A long-term disability (LTD) policy is a contract. Contracts outline the obligations of each party. For LTD policies, applicants are required to submit timely applications, and the insurance company is supposed to provide a timely decision on the application. The policy also outlines the benefit payable and the requirements an applicant must meet to be entitled to the benefit. All policies have a waiting period, sometimes also called an “elimination period”. A waiting period is just that, a specific period of time an applicant must wait before LTD benefits are payable. But what happens during the waiting period and what should you be doing to ensure a smooth approval process?
TL;DR:
A long-term disability (LTD) waiting period, also called an elimination period, is the time you must wait before benefits begin, after applying for disability benefits. In Ontario, this period typically ranges from 8 to 26 weeks. During this time, insurers assess your medical eligibility while you may rely on short-term disability or Employment Insurance (EI) sickness benefits for income. Understanding how the waiting period works, and what you should be doing during it, can make the difference between a smooth approval and a delayed or denied claim.
What is a Long-Term Disability Waiting Period?
A long-term disability policy is a contract that outlines the obligations of both you and the insurance company. One of the most important terms in that contract is the waiting period, which is defined as a period of time you must be continuously disabled before you can receive LTD benefits. For LTD policies, the waiting period can range from 8 weeks up to 26 weeks (60-180 days). Each policy is different and will outline the specific waiting period in your benefits schedule.
What Happens During the LTD Waiting Period?
During the waiting period, your claim is actively developing, even if you are not yet receiving LTD payments.
During the waiting period, what typically happens:
- Supplemental income
You may receive supplemental income from short term disability benefits or employment insurance sick benefits.
- Medical evidence is reviewed
Your LTD insurer will look at your medical documentation in deciding to approve or deny your claim.
- Ongoing treatment
It is critical to continue seeing your medical practitioners and building a consistent, documented medical chronology. This is essential for approval.
- Claim Preparation
The insurance company is building your file quietly.
The waiting period is not “inactive time” but rather, it is when insurers gather the evidence that will determine your claim outcome.
Does the Waiting Period Affect When You Should Apply?
Yes, but not in the way many people assume. A waiting period does impact application timelines.
- If your STD and LTD insurer is the same, your claim should automatically transition if you complete the LTD waiting period.
- If LTD coverage is different than STD, you’ll need to submit an separate application.
A longer waiting period means you’ll have to wait longer to submit your LTD application, but the timeline to apply does not change. Most policies require an LTD application be submitted 30-60 days prior to your LTD benefit start date.
This gives the insurance company ample time to review the application and determine if further information is required.
Can You Be Denied LTD During the Waiting Period?
Yes, you can, but it is uncommon.
Insurance companies usually wait until benefits are payable before providing a decision denying benefits.
How Long Does It Take to Get a LTD Decision?
Once the application is submitted, most insurance companies will provide a decision in 4-8 weeks.
- LTD insurers are required to provide a response within a reasonable time after an application is submitted.
- Decisions on applications can be tolled if the insurer is waiting on medical information.
What If You’re Still Waiting After the Waiting Period Ends?
Insurance companies are required to make decisions within a reasonable timeframe, but delays can happen, especially if:
- Medical records are incomplete
- Additional reports are requested
- Your condition requires further evaluation
If your waiting period has ended and you still don’t have a decision, it may be time to follow up or seek legal guidance from a disability lawyer.
Tips to Strengthen Your LTD Claim During the Waiting Period
To take control of your claim outcome, you should take the following actions:
- Attend all medical appointments
- Ensure your doctor’s office can be reached to provide clinical notes
- Be responsive to communications from your LTD case manager
- Complete paperwork in a timely manner.
Frequently Asked Questions
How long is the LTD waiting period in Ontario?
Typically, between 8 and 26 weeks (60 to 180 days), depending on your policy.
Do you get paid during the waiting period?
Not through LTD. However, you may receive short-term disability benefits or EI sickness benefits, depending on your coverage and eligibility.
When should I apply for LTD?
Usually 30–60 days before your waiting period ends.
Can my LTD claim be denied before the waiting period ends?
It’s possible, but most insurers wait until benefits are payable before issuing a denial.
What is the most important thing to do during the waiting period?
Maintain consistent medical treatment and medical documentation to support your claim.
When to Contact a Disability Lawyer?
The sooner the better.
Many people wait until a denial before getting legal guidance from a disability lawyer. Getting advice and guidance during the waiting period can help you:
- Navigate the application intricacies
- Ensure your medical evidence meets insurer expectations
- Strengthen your claim before a decision is made
This can make a difference between an approval or denial of your claim.
The experienced disability legal team at Whitten & Lublin offers free consultations for short- and long-term disability claims.
If you are approaching or are within your waiting period and have questions, please reach out online or call 416 640 2667.
