How Long Does It Take to Win a Long Term Disability Claim?

Maybe the most common and urgent question we hear at Grillo Law is: “How long does it take to win a long term disability claim?”

When you are no longer able to work due to a disabling injury or illness, seeking long term disability (LTD) benefits due to a medical condition might feel overwhelming, and even more so when your future finances are on the line.

Unfortunately, there isn’t a blanket answer. The timeline will vary depending on such factors as the elimination period, the caliber of your medical records, how quickly your insurer responds, and whether your claim is approved or denied. That all being said, having some knowledge of the typical LTD claim process and eligibility can create realistic expectations and avoid delays.

The Typical Timeline for an LTD Claim

Here’s a general outline of the steps involved in most long term disability claims in Canada, along with estimated timelines:

Initial Application Process (0–2 months)

• The LTD forms are given by your employer or union.
• You, your doctor, and your employer, occasionally, fill out various sections.
• Your LTD application is received by the insurer.

Tip: Send the application with all the necessary documents in a timely manner to prevent delays.

Elimination Period

Elimination Period (usually 90–180 days)

• Also referred to as the waiting period, this is the time that passes before LTD benefits begin.
• Most but not all policies require you to be disabled during this period.
• Short term disability or sick leave benefits normally fills in the gap.

What It Means and Why It Matters:

The elimination period is the waiting period between when your disability begins and when LTD benefits begin. The duration of this period varies depending on your policy but usually is 90 to 180 days.

Why Elimination Period Matters:

• No LTD benefits are paid during it.
• You will have to prove you are continuously unable to work due to an illness or injury.
• Some employers provide short term disability or EI sickness benefits during this stage.
• Missing deadlines within the elimination period will put your claim in jeopardy.

Provided that your claim is robust and you have submitted everything well ahead of time, you can start receiving LTD benefits soon after the elimination period is over. Delays in paperwork, missing out on medical reports, or disagreements with your insurer can delay the process by a long way.

Insurance Company Claim Review

Insurance Company Claim Review (1–3 months)

Your insurance company examines your physician reports, medical history, and your job duties.

You may need to undergo an independent medical exam or provide extra forms.

Initial Decision

Approval or Denial

• If approved, benefits typically start shortly after the elimination period ends.
• If denied, you will be mailed a written notice with reasons and your appeal right.

Appeals and Litigation

Appeal Process (3–6+ months)

If your LTD claim is denied, you may appeal internally with the insurance company.

You will have to submit additional medical evidence or reports. Some appeals take months and typically lead to additional denial.

Lawsuit or Legal Action (6–24+ months)

The second choice, following failure on appeal, is to bring a lawsuit against the insurer.

This period will depend on court time availability, insurer cooperation, and whether the case is settled early. The majority of LTD cases are resolved through negotiation rather than being tried.

Factors Influencing the Duration of a Claim

If you are unemployed due to an extended illness or accident, long term disability (LTD) benefits are often your bread and butter. But maybe one of the most anxiety-provoking aspects of the ordeal is having no clue when you will actually receive those benefits.

At Grillo Law, we understand how instantaneous this is. Clients commonly ask, “How soon can I get disability benefits?”

The reality is, it depends on a variety of things, from the accuracy of your claim to the workings of the insurance company. What follows explains the most common factors that determine the timeline of a long term disability claim and how to get a smoother, faster process.

Completeness of Application

A properly prepared LTD application can result in weeks or even months of avoided processing time. An imperfect or incoherent application, however, is one of the most common reasons for claims delay or denial.

What makes up a complete application?

• A completely filled-out claimant statement detailing your condition and limitations
• An Attending Physician’s Statement from your doctor which supports your inability to work
• A job description of your physical and mental responsibilities
• Any applicable employment records or sick leave records

Tip: Incomplete forms or lack of signatures usually compels insurers to request more information, prolonging the process.

If your claim already has been delayed or rejected because of paperwork problems, our long term disability lawyer can help you fight back.

Medical Documentation

The quality and quantity of medical records you submit determine in great part how quickly your claim is processed for any income tax implications. Insurers require complete, unbiased records proving that your disability prevents you from performing the job’s fundamental responsibilities.

Good medical documentation consists of:

• Diagnostic examinations (e.g., MRI, CT scan, blood work)
• History of treatment
• Referrals to specialist doctors
• Medical professionals’ prognosis
• Mental health assessments (as required)

Weak or ambiguous documentation typically results in requests for more medical documentation or referrals to independent medical examinations (IMEs), all of which can have a severe impact on your claim.

Insurer’s Procedures

All insurance companies have their own internal processes, review guidelines, and time limits for disability claim processing. They all attempt to respond within 30 to 60 days but too often take much longer.

Common insurer delays are:

• Requesting redundant clarification or documentation
• Waiting for treating physician reports
• Scheduling and analysis of third-party testing
• Case reassigned to other adjusters

These waiting periods can be absolutely infuriating, especially when you’re struggling to make ends meet. That’s why you need to have a legal team that knows how to battle back against insurance company tactics and the complexities of the Canada pension plan to accelerate the process.

Legal Representation

Engaging a lawyer at the start can prevent unnecessary delays, especially if your insurer is uncooperative or your case is complex.

What Grillo Law can do for you:

• Ensure your claim complies with the terms of your policy
• Secure complete medical and vocational evidence
• Take over all communication with the insurer
• Negotiate a fair settlement or litigate if necessary

Most of our clients only visit our law firm after being rejected or postponed, but the sooner we are hired, the better, especially in ensuring you obtain your disability tax credit certificate.

Legal Considerations

Aside from administrative concerns and medical issues, legal considerations might also influence your timeline of claim, particularly in case your claim is denied or case goes to trial.

Limitation Period

In Ontario, you have usually two years from the date that your claim for disability is denied in which to sue. This is called the limitation period.

Why does the Limitation Period matter?

• If you let the deadline expire, you may forfeit your right permanently to pursue a claim
• Certain policies contain shorter contractual limitation periods
• Your insurance company is not necessarily obligated to remind you actively of this deadline
• If your claim was rejected, don’t wait. Call us today for a free consultation to preserve your rights

Policy Terms

Each LTD policy has its own definition and terms that affect how your claim is considered and how long it will last.

Key terms that can affect the timeline:

• Elimination period (usually 90–180 days)
• “Own occupation” vs. “any occupation” disability definitions
• Benefit duration (e.g., 2 years, 5 years, or until age 65)
• Mental health exclusions or limitations
• Pre-existing condition clauses

Your insurance company may also change the definition of disability after a certain period (most often 24 months), resulting in additional reviews and delays. Our lawyers can help you interpret your policy and ensure your claim is being evaluated on an equitable basis.

Tips for a Successful Claim

While some delays are out of your control, others can be avoided with the right strategy. Here are a few ways to keep your LTD claim on track.

Early Preparation

Start preparing your claim as soon as your disability affects your ability to work, even if you’re still receiving sick leave, short term disability, or Employment Insurance (EI) benefits.

What to do early:

• Keep a medical journal tracking symptoms, appointments, and treatments
• Request copies of all test results and specialist reports
• Have open discussions with your physician about your functional limitations
• Get a copy of your group insurance policy from your workplace
• Professional advice

It’s difficult to make a long term disability claim. You’re dealing with tight deadlines, exact forms, and typically an adversarial insurer. It makes such a difference to have a team of lawyers to stand behind you.

With Grillo Law, you get:

• Over 40 years of experience in personal injury and disability law
• Access to trusted medical and vocational experts
• Zero upfront legal fees, we only get paid if you win
• Personalized support and regular updates on your claim status

We’ve successfully represented thousands of clients and helped them recover millions in compensation. If your LTD claim has been denied or unreasonably delayed, our legal team can help.

Professional Guidance

Your financial security shouldn’t be at the mercy of an insurance company. If you want to know how long it will take to receive disability benefits, or if you’re experiencing delays, denials, or obscure insurer requests, contact Grillo Law today.

We will review your case, define your options, and guide you in making a decision. You are owed clarity, protection, and justice, and we will fight for it.