6 Steps to Get Help with Denied Disability Benefits in Ontario
Being denied disability benefits in Ontario can be devastating. Whether you're applying through a private insurance plan, the Canada Pension Plan Disability (CPP-D) program or the Ontario Disability Support Program (ODSP), a denial often leaves people feeling confused, angry and unsure of their next move. This article will explore the specific steps you can take if you have been denied disability benefits in Ontario.
1. Understand the Reason for the Denial
Before doing anything else, carefully review the letter you received from the insurance company or government agency. The denial letter should outline why your claim was rejected. Common reasons include:
- Insufficient medical documentation.
- Lack of evidence that your condition prevents you from working.
- Missed deadlines or incomplete forms.
Identifying the reason for the denial is critical because it determines how you should proceed with your appeal. Keep a copy of all documents, including medical reports and correspondence, as they will be essential during the appeals process.
2. Gather Additional Evidence
Once you know why you were denied, you’ll likely need to gather stronger evidence to support your claim. This may include:
- Detailed medical records.
- Reports from specialists.
- Updated forms from your doctor.
- Statements from employers or colleagues.
Your medical evidence should clearly show how your condition limits your ability to work. It’s helpful if your healthcare provider can explain why your condition prevents you from doing your previous job or any other type of work.
3. Don’t Miss Appeal Deadlines
Appealing a denial is time-sensitive. For CPP Disability, you typically have 90 days to request a reconsideration. If you’re denied again, you can appeal to the Social Security Tribunal. For long-term disability insurance claims, the deadline may vary depending on your policy. ODSP denials must be appealed through the Social Benefits Tribunal within 30 days.
Missing a deadline can make it much harder, or even impossible, to continue with your claim. Mark deadlines clearly and act quickly.
4. Consider Getting Legal Help
Many people assume they can handle the appeal process on their own, but disability law is complex. Insurance companies and government programs have entire teams trained to protect their interests. Having an experienced disability lawyer on your side can greatly increase your chances of success.
Disability lawyers typically work on a contingency basis, meaning they only get paid if you win. A good lawyer can help you:
- Review your policy or program criteria.
- Collect and submit compelling evidence.
- Communicate with the insurer or tribunal.
- Represent you at hearings or in court.
Share Lawyers has over 35 years of experience handling disability insurance claims. They offer a free consultation and only charge fees if your claim is successful. They focus on long-term disability insurance denials and are known for taking on clients who feel overwhelmed or dismissed by large insurance companies.
Diamond & Diamond is another respected name in Ontario. They handle personal injury and disability law and offer services across the province. Known for their high-profile media presence and client advocacy, they also provide free consultations and contingency-based fees.
Both firms can help you assess your options and determine whether a lawsuit or appeal is your best next step.
5. Stay in Communication
While you wait for your appeal or legal process to move forward, it’s important to stay engaged. Respond to requests for information, follow up with your healthcare providers and keep records of all communications. This shows that you’re serious about your claim and may speed up the resolution.
6. Look Into Alternative Supports
If your appeal is taking time or you’re facing financial difficulty, consider applying for interim supports. These might include:
- Employment Insurance (EI) sickness benefits.
- Ontario Works (if you’re not receiving ODSP).
- Local charities or community support programs.
These won’t replace the full value of your disability benefits, but they can provide short-term relief while your case is being reviewed.
Final Thoughts
Getting denied disability benefits in Ontario is discouraging, but it is not the end of the road. By understanding why your claim was denied, acting quickly, gathering the right evidence and speaking with a disability lawyer, you can fight back effectively. Don’t give up. Many people successfully overturn their denials and go on to receive full benefits. Your health and livelihood are worth fighting for.