Mental Health and Long-Term Disability Denials in BC

When the System Fails You

You never thought you’d be here.

Not long ago, you were pushing through your workdays, holding everything together—until you couldn’t. Somewhere between the pressure, the sleepless nights, the panic attacks in the bathroom or the numbness you couldn’t explain, you reached a breaking point. A doctor finally gave it a name: depression, anxiety, PTSD—something real.

So, you filed for long-term disability, thinking, “Finally, I can breathe. I can rest. I can begin to heal.”

Then the denial came.

A letter. Cold. Clinical.
A decision made by someone who’s never met you.

“Insufficient medical evidence.”
“Not totally disabled.”
“Claim not approved.”

It’s not just a financial setback. It feels like they’re denying your reality. As if they’re saying your pain doesn’t count. That what’s happening to you doesn’t qualify as real suffering.

Let us tell you something clearly:

You’re not imagining it. You’re not weak. And this is not the end of your story.

At TimLouisLaw.com, we’ve stood with people just like you—strong professionals, parents, partners, caretakers—who’ve quietly carried invisible burdens until they collapsed under the weight. We’ve helped them make sense of LTD denials, understand their rights, and rebuild their path forward.

Because what you’re going through isn’t rare.
But the right support? That’s rare—and you deserve it.

You don’t need to suffer in silence, and you don’t need to fight this battle alone.

Read how Tim Louis Law fights for clients with invisible disabilities → https://timlouislaw.com/ltd-for-invisible-illnesses-in-bc/

Understanding the Landscape in BC

Navigating an LTD claim is hard enough—add in the fine print of an insurance policy, and it can feel like trying to read through fog.

What most people don’t realize is that many LTD denials aren’t based on whether your condition is “real” or not. They’re based on definitions, timelines, and buried clauses—details that can work against you if you don’t know what to look for.

Here’s what you need to understand:

“Own Occupation” vs “Any Occupation”

When you first apply for LTD benefits, most policies define disability based on whether you can do your own job. This is called the “own occupation” period. If your condition prevents you from performing the core duties of the work you were doing before your disability, you may qualify—at least at the start.

But after 24 months, many policies switch the definition. Now, your insurer may only pay you if you can’t do any occupation you’re reasonably suited for—regardless of whether it matches your training, income level, or past responsibilities.

That architect with PTSD? After two years, the insurer might claim she can flip burgers at a fast-food restaurant and deny her claim.

This shift catches thousands of people off guard—and it’s one of the most common points of denial in mental health cases.
Many professionals don’t even realize the definition has changed until their payments stop.

You might be wondering:

“What’s the difference between ‘own occupation’ and ‘any occupation’ in LTD claims?”

Here’s what matters:
During the first 24 months, LTD usually covers your ability to do your own job. But after that, insurers often deny benefits if they believe you can perform any job—regardless of how unsuitable it is for your skills, experience, or mental health limitations.

The 24-Month Mental Illness Clause

Many LTD plans contain limitation clauses that cap benefits for “mental or nervous disorders” at just 24 months—no matter how severe the condition is.

These clauses are deeply controversial. They imply that mental illness has an expiry date—that after two years, you should be “better.”

But here’s the truth: mental illness doesn’t follow a schedule. Depression isn’t cured by a calendar. Trauma doesn’t pack up at the two-year mark.

There are exceptions to these limits—especially if your policy is unclear, or if your condition overlaps with other physical symptoms. But you’ll need legal support to navigate that grey area effectively.

Read the Fine Print. Twice.

Every LTD policy is different. Some are written to give insurers wide discretion. Others are more protective of your rights—but you’d never know unless you read closely.

• Are mental health conditions listed as exclusions?
• Is there a change in definition after 24 months?
• Does your policy require “objective evidence” of disability?

You can’t fight what you don’t understand. And most policies weren’t written for you—they were written to protect insurers.

Tip:
You have a legal right to fair treatment under BC’s Human Rights Code. If your insurer discriminates against your mental health condition, you may have grounds for legal action.

Why Mental Health LTD Claims Get Denied — Even When They’re Real

Your diagnosis is real. Your struggle is real.
But for many insurance companies, that’s not enough.

Mental health LTD claims are denied at alarming rates—not because the pain isn’t legitimate, but because the system is wired to doubt you. If you’ve been denied, chances are it wasn’t personal. It was procedural.

Here’s how the game is played:

 “Lack of Objective Evidence”

Mental illnesses don’t show up on X-rays or blood tests. They’re invisible, often fluctuating, and hard to quantify.
And yet, many insurers still expect “objective evidence”—something that doesn’t really exist for depression, anxiety, PTSD, or panic disorders.

So when you submit a claim backed by psychotherapy notes, physician letters, and symptom descriptions, they may say:

“We acknowledge your condition, but there’s no objective evidence of total disability.”

That’s code for: We don’t trust mental health claims.

Surveillance & the “You Look Fine” Fallacy

Insurers sometimes hire private investigators to follow claimants. They look for you walking your dog, attending a yoga class, or buying groceries.
If they catch a few minutes of what looks like “normal” behaviour, they’ll argue:

“You appear functional in public. This contradicts your reported limitations.”

But here’s what they won’t show:

• The panic attack that happened before you left the house.
• The three days in bed that followed.
• The mental strain of pretending to be okay.

Living isn’t the same as healing. Functioning for an hour doesn’t mean you’re able to work full-time again.

Doctor’s Notes That Undermine You (Unintentionally)

Your family doctor may mean well—but a vague or incomplete note can wreck your LTD claim.

Phrases like:

• “Patient is stressed”
• “May benefit from some time off”
• “Experiencing burnout”

…may sound accurate, but they lack functional language. Insurers want clear statements that show how your condition limits your ability to perform essential work duties.

Without that? Your claim looks optional, not necessary.

Stigma in Disguise: “You Just Need a Break”

Even when policies claim to support mental illness, bias seeps through. There’s an undercurrent of dismissal:

“You’re tired, not disabled.”
“You just need a bit of rest.”
“Try harder. It’ll pass.”

Insurers use this line of thinking to frame your suffering as temporary—or worse, as weakness. It’s a subtle but powerful strategy that results in valid claims being turned away.

That’s why so many people, even with serious diagnoses and strong medical support, still hear “Denied.”

And that leads us to a question we hear almost every day:

Q: Why did my LTD claim for depression get denied?
A: Insurers often deny depression or anxiety-related LTD claims due to lack of “objective medical evidence,” vague doctor’s notes, or surveillance that misrepresents your condition—even when your disability is very real.