Cut Off at 24 Months? Your Any-Occupation Survival Plan (BC)

Fact checked by Vancouver Long-Term Disability Lawyer Tim Louis

At 24 months many LTD policies change from “own occupation” to “any occupation,” and that is when benefits are often cut off. This page shows how to prepare, what evidence helps, and the steps to protect your income.

When you are living with symptoms and trying to heal, a letter that says you can work “in any occupation” can feel unreal. The change of definition at the two-year mark is not about who you were before you got sick. It is a stricter test that asks whether you can reliably do another job you are reasonably suited for by your education, training, and experience. Insurers use this moment to trigger paper reviews, independent exams, and surveillance. Many people are denied because their file is light on functional details, not because their condition disappeared.

Here is the good news. With a clear plan and the right documents, many claims survive the switch. We will walk you through a simple 60-day countdown: what to request, what to track, how to talk with your doctors, and when to push back. If you want help now, call (604) 732-7678 or write [email protected] for a free consultation.

What the 24-month switch really means

Most LTD policies start with an own occupation test. For the first two years, the insurer asks whether your symptoms prevent you from doing the substantial and essential duties of your own job. At the two-year mark the test often changes to any occupation. Now the question becomes: can you do any work you are reasonably suited for by your education, training, and experience, usually at a gainful level of income.

This is why files tighten at 24 months. Insurers review the entire claim, order paper reviews or independent medical exams, and look for gaps they can rely on. The new test is broader, and they often interpret it in their favour. A task you can perform once on a good day is not the same as work you can do with reliability, consistency, and reasonable productivity week after week. That distinction is at the heart of many successful appeals and lawsuits.

Set your expectations for the letter you might receive. Common phrases include:

• Insufficient evidence. The file lacks clear functional limits like sitting or standing tolerance, off-task time, absences, or stamina.
• Improvement noted. Selected chart entries are used to suggest recovery even when the overall picture is mixed.
• You can do other work. Generic statements about “sedentary roles” or lists of jobs with no proof of fit, earnings, commute, or tolerance for absences.

To meet the any-occupation test, focus on function, not just diagnosis. Your records should show what you can do, for how long, how often you would be off task, and how many days you would miss. Mental-health files should include cognitive load, stress tolerance, and social interaction limits. Ask your doctors to use concrete examples from your day. If you are approaching month 20, start building this picture now. If you are already past 24 months, we can help you assemble the evidence and respond with strength.

The 60-day prep plan

Think of the next two months as a quiet sprint. Each step builds the record you will rely on if the insurer cuts benefits at the change of definition.

Day 60 to 45 – gather and map

• Request your full claim file in writing. Ask for the policy, adjuster notes, internal medical reviews, vocational reports, surveillance, phone logs, and every letter in and out.
• Read for gaps: missing specialist notes, no functional limits, or clinic entries that sound better than you feel day to day.
• Book updates with your treating providers. Tell them you need clear functional limits, not just a diagnosis.
• Start a simple daily diary: wake time, activities, pain or symptom levels, rest breaks, naps, time off task, and side effects from medication.

Day 44 to 30 – put numbers on function

• Give your doctors a short RFC form that lists concrete limits: sitting and standing tolerance, lifting, use of hands, concentration, pace, off-task time, and expected absences each month.
• Clarify restrictions versus preferences. “Cannot sit more than 20 minutes without changing position” is stronger than “prefers to lie down.”
• Make sure clinical notes match the limits. Ask providers to record what they observe in the exam and what you report at home, including good and bad days.

Day 29 to 15 – reality check on work

• Do a vocational snapshot with us: what jobs you trained for, what they pay, and whether you could do them reliably with your current limits.
• Document reliability: how often symptoms would cause lateness, early departures, or missed days.
• If your employer tried to accommodate you, ask for a short letter that confirms dates, duties offered, and why the attempt failed.

Day 14 to 0 – put it together and choose a path

• Send a concise letter to the insurer. Attach updated medicals and RFCs. List your functional limits and explain how they affect real jobs in your field. Ask the insurer to name any positions they say you can do, the wages, and how those jobs tolerate absences and off-task time.
• Decide your route: internal appeal, negotiation, or litigation. Check limitation periods so you do not lose the right to sue while waiting on an appeal.
• If you have not applied for CPP-D, discuss it with your doctor. Approval can support the severity and duration of your disability, and we will address any policy offset.

If you would like help with the diary, the RFC form, or the insurer letter, call (604) 732-7678 or email [email protected]. A short conversation can save weeks of frustration and protect your claim.

Evidence that moves “any occupation” decisions

Insurers decide at 24 months on function, not labels. A strong file shows what you can do, for how long, and how reliably you can do it.

Make function measurable

• Sitting and standing tolerance. Example: “Needs to change position after 15–20 minutes. Total sitting tolerance two hours over an eight-hour day.”
• Walking and lifting limits. Example: “Walks one block on level ground. Lifts to five kilograms occasionally.”
• Pace and accuracy. Off-task percentage, error rate, need for extra supervision.
• Absences and recovery time. Example: “Predictable absences four to six days per month due to symptom flares.”
• Hand use, keyboarding, high-repetition tasks, driving tolerance, and safe exposure to noise or screens when relevant.

Objective vs clinical

• Use tests when they exist (imaging, labs, range-of-motion, sleep studies, neurocognitive screens).
• Many conditions are diagnosed and managed clinically. Chronic pain, fibromyalgia, ME/CFS, migraine, depression and anxiety often rely on history, exam findings, response to treatment and longitudinal consistency across notes. Explain why a “normal” scan does not equal work readiness.

Mental-health records

• Record diagnosis, treatment plan, and adherence.
• Tie symptoms to work tasks: concentration span, memory, decision-making, stress tolerance, social interaction, public contact, and predictable attendance.
• Give examples from real days: “After 30 minutes of focused reading, requires a one-hour break due to cognitive fatigue.”

Keep the story consistent

• Medical notes, CPP-D forms, insurer questionnaires, and any employer letters should align.
• Explain medication side-effects such as sedation, dizziness, mental fog or GI upset and how they affect reliability and safety.

CPP-D interplay

• Applying for CPP-Disability can help show that your condition is both severe and prolonged.
• If approved, most policies offset part of the LTD payment. The medical evidence that supports CPP-D often strengthens the LTD claim as well.

Quick checklist for your next appointment

1. Bring a one-page RFC list with the limits above.
2. Ask your provider to write numbers, not adjectives.
3. Confirm that clinic notes reflect bad days and recovery time, not only good moments.

Need help? Call Tim Louis at (604) 732-7678 or email [email protected] for a free consultation.

Insurer tactics at the change of definition and how to respond

Insurers lean hard at 24 months. Here is how to meet the moment with calm, organized answers.

Paper reviews and IME shopping

• Expect a file review by an insurer doctor who has never met you, or a request for an “independent” medical exam.
• Ask for the reviewer’s specialty, the questions they were asked to answer, and any raw test data.
• Give your treating providers a short, numbered memo of the reviewer’s claims and ask for a written rebuttal tied to functional limits: sitting and standing tolerance, off-task time, expected absences, safety concerns.
• If testing is helpful, arrange functional capacity testing or targeted assessments (neurocognitive, sleep, balance) and submit the results with a clear summary.

Surveillance and social media

• Insurers may hire licensed investigators to film you in public places. They cannot enter your home or harass you.
• Do not “perform” on a good day to prove anything. Follow medical advice, keep your diary, and stay consistent.
• If surveillance is raised, request the full footage, date and time logs, and the investigator’s report. Provide context in writing: how long you were out, breaks taken, pain or fatigue after, and how that activity compares to an eight-hour workday. One short clip does not equal reliable work.

“Any occupation” assertions

• Demand specifics: job titles, wages, training period, commute, and how the role tolerates your off-task time and absences.
• Explain why proposed jobs are not realistic with your limits or background. If the insurer lists “sedentary work,” ask which roles, how many exist locally, and whether they meet the policy’s “gainful” earnings threshold.
• Keep your response short and numbered. Attach medical and vocational support, not just argument.

One-page response outline you can use

1. Diagnosis and current treatment.
2. Functional limits with numbers.
3. Real-world impact on proposed jobs.
4. Evidence summary (RFCs, test results, employer letter).
5. Requests to the insurer (full surveillance, job specifics, policy sections relied on).

If you want help drafting a tight reply, call (604) 732-7678 or email [email protected] for a free consultation.

Timelines and limitation periods (do not sleep on these)

Two clocks may run at the same time:

• Internal appeal deadlines. These are set by the insurer, often 30 to 90 days. Missing them can close the appeal path.
• Court limitation period. Your right to sue can expire even while you are appealing internally. Many claims in BC are subject to a two-year limitation, but some policies shorten the window by contract. Do not assume you have time.

Smart steps now:

• Treat the denial letter date as the trigger. Mark the appeal deadline and a conservative lawsuit deadline.
• Ask the insurer in writing to confirm the limitation date they say applies.
• Consider negotiating or starting a claim rather than waiting out multiple internal appeals.
• Do not sign a broad release or “final” settlement without legal advice.

If you are inside the last few months of your possible limitation period, speak to a lawyer immediately. We can check the policy, calculate your deadline, and map the safest next move while preserving your rights.

Free consultation: (604) 732-7678 · [email protected] · https://longtermdisabilityinsights.com/contact/

If you were terminated while on LTD

Being let go while you are on long term disability is overwhelming. It is also a moment to protect both sides of your rights: the insurance claim and your employment claim.

Your employer’s duties.
In BC, employers must consider reasonable accommodation of a disability up to the point of undue hardship. That can include modified duties, reduced hours, extra breaks, or a gradual return when your doctors say it is safe. Ending employment because of disability, or refusing to consider real accommodations, can raise human rights issues as well as wrongful dismissal.

How this connects to LTD.
Your LTD claim does not vanish because the employment ends. If you were disabled while covered under the plan, the insurer must assess your disability under the policy. The fight with the insurer is about function. The dispute with the employer is about notice, severance, and whether they met their duty to accommodate. These files should be coordinated so you do not give up one to improve the other.

What to do right away

1. Do not sign a release or resignation before getting advice. Many releases try to waive future claims and can create problems for your LTD case.
2. Collect documents: employment contract, termination letter, benefits booklet, LTD policy or summary, emails about accommodations, and pay records.
3. Ask, in writing, whether group benefits continue during notice and how premiums will be handled.
4. Keep medical updates current. Your doctors should set clear restrictions and explain why a safe return is not possible now.
5. Save all messages with HR and the insurer. Note every call, date, and promise.

Coordinating the strategy.
We look at the policy, the termination, and your medical evidence together. We plan the order of steps, negotiate severance without harming the LTD claim, and preserve your human rights options. A short call can steady the ground and map your next move.

Free consultation: (604) 732-7678 · [email protected] · https://longtermdisabilityinsights.com/contact/

Real BC Outcomes — Any-Occupation Case Snapshot (linkable dataset)

Why each case is unique
Outcomes turn on facts: policy wording, quality and consistency of medical evidence, real-world employability, mitigation, and how both sides conduct themselves.