Disability

Disability Insurance Lawyers Serving Ontario

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Why Choose Aaron Waxman and Associates for Your Disability Case?

If your disability claim has been denied for any reason, do not hesitate to contact our legal team for a free no obligation consultation.

We help with the following Disability claims

Who can we help?

Our lawyers help clients whose short-term and long-term disability benefits claims have been denied. You may be off work due to physical injury or illness such as diabetes or fibromyalgia, or a psychological illness like depression or anxiety. We understand this is a difficult time for you as receiving a denial letter is stressful at a time when you are in need of an income.

We're dedicated to our clients

Our lawyers do not do any work for insurance companies and have your best interests in mind. Our lawyers will help you to achieve the settlement you deserve and to resolve your disability claim. We do not get paid until your case settles and do not charge you any upfront or ongoing legal fees.

Answers to commonly asked questions

  • What is a disability?

    In disability claims, the term “disability” refers to your ability to perform the duties of your job (occupation). In order to qualify for benefits, you must meet your policy’s definition of what is referred to as “total disability”. In general terms, “totally disabled” means that you are reasonably unable to work.


    During the “own occupation” period of your long-term disability claim, “totally disabled” means, that as a result of injury or illness (physical or psychological), you are unable to perform the regular duties of your occupation. During the “any occupation” period of your claim, it means that as a result of injury or illness (physical or psychological), you are unable to perform the regular duties of any occupation for which you are suited for by education, training or experience.


    According to the Supreme Court of Canada (Paul Revere Life Insurance Co. v. Sucharov [1983] 2 SCR 541 1983 CanLII 168 (SCC) ):


    The test of total disability is satisfied when a reasonable person would recognize that he/she should not engage in certain activity, even though he/she literally is not physically unable to do so. In other words, total disability does not mean absolute physical inability to do any kind of business in one’s occupation, but rather that the insured’s injuries are substantial enough that he/she is required to to stop performing his/her business or occupation in order to properly heal. In other words, if the condition of the insured is substantial enough that to properly cure or prolong life he/she must cease all work, the insured is totally disabled within the meaning of health or accident insurance policies.

  • What types of disability claims can you sue for?

    We can help you if your claim for short-term/long-term disability benefits or critical illness insurance benefits have been denied. We also handle claims for life insurance denials. If your disability claim has been denied or if you have questions about a letter you received from your insurance company, you can call our firm for a free initial consultation.

  • Why was your disability claim denied?

    Your insurance company may deny your claim for a variety of reasons. Perhaps your insurer feels you did not complete the qualifying period (waiting period), where you were continuously disabled for a set amount of time. Therefore they deny you entitlement to long-term disability benefits.


    Your insurance company may tell you that there is a “lack of objective medical evidence” and that your disability is not medically supported.


    Another reason for a denial is that you do not have a diagnosis for your condition, so the insurance company cannot determine your restrictions and limitations.


    A denial can occur at the outset of a claim, where you are denied entitlement to benefits. It can occur during the own occupation period, at the change of definition period and during the any occupation period.

  • Can you dispute your denied disability claim?

    Yes, you can dispute an insurer’s decision to deny your claim (for short-term disability benefits, long-term disability benefits, critical illness insurance & life insurance). Don’t be discouraged. You can dispute the denial by appealing the insurance company’s decision. You also have the option of commencing a lawsuit against the insurance company. It is important to consult a lawyer as soon as you receive a denial letter from your disability insurer, as there are limitation periods to fight this. You do not want to run out of time to sue your insurer. If you start a court action against your insurer as soon as possible, your case is in the court system faster and this will help to expedite matters.

  • Has your insurer denied your disability claim?

    If your disability insurer has denied your claim, you should consider consulting a lawyer. Insurance policies are complex and contain many clauses that may be hard to understand or are unclear. You may have applied for short-term or long-term disability benefits through your employer, or you may have purchased an individual policy and been denied a claim under the policy. There could be a number of reasons as to why your insurance claim is denied. It could be anything from an incomplete application to “lack of medical evidence”, or even failing to be under the regular care of an appropriate physician.

  • What am I suing for if I start a lawsuit against my disability insurer?

    If your claim for short-term or long-term disability benefits has been denied, by hiring a disability lawyer, you can start a court action against your insurance company. 


    What you are suing for is a declaration of coverage (that you are entitled to benefits) and a reinstatement of benefits (also referred to as getting back on claim). 


    When settlement of your case occurs, you have the option of receiving a lump-sum settlement or reinstatement of benefits. It is often the case that a lump-sum settlement occurs. If you have questions about the legal process or how a lawsuit works, contact a disability lawyer today.

  • Has an illness left you unable to work? What should you do?

    If you have an illness that leaves you unable to work for a prolonged period of time, and you have access to short-term or long-term disability benefits under a group benefits policy, you should consider making an application. Disability benefits are meant to provide income replacement if an employee is unable to work due to injury or illness. Illnesses can include both mental and physical illnesses such as depressive disorders, mood disorders, cancer or neurological conditions that would affect a person’s ability to perform his or her job. If you are making a claim for disability benefits as a result of an illness, be sure to include as much medical information as possible with your application, including specialist reports, consultation notes, blood work, surgical reports and any documentation that shows how your illness affects your ability to work. It’s also a good idea to explain what your restrictions are. Insurance companies want evidence that you are receiving proper treatment, complying with treatment and attending appropriate physicians.

  • How does the insurance company assess your claim?

    Your insurance company reviews your application, the doctor’s statement (Attending Physician’s Statement) and any medical documents submitted. They will also conduct a telephone interview with you. For this reason, it is important to submit a completed application.

  • Why didn't you qualify for disability benefits?

    Insurance companies deny benefits for various reasons. Some reasons could include:

    • Incomplete application (i.e. missing Plan Sponsor Statement or Attending Physician’s Statement)
    • Forms not filled out properly/sections missing
    • Not enough “supportive medical evidence” (i.e. x-rays, diagnostic injuries, specialist reports or medical documents that support your restrictions and limitations)
    • The insurer does not feel they have enough medical evidence and have requested further documentation
    • The insurer does not feel there is evidence of appropriate medical treatment/rehabilitation
    • The insurance company was unable to obtain documents or additional information from your doctors/specialists
  • Do you need to apply for CPP Disability Benefits?

    If you have a disability that prevents you from working on a long-term basis, you should apply for Canada Pension Plan Disability Benefits. If you are or have made a claim for long-term disability benefits with your insurance company, it is still a good idea to apply for CPP Disability Benefits. You can find the application on the Service Canada website. You will have to have your doctor complete a Medical Report as part of the application. It is important to keep your lawyer informed of any decisions made by Service Canada with respect to CPP Disability Benefits.

  • Can we help if you have a union?

    Yes. If you are a member of a union you are able to hire a lawyer to represent you for a disability claim denial instead of pursuing a grievance through a union representative. Contact our law firm for more information.

  • Do I still need to attend treatment and medical appointments if my claim has been denied?

    Yes. It is important that you are actively under the care of a physician appropriate for your type of disability and that you are getting appropriate treatment. If you are able to afford treatment, it is recommended you continue to do so to show that you are actively participating in your recovery.

  • What is a Functional Telephone Interview

    As part of the application process for STD or LTD benefits, the case manager assigned to your claim will contact you for an interview. This is usually referred to as a "functional telephone interview”, as your insurance company is looking to gather information about your functional abilities and how your disability affects your overall daily functioning. 


    This type of information is required, as your case manager is looking to see if the medical information matches your description of symptoms, restrictions/limitations and perceived barriers to returning to work.

  • What is an Employer Statement in a Disability Application?

    When you apply for STD or LTD benefits, part of the package includes an Employer Statement (aka Plan Sponsor Statement). This form is required, as it provides information such as your job title, duties, hire date, salary, regular hours and last day worked. This information is needed in order to determine the date your disability started and benefit amount.

  • What is an Employee Statement in a Disability Application?

    Part of the STD/LTD Application includes an Employee Statement (also called a Plan Member Statement). On this statement you are asked to provide information about your condition, symptoms, treatment, doctors, work experience and education. This is your opportunity to explain why/how your condition prevents you from returning to work, and how it impacts your daily functioning.

  • What is an Attending Physician Statement in a Disability Application?

    The Attending Physician's Statement is an important component of your application. This is where your doctor lists your diagnosis, symptoms, treatment, restrictions and limitations. Your doctor will also indicate your prognosis for returning to work. It is important to have the doctor who is most familiar with your condition complete this form.

  • Why should I sue my insurance company instead of appealing their decision?

    Your insurance company will give you with the option to appeal their decision up to three times.


    Every time you advise your insurance company that you intend to appeal their decision, you are required to submit new medical information. The Appeals Board reviews the information, and may or may not send it to a medical consultation to review. They may also request further information. This can be a lengthy process.


    When you hire a lawyer to start a lawsuit against your insurance company, you do not have to wait to exhaust all appeals levels to find out your claim is still denied. Your lawyer can simply start the lawsuit and get your case into the court system as soon as possible. This also means that you will have immediate representation.

  • How do I know if my treatment is reasonable and appropriate for my condition?

    As part of your disability claim, you must be under the care of a physician and receiving treatment. The treatment you receive must be appropriate for your condition. For example, if you have made a claim for disability benefits for a psychological illness, the insurance company will want to see that you are under the care of a psychiatrist or psychologist. Your physician must be a legally licensed doctor of medicine. Your insurer wants to see that your physician is a specialist for the condition you are claiming a disability for.


    If your disability is related to a substance abuse disorder, your treatment program must include participation in a recognized substance withdrawal program.

  • What do the terms limitations and restrictions mean and how do you prove what they are?

    • A restriction refers to an activity that your doctor has advised you against performing because of the risk of it aggravating your symptoms.
    • A limitation refers to an activity that you cannot perform due to a physical or psychological burden.
    • A restriction or limitation can be temporary or permanent.

    Your treating physician(s) will be asked by your insurance company to complete forms that describe your restrictions and limitations. It is important that they provide complete information and, if applicable, supporting documentation. This will help the insurer to understand the nature of the restrictions and limitations.

  • What is "Appropriate Treatment?"

    Any treatment that is performed and prescribed by a doctor, or when the insurer believes necessary, by a medical specialist, must be usual and reasonable treatment for the condition. It must be provided as frequently as it is usually required for your condition. This should not be limited solely to examinations or testing. Failure to attend appropriate treatment is a common reason for denial in disability claims.

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