Can You Get LTD for Mental Health in Ontario?
Here in Ontario, we've seen a significant increase in long-term disability (LTD) claims for mental health issues such as depression, anxiety, and PTSD. This rise is understandable: workers face higher rates of burnout, chronic stress, and understaffing, all of which harm mental well‑being and can make regular work difficult. As of 2025, however, insurers have become much stricter when assessing these claims. They are increasingly requesting additional questionnaires, ordering independent medical examinations (IMEs), and scrutinizing mental health disabilities more skeptically than in the past.
Eligibility Basics: What Your Policy Actually Covers
To qualify for LTD benefits, you must meet your policy's definition of "total disability." This term does not normally mean that you are completely unable to do anything. Rather, in the initial period you typically must show you cannot perform the essential duties of your own job. After a specified timeframe many policies move to a more stringent definition: you must demonstrate you cannot perform any reasonable occupation that matches your education, training, and experience.
Mental health conditions can be disabling if they substantially limit your ability to function at work. Common diagnoses insurers frequently recognize include:
Major depressive disorder
Generalized anxiety disorder
Post-traumatic stress disorder (PTSD) and trauma-related disorders
Bipolar disorder
Obsessive-compulsive disorder (OCD) and other recognized psychiatric illnesses
That said, many policies include important limitations. Some plans cap benefits for conditions "primarily caused" by mental illness (for example, at 24 months). Others require ongoing treatment with a qualified psychiatrist or evidence you are adhering to prescribed medication. Carefully reviewing your insurance contract is crucial because these provisions directly affect eligibility and claim duration.
The Proof You Need: More Than Just a Diagnosis
Insurers want clear evidence of how your condition limits your ability to perform at work — not just a diagnostic label. Strong claims include detailed, consistent documentation that explains how your symptoms impair job performance. Key supporting evidence includes:
Medical records documenting symptom onset, progression, and severity.
Treatment notes from therapists, psychologists, or psychiatrists describing treatment strategies and responses.
Functional assessments identifying specific work-related limitations, such as impaired concentration, fatigue, panic attacks, or cognitive difficulties.
A history of prescribed medications and evidence of adherence.
Referrals to specialists or community supports and any occupational rehabilitation reports.
A comprehensive, consistent record strengthens your claim and reduces the insurer's opportunities to deny for technical reasons.
Common Pitfalls That Can Sink Your Mental Health Claim
Even well-founded claims can fail if avoidable errors create doubt. Insurers will seek inconsistencies or gaps to question whether symptoms are serious or ongoing. Common mistakes include:
Posting social media content that contradicts your reported limitations.
Surveillance or other evidence showing activities inconsistent with your claimed disability.
Gaps in treatment, missed appointments, or failure to follow recommended care.
Vague or boilerplate doctor's notes that do not describe specific functional limitations.
Returning to work prematurely without clear medical clearance or documentation.
Maintaining consistent treatment, communicating clearly with healthcare providers, and keeping detailed records are essential steps to reduce the risk of denial.
Free Policy Review: Know Where You Stand
Handling LTD claims for mental health can be complex and stressful, particularly now that insurers are scrutinizing them more closely. If you are unsure whether your condition qualifies, or if your claim was denied, a professional review of your policy and claim file can help. A free consultation can clarify the evidence you need, evaluate the strength of your claim, and outline the best next steps to protect your legal and financial rights.
Pelz Law Group is a Toronto-based legal team that specializes in employment and disability law and has extensive experience with mental health-related LTD claims. Their services include interpreting complex policy language, assembling persuasive medical evidence, and advocating for claimants when insurers push back. To learn more about managing long-term disability claims for mental health in Ontario, contact Pelz Law Group for a consultation.
