've never met you. And it's wrong.
A denial is not a medical opinion. Your doctors know your condition. The insurer doesn't. What the denial letter actually tells you is that saying no was cheaper than saying yes. That's it.
You've been questioning yourself long enough. We believe you. And we can help.
Searching on behalf of someone you love? A lot of calls start that way — a spouse, a parent, a partner who's watching someone struggle and wants to help. You can absolutely call for them. We'll walk you through everything and be ready when they are. (289) 210-9449
The Truth About Denials
It's not about your health. It's about their bottom line.
Insurance companies have entire departments dedicated to finding reasons to say no. Here's what's actually going on behind that denial letter:
Denials are profitable. Every claim they deny stays on their balance sheet. Your suffering is — quite literally — their savings.
They set impossible standards. They demand "objective evidence" for conditions like depression, chronic pain, and fibromyalgia — conditions that are diagnosed clinically, not by a blood test. Then they say you didn't meet the bar they designed for you to fail.
They hire doctors who've never met you. Their "independent" medical examiners are selected and paid by the insurance company. They review your file for 30 minutes and override years of treatment from your own physicians.
They watch you. Private investigators. Social media monitoring. They'll take a photo of you smiling at a family dinner and use it to argue you're not disabled.
They count on you giving up. The process is designed to exhaust you. They know most people are too sick, too tired, and too overwhelmed to fight back. That's the strategy.
That's why you need someone who knows their playbook — and knows how to use it against them.
The Reality of Disability Denials in Ontario
60%+
Of legitimate claims in Ontario are initially denied
24 mo
The policy shift where most benefit terminations happen
$0
What you pay upfront — we only get paid if you win
2 yr
The limitation period to take legal action in Ontario
Sources: Canadian LTD industry data, Ontario insurance claims research.
Denial Reasons We Overturn
Every denial has a reason. Every reason has a weakness.
"Insufficient medical evidence"
This is the most common denial reason — and the most beatable. Insurers set a bar they've designed for you to fail, then tell you that you didn't meet it. We know exactly what evidence they're actually looking for, and how to build a case they can't dismiss.
"Able to work in some capacity"
They hired a vocational expert who says you can do "some job." But "any occupation" doesn't mean any job on earth — it has to realistically match your education, training, and actual medical limitations. Insurers almost always interpret this too broadly.
"Pre-existing condition exclusion"
They're claiming your condition existed before your coverage started — even when your symptoms didn't appear until years later. The timeline matters, the medical evidence matters, and both can be challenged.
"Change of definition at 24 months"
For two years, the question was whether you could do your job. Then at the 24-month mark, they quietly switched it to whether you could do any job — and terminated your benefits. This is where most cutoffs happen. It's also where a lot of these cases are won.
"Mental health limitation"
Many policies cap mental health benefits at 24 months. But if your depression, anxiety, or PTSD causes physical symptoms too — or if the cap was applied incorrectly — there's a real argument for extending benefits beyond that limit.
"Surveillance contradicts your claim"
They filmed you carrying groceries or playing with your kids and say it proves you can work full-time. Picking up your kids from school doesn't prove you can work a full shift. Courts understand that — a thirty-second video of a good moment doesn't tell the full story.
Your Appeal, Step by Step
Here's exactly what happens when you call.
We review everything.
Your denial letter, your policy, your medical records, the insurer's stated reasons. We go through it all to find the weaknesses in their argument — and there are always weaknesses.
We build the evidence they can't dismiss.
We work with your doctors to strengthen your medical evidence — specialist opinions, updated clinical assessments, and when needed, independent medical evaluations chosen by us. Not the insurer's hand-picked doctors.
We build the legal case.
This isn't a polite letter asking them to reconsider. It's a comprehensive legal argument that addresses every reason for denial, backed by evidence the insurer can't wave away.
We fight until the outcome is right.
If negotiation doesn't resolve it, we take your case to the Ontario Superior Court of Justice. Back benefits, ongoing payments, interest, and — where applicable — damages for bad faith. We don't stop until it's right.
Conditions Insurers Love to Deny
Invisible conditions. Visible results.
These are the conditions insurance companies call "subjective," "unverifiable," or "self-reported." We call them what they are — real disabilities that deserve real protection.
Mental Health
Depression doesn't show up on an X-ray. That doesn't make it any less disabling.
- Depression & Treatment-Resistant Depression
- Anxiety Disorders & Panic Disorder
- PTSD & Complex Trauma
- Bipolar Disorder
- Chronic Stress & Burnout
Chronic Pain & Invisible Illness
There's no blood test for fibromyalgia. Insurance companies use that against you.
- Fibromyalgia
- Chronic Fatigue Syndrome (ME/CFS)
- Long COVID
- Migraines & Chronic Headaches
Neurological
Cognitive and neurological conditions are real — even when they're invisible from the outside.
- Multiple Sclerosis (MS)
- Parkinson's Disease
- Post-Concussion Syndrome
- Migraines & Chronic Headaches
- Cognitive Impairment
Autoimmune & Chronic Disease
Your immune system is attacking your body. Your insurance company shouldn't be too.
- Lupus
- Rheumatoid Arthritis
- Crohn's & Ulcerative Colitis
- Lyme Disease
Cancer & Treatment Effects
You should be focused on treatment — not fighting your insurance company.
- Cancer Treatment Side Effects
- Chemotherapy-Related Cognitive Impairment
- Radiation Effects
- Post-Surgical Complications
Back, Spine & Musculoskeletal
Heavily surveilled, frequently dismissed. We know how to challenge the insurer's snapshot evidence.
- Herniated Discs
- Spinal Stenosis
- Degenerative Disc Disease
- Failed Back Surgery Syndrome
- Chronic Back & Neck Pain
Don't see your condition? We handle these diagnoses and more — get in touch.
The Insurers We Take On
Every insurer has a playbook. We've read them all.
Each insurer has different denial tactics, preferred IME doctors, and surveillance strategies. The playbook changes — but the goal is always the same: deny, delay, and hope you go away.
What We Do Differently
Long-term disability is all we do. That matters.
There's a difference between a firm that handles some disability cases and one that focuses on this work exclusively. Here's what that difference looks like when your benefits are on the line.
We Start from Belief.
You've already been questioned, doubted, and disbelieved by your insurance company. We don't do that. We review every page of your medical records — not just the summary your insurer cherry-picked — and we start from a simple position: we take you at your word.
You Talk to Your Lawyer.
When you hire Mirza Law, you work directly with your lawyer — the person who knows your case, your condition, and your name. Not a rotating cast of associates. Not a call centre. The same person, every time.
We Don't Push You to Settle.
Some firms pressure clients to accept the first offer so they can close the file. We don't do that. We'll tell you what we think your case is worth, explain what's on the table, and let you make the decision. If an offer isn't fair, we keep fighting.
Your Questions, Answered
Everything you need to know — in plain language.
Still have questions? That's okay — this is a big decision and we're happy to talk it through. No pressure, no obligation.
(289) 210-9449If any of this sounds familiar, the next step is a conversation.
Free case review. Responsive. No obligation at all.
Responsive