Invisible Illness, Real Disability: Documenting Anxiety & Depression for LTD Claims (Ontario)

In addition to (or perhaps as a result of) your physical health challenges, your mental health has taken a strong turn for the worse, you realize.

Your doctors and mental health professionals are just now beginning to see the extent to which those all-too-frequent bouts of anxiety and depression are hindering your physical healing process.

Outwardly, you’re looking better, your neighbors and one or two of  your remaining friends tell you, but you realize that getting “better” is not really happening  for you. Yes, you’re making a sincere effort, each and every day, to regain the physical strength you were once so proud of.

However, perhaps because it’s become more and more difficult for you to fall –or stay–asleep at night, during the day, you’re finding it nearly impossible to focus on even the smallest of decisions.  

 Related to the 24-month termination of benefits notice you received from your Ontario long term disability insurance company, you’re scheduled for some Independent Medical Examinations, ostensibly designed to evaluate the treatments recommended by your own doctors and therapists. Even thinking about those evaluations causes you fear and anxiety.

Invisible from the outside, your symptoms  are very real to you. If only you could make them understand how frightening everything now seems – you’d give anything to have your old, active life back the way it used to be…

Quick answer:
Anxiety and depression can qualify for LTD in Ontario, but approvals usually depend on functional limits, not labels. The strongest claims show consistent medical treatment, clear work restrictions (reliability, focus, pace, attendance, stress tolerance), and documentation that matches over time—doctor notes, therapy records, symptom logs, and employer evidence.

What are “Invisible” Disabilities?

The term non-visible disability, VHA Home HealthCare explains, covers a wide spectrum of conditions or illnesses including:

• chronic pain
• gastrointestinal disorders
• sleep disorders
• severe allergies
• PTSD
• anxiety.

 Mental health disability benefits in Ontario, Canada

In evaluating any claim for medical benefits, your Toronto, Ontario LTD insurance company has been, and will continue to be, scrutinizing your medical records, looking for several things:

• any pre-existing conditions (that were present prior to your claim)
• the kinds of treatment you’ve needed
• evidence of pain and suffering
• wages you’ve lost that are related to your disability

While the insurer realizes you may in fact be suffering from “invisible injuries” , including  psychological trauma, sleeplessness, social anxiety,  and PTSD, these injuries are especially difficult to prove and are often questioned by insurers.

Not only will the insurance company require formal diagnoses, proof must be established that those “invisible” disabilities are preventing you from doing substantial work going forward.

How does the 24-month change of definition relate to “invisible” disability conditions?

Every LTD policy contains a definition of disability, defining what conditions must exist for the insured to collect benefits. In most Canadian LTD policies, for the first 24 months of coverage, there is an “own occupation” definition of disability, meaning that the insured has been unable to perform the duties of his or her own occupation.

After 24 months, the definition changes to “any occupation”. The insured is eligible to collect benefits only if it is proven that he or she is unable to work at any occupation for which he or she qualifies based on education, training, and work experience.

In fact, your LTD insurance company’s aim in requiring you to undergo Independent Medical Examinations is to demonstrate that you are, in fact, despite your “invisible” disability conditions, capable of working (based on the “any occupation” definition) and therefore do not “deserve” to continue collecting disability benefits.

In addition to the IME that’s been scheduled, it’s possible that your Ontario LTD insurance company might require other assessments, including:

• a Functional Capacity Limitation Impact study
• a Functional Capacity Evaluation
• a Transferable Skills Analysis
• a Competitive Employability Study

(It’s important to realize that the insurer might well require that you cover part or all of the cost for any or all of these evaluations.)

Read more about Own Occupation vs. Any Occupation: What Happens at 24 Months and How to Prepare

In Canada, aren’t anxiety and depression considered to be disabilities?

 Yes, but….

According to First Session, the Canada Health Act requires provinces and territories to cover medically required services.  Even so, they point out, mental health and counseling services are often limited or under-serviced across Canada.”

An unpleasant truth: Whereas IME and other assessment results can be used to provide a neutral, unbiased assessment of your condition and of the treatments you’ve received, it is not in the best interest of any insurance company to continue to pay you benefits.  On the contrary, it is often the case that, in looking to deny or terminate your LTD benefit payments, an insurer is seeking a medical justification for denying or reducing payments to you.

When a long-term disability claim for an “invisible” condition is denied, how can an experienced Ontario LTD lawyer help?

Long Term Disability insurance is supposed to cover “invisible” disability claims.  Sadly, people with invisible conditions are often denied the benefits they deserve.

An experienced Ontario, Canada LTD lawyer can help avoid denials or appeal claims that have been rejected, navigating the legal process to secure payment of deserved benefits.

But how?

• by gathering strong medical evidence
• by filing an appeal
• by knowing how to counter denial reasons
• by negotiating settlements
• by understanding complex policy clauses
• by holding the LTD insurance company accountable

Remember:  Insurers, including companies such as Manulife, Sun Life, Canada Life, often try to minimize payouts. It is the goal of a Canada LTD lawyer to understand the law and to make sure your rights as a claimant are properly respected.