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Denied LTD in BC? Here’s What Happens Next

Denied LTD in BC? Here’s What Happens Next

By Long-Term Disability Lawyer Tim Louis


Being denied long-term disability can feel like losing your footing twice: once to illness, and again to disbelief. In British Columbia, you still have rights, and you still have time to act.

When an insurer tells you no, it rarely means the end of the road. Most denials are not final decisions; they’re the company’s interpretation of paperwork, timing, or medical language that can be challenged. Still, the moment you read that letter, fear sets in — How will I pay my bills? Who will believe me? What now?

Take a breath. You do not need to fight this alone. At Tim Louis & Company, we’ve helped British Columbians reclaim denied benefits for over forty years — people with chronic pain, depression, cancer, autoimmune disease, and other conditions that don’t always show on a scan. We know how insurers think, and we know how to make them listen.

If your LTD claim was denied or cut off, this guide will walk you through what that decision really means, what steps to take next, and how to protect your health and income while we challenge the denial together.

Need help now?
Call Tim Louis & Company for a free consultation.

📞 (604) 732-7678 📧 timlouis@timlouislaw.com 🌐 https://timlouislaw.com/contact-us/
English y español disponibles.

What an LTD Denial Really Means in BC

A denial does not mean you are not disabled. It means the insurer says it does not yet have what it needs. The letter is often a template with phrases like “insufficient medical evidence,” “not totally disabled under the policy,” or “pre-existing condition.” That language protects the company, not your health.

Most LTD denials in British Columbia are not final. You usually have a right to an internal appeal, and you can start a legal claim if benefits remain refused. You do not have to finish the insurer’s appeal process before filing a claim. Waiting too long can risk the two-year limitation period.

Internal appeal vs legal claim

  • Internal appeal: The insurer looks at the file again. Timelines are short, often 30 to 90 days. New medical reports can help, but the same people may be reviewing your case.
  • Legal claim: A court action under BC law. This preserves your rights and stops the clock on limitation issues.

Common reasons for denial

  • Records do not show enough “objective” proof.
  • Missing forms, signatures, or late doctor notes.
  • A paper review doctor disagrees with your treating physician.
  • The insurer says the condition is pre-existing.
  • The policy switched from “own occupation” to “any occupation” at 24 months and the insurer says you can work elsewhere.

Each of these can be challenged with the right evidence and timing. At Tim Louis & Company, we translate insurer language into plain terms, collect focused medical and vocational proof, and hold insurers to the policy and the law.

If you received a denial, keep treatment consistent, save every letter and email, and contact us early. A short call can clarify next steps and protect deadlines.

What to Do and Not Do in the First 72 Hours After Denial

Take a breath. You have options, and you have time to use them wisely.

What to do

1) Read the denial letter carefully.
Note the date, the stated reasons, and any deadlines for appeal. Keep the envelope and all pages.

2) Ask for your claim file in writing.
Request the full file from the insurer, including adjuster notes, paper review reports, IME reports, surveillance, and internal emails. Keep a copy of your request.

3) Book medical follow-ups.
See your family doctor and any specialists. Bring the denial letter so they can address the insurer’s concerns directly. Update referrals, diagnostic tests, and treatment plans.

4) Start a simple symptoms and function diary.
Write one page per day. Record pain levels, fatigue, sleep, medication effects, and what you could and could not do. Consistent notes help your case.

5) Organise your records.
Create a folder for medical reports, test results, employer letters, job description, benefits booklet, and all insurer correspondence. Save emails as PDFs.

6) Protect your income.
If you are eligible, apply for EI sickness benefits or CPP-D. These can run alongside an LTD dispute. Note interaction rules so you are not penalised.

7) Call a lawyer early.
An early review helps you avoid missed deadlines and unhelpful appeals. We can map the best path and preserve your limitation period.

What not to do

1) Do not argue by phone only.
If you speak with the insurer, follow up with an email that confirms what was said.

2) Do not stop treatment.
Gaps in care can harm your health and your case.

3) Do not rely on internal appeals alone.
You are not required to finish them, and they do not stop the two-year limitation period.

4) Do not post about your claim online.
Insurers often review social media. Context is easy to lose in a photo or short post.

5) Do not send long, emotional letters.
Keep communication factual and brief until you have advice.

Need help now?
We will review your denial letter and explain your options in plain language.
Tim Louis & Company • (604) 732-7678 • timlouis@timlouislaw.com • https://timlouislaw.com/contact-us/

Denied LTD in BC

Medical Evidence That Moves Claims

When an insurer says there is not enough proof, it can feel personal. Your pain is real, and so is your fatigue. The job here is to help the record reflect your day-to-day reality in a way decision makers understand. We will walk with you through that process.

Start with function.
Describe what life looks like. How long you can sit, stand, or focus. How far you can walk. How often symptoms flare. Note what tasks you need help with and what happens after activity. A short daily diary is more powerful than you think.

Objective tests and clinical notes.
Tests like MRIs, EMGs, sleep studies, or lab work can help. So can regular clinic notes that show patterns over time. A normal test does not cancel real limits. Ask your providers to connect the dots from findings to function. Plain language helps everyone.

Work capacity forms.
Residual Functional Capacity forms turn symptoms into clear restrictions. Safe lifting, posture limits, expected absences, and the need for breaks. Invite your doctor to be specific. Instead of words like moderate, ask for numbers, times, and examples.

Keep stories aligned.
Insurers compare your diary, doctor notes, pharmacy refills, therapy charts, and imaging. Small differences are normal. Large gaps create doubt. Bring the denial letter to appointments so your providers can respond to the concerns that were raised.

Mental health matters.
Depression, anxiety, PTSD, and cognitive issues are real and disabling. Useful records include counselling notes, psychiatric opinions, scales that track symptoms, and neuropsychological testing when appropriate. Describe concentration, memory, decision making, and how stress shows up in your body. Safety plans belong in the file if needed.

Medication side effects and combined impact.
Fatigue, brain fog, dizziness, nausea. These can limit safe and reliable work. Write down what you experience and how often it happens. The combined effect of conditions and treatment often explains why steady work is not possible.

Your job, on paper.
Ask for your job description and any notes on duties or attendance. A brief employer letter that confirms essential tasks and productivity expectations can be very helpful.

CPP Disability and LTD.
A CPP D approval can support your LTD claim because both focus on capacity for work. A CPP D denial does not end your case. Share any CPP decisions so we can keep your record consistent.

You are not alone in this. We can help you gather what is needed, speak with your care team, and present your story with dignity and clarity.

 

Insurer Tactics We See and How We Counter

Insurers use patterns. Knowing them helps you stay steady and lets us respond with the right evidence.

Paper reviews.
An insurer doctor may review your file without meeting you and say you can work. We counter with detailed treating physician opinions, work capacity forms, and, when useful, independent specialists who examine you.

Surveillance.
Short clips on a good day can be used to suggest you are fine. We place the footage in context with your diary, medical notes, and the reality of fluctuating conditions. A few minutes of activity does not equal full-time, reliable work.

Independent Medical Examinations (IMEs).
These are arranged by the insurer. We prepare you, clarify the scope in writing, and request the examiner’s notes and test data. If the report is incomplete or unfair, we rebut it with focused medical evidence.

The “any occupation” switch at 24 months.
After two years many policies tighten the test for disability. We gather vocational assessments, job market data, and medical opinions that address stamina, reliability, and cognitive limits, not just job titles.

Pre-existing condition clauses.
Insurers may say your condition existed before coverage. We examine the lookback dates, policy wording, and medical records to show onset, flare, or aggravation within the insured period.

Failure to accommodate.
If your employer could not or would not accommodate safe duties, we collect the emails, schedules, and doctor notes that prove attempts were made. This supports both LTD and, when appropriate, human rights or employment claims.

You do not have to engage in a tug-of-war alone. Our job is to turn scattered records into a clear, credible story that the insurer must answer.

Free Download — Denied LTD in BC: 7 Documents Your Lawyer Needs Today

Before you appeal or respond to your insurer, make sure you’ve gathered the documents that can protect your claim.
Download our free checklist to get started.

Download the PDF

Timelines and Limitation Periods in BC

Deadlines matter. Insurers run internal appeal clocks, often 30 to 90 days from the denial letter. Courts apply limitation periods, most often up to two years for a civil claim in British Columbia. These are separate tracks. Finishing the insurer’s appeal process does not extend a court deadline.

Why this matters: some people use all the internal appeals, then learn they are out of time to sue. Others keep negotiating by phone while the limitation period quietly runs down. Both are avoidable.

What to do:

  • Save the denial letter and note every date in it.
  • Ask the insurer, in writing, for the appeal deadline and for a full copy of your claim file.
  • Speak with a lawyer early about the court limitation period that applies to your policy and denial.
  • If negotiation makes sense, we can keep talking with the insurer while we preserve your rights by filing a claim before any deadline.
  • In some cases, we may secure a tolling or standstill agreement so talks can continue without risk.

You do not need to choose between being reasonable and being protected. We can do both at the same time, in writing, and on your timeline.

 

If You Were Terminated While on LTD

Losing your job while you are ill can feel like the floor giving way. In BC, employers have a duty to accommodate medical limitations up to undue hardship. Ending employment while you are on long-term disability may raise human rights issues as well as employment and insurance claims.

Here is how we look at it:

  • Accommodation record. Emails, schedules, and doctor notes that show modified duties were requested or could have been tried.
  • Benefits and coverage. Whether LTD, life insurance, and health benefits were continued or cut off, and on what date.
  • Severance and notice. Termination without cause while sick can still require fair notice or pay in lieu, including the value of lost benefits.
  • Coordinated strategy. LTD, wrongful dismissal, and human rights claims often overlap. We align the facts, medical evidence, and timelines so your story is consistent and strong.

If you were let go while on LTD or medical leave, keep every document and see your doctor. Then call us. We will explain your options in plain language and build a coordinated plan that protects your income, your health, and your dignity.

 

Real BC Outcomes — LTD Case Snapshot (2019–2025)

Every long-term disability case is different. The court looks at evidence, credibility, and how the insurer handled the claim. The following BC decisions show the range of outcomes over the past few years. They are shared to inform, not to promise any result. Context always matters.

These public cases are drawn directly from CanLII, the Canadian Legal Information Institute, which hosts official court decisions.

Case

Year

Issue

Outcome

Lesson

Okano v. Cathay Pacific Airways Ltd., 2022 BCSC 881

2022

Termination of long-service employee with disability history

24 months’ notice adjusted for mitigation

Courts reaffirm the 24-month ceiling but adjust for efforts to find work.

McKnight v. Sun Life Assurance Co. of Canada, 2023 BCSC 1861

2023

Denial of LTD for chronic fatigue and fibromyalgia

Benefits reinstated; insurer ordered to pay costs

Courts recognise chronic pain and fatigue syndromes when well-documented.

Chand v. Zurich Life Insurance Company Ltd., 2021 BCSC 1428

2021

Denial based on surveillance and “any occupation” change

Plaintiff successful; full benefits and legal costs awarded

Short video clips did not outweigh consistent medical evidence.

Schaefer v. Mutual Life Assurance Co. of Canada, 2020 BCSC 1049

2020

Psychiatric condition; insurer alleged exaggeration

Benefits reinstated

The court stressed compassion and careful consideration for mental-health claims.

Wang v. Industrial Alliance Insurance, 2019 BCSC 1213

2019

Denial for lack of “objective” proof

Insurer ordered to pay arrears

Courts continue to reject the myth that only objective findings count.

How to read this table:
Each decision turns on the facts. The judge looks at how the insurer handled the file, whether medical records were consistent, and whether the claimant was credible and compliant with treatment. Similar facts can lead to different outcomes depending on documentation and timing.

If your LTD claim was denied or cut off, we can explain how your situation fits within this legal landscape and what steps can move your case toward resolution.

FAQ

Many denials are based on missing paperwork, limited medical detail, or an insurer’s “paper review” that downplays symptoms. It often comes down to wording, not truth. Most claims can be challenged with fuller medical and functional evidence.

No. You can start a legal claim without completing the insurer’s internal appeal process. Internal appeals do not pause the two-year limitation period to sue. Speaking with a lawyer early ensures you do not lose that window.

Detailed medical notes that explain how symptoms affect work capacity. Functional forms, daily diaries, and employer letters that describe actual job demands all help. Consistency across records matters more than a single test.

Yes, in some cases. Policies vary, but limited or therapeutic work often supports your case when done under medical advice. Keep a record of hours, symptoms, and your doctor’s guidance.

Most BC LTD claims must be filed in court within two years of the insurer’s final denial letter. This timeline can differ by policy. Always note the date on the letter and get legal advice right away.

Further Reading & Community Support

BC Human Rights Tribunal (BCHRT)
Info on discrimination, the duty to accommodate, how to file a complaint, and timelines.
https://www.bchrt.bc.ca/

CPP Disability (Government of Canada)
Who qualifies, how to apply, required medical reports, and appeal routes for Canada Pension Plan Disability.
https://www.canada.ca/en/services/benefits/publicpensions/cpp/cpp-disability-benefit.html

WorkBC
Job-search tools, training programs, wage subsidies, and career services that can support return-to-work plans.
https://www.workbc.ca/

Employment Standards Branch — Termination & Benefits (BC Government)
Minimum standards for termination pay, benefits continuation, and related employment protections.
https://www2.gov.bc.ca/gov/content/employment-business/employment-standards-advice/employment-standards/termination-pay

Tim Louis & Company — Long-Term Disability Hub
Plain-language guides on LTD denials, evidence, timelines, and how we challenge insurers.
https://timlouislaw.com/long-term-disability-lawyer-vancouver-bc/

Tim Louis & Company — Blog
Recent BC cases, practical checklists, and step-by-step advice for LTD and employment issues.
https://timlouislaw.com/blog/

Closing Reflection

An LTD denial can make you feel unseen. Your symptoms are real, yet a letter suggests otherwise. Take heart. The law in British Columbia gives you a path forward, and your story can be told in a way that decision makers understand. With clear evidence, steady treatment, and the right guidance, many denials are reversed. You do not have to carry this alone. We are here to listen, to explain the steps in plain language, and to protect your health and income while we challenge the decision together.

Talk to Tim

Tim Louis & Company
2526 West 5th Ave, Vancouver, BC V6K 1T1
📞 (604) 732-7678
📧 timlouis@timlouislaw.com
🌐 https://timlouislaw.com/contact-us/

Free consultation: Email or call with your denial letter and we will review it. Clear, compassionate advice. No pressure.
English y español disponibles.

You can also download our free checklist, “Denied LTD in BC — 7 Documents Your Lawyer Needs Today,” to help you organize your information before we talk.
Having these documents ready can make your free consultation faster and more effective.

Download the PDF

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About the Author – Tim Louis, LLB

Tim Louis is a Vancouver-based lawyer with over 40 years of experience in personal injury, long-term disability, employment law, wills and estate planning, probate, and estate litigation. A graduate of the University of British Columbia’s Faculty of Law, Tim is known for his client-first approach, honest communication, and record of success in helping British Columbians navigate complex legal issues.

Location: Vancouver, BC

Education: LLB, University of British Columbia

Phone: (604) 732-7678

Email: timlouis@timlouislaw.com

Website: www.timlouislaw.com

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