Overview
Has Your Insurer Denied Your Depression or Anxiety Claim?
A denial can feel discouraging, especially when you’re already trying to manage symptoms, treatment, and day-to-day responsibilities. Insurers may deny a claim at the start or terminate benefits after initially approving them. In many cases, the denial is not the final word. It often reflects the insurer’s position on the documentation, the treatment history, or how they interpret your ability to work. If you have received a denial letter, it is important to take it seriously and act quickly. Deadlines may apply, and the steps you take next can affect your ability to appeal or pursue benefits.
Common Reasons Insurers Deny Depression and Anxiety Claims
Limited clinical notes or incomplete medical records
Gaps in treatment or missed follow-ups
Lack of specialist involvement when a referral is expected
Inconsistent reporting of symptoms and limitations
Records that do not clearly connect symptoms to work restrictions
The insurer claims that you are able to work with accommodations
Surveillance or social media evidence used out of context
A return-to-work attempt that the insurer treats as proof of capacity
The Aaron Waxman Difference
How Can Aaron Waxman and Associates, P.C. Help?
If your insurer denied your STD or LTD claim for depression and/or anxiety, Aaron Waxman and Associates, P.C. can help you understand your options and build a clearer, better-supported case. This may include reviewing denial letters, identifying evidence gaps, organizing a treatment timeline, and helping you present the functional impact of your condition in a way that matches what insurers typically look for.
If you’re looking for an Ontario disability lawyer to review a denied disability claim, our team can speak with you and explain potential next steps.
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We take the time to understand what you are facing, then build a plan that protects your rights and supports your next steps.
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We take on insurer and employer pushback, manage deadlines, and keep your claim moving so you can focus on recovery and stability.
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Frequently Asked Questions
Depression is a mood disorder that can affect how you feel, think, and function. It can impact energy, motivation, sleep, appetite, and concentration. Depression can develop gradually or follow major stressors such as illness, loss, trauma, or workplace conflict. The Centre for Addiction and Mental Health (CAMH) describes depression as complex and influenced by multiple factors.
Depression is diagnosed by a qualified healthcare professional through clinical assessment. This often includes questions about mood, thoughts, behaviours, daily functioning, symptom duration, and severity. Your provider may also review medical history and rule out other causes. Treatment can include therapy, medication, lifestyle supports, and follow-up care. For disability claims, documentation often focuses on symptoms, treatment plans, and functional restrictions.
Anxiety disorders involve persistent fear or worry that becomes difficult to control and may interfere with daily activities. Anxiety can present as constant worry, panic attacks, or avoidance behaviours that limit your ability to function at work or in public settings. CAMH notes that anxiety can be so intense it can be immobilizing.
Diagnosis is typically based on clinical assessment by a healthcare professional. They may evaluate symptom intensity, frequency, triggers, physical symptoms, impact on daily functioning, and how anxiety affects work and relationships. Documentation often includes treatment history and work-related limitations.
They can be. Depression and anxiety are widely recognized as disabilities when they significantly limit a person’s ability to function, including the ability to work. Most STD and LTD policies focus less on the label and more on whether your symptoms and limitations prevent you from doing the essential duties of your job.
Depression and anxiety can affect reliability and performance in ways that make continued work unrealistic or unsafe. Common work impacts include:
- Reduced concentration and slowed thinking
- Fatigue, disrupted sleep, and low stamina
- Difficulty regulating emotions and stress
- Panic symptoms and avoidance behaviours
- Memory problems and impaired decision-making
- Difficulty interacting with coworkers, clients, or the public
- Unpredictable symptoms that affect attendance and consistency
These limitations often matter more than the diagnosis alone because disability policies usually focus on whether you can perform the essential duties of your occupation.
If you’re wondering how to go on disability, the process usually starts with medical support and paperwork that explains (1) your diagnosis and treatment plan and (2) your functional restrictions at work. If you’re applying for disability in Ontario, Canada through an insurer, the application package often includes:
- Employer Statement (Plan Sponsor Statement)
- Employee Statement (Plan Member Statement)
- Attending Physician’s Statement
Keep copies of what you submit, follow your treatment plan, and make sure your restrictions are clearly tied to your job duties.
Depending on your circumstances, you may have access to:
- Employment Insurance (EI) sickness benefits
- Workplace safety or workers’ compensation benefits in some work-related cases
- Short-term disability (STD) benefits
- Long-term disability (LTD) benefits
Eligibility depends on the benefit program, your policy wording, medical evidence, and how your symptoms affect your ability to work.
These claims can be more challenging because:
- Symptoms may fluctuate and be harder to measure
- Insurers often request extensive documentation
- There may be fewer objective tests compared to physical injuries
- Functional impact can be misunderstood or minimized
- Insurers may focus on perceived inconsistencies or daily activities
A clear record of treatment and consistent documentation of functional limitations is often essential.
Yes. If your STD or LTD claim has been denied or your benefits were cut off, you may be able to challenge the decision. The right path depends on your policy, the denial reason, and the timeline. Many people are denied because the insurer argues the evidence is not strong enough, not because the condition is not real. Challenging a denial often involves strengthening the medical and functional evidence and responding directly to the insurer’s stated reasons.
If you are facing a denial, getting advice early can help protect your options and avoid missed deadlines.