Disability Denials
The Change of Definition at Two Years
The change of definition is the scheduled date on which a group LTD policy stops asking whether you can do your own job and starts asking whether you can do any job you are reasonably suited for. Most policies set it at 24 months of benefit payments, and terminations cluster there for that reason alone. Nothing about your health has to change for payments to stop on that date.
What Changes at the 24-Month Mark
Before the date, the insurer measures your restrictions against the essential duties of the occupation you actually held. After it, the comparison is to any occupation for which you are reasonably suited by education, training or experience. The two tests are set out in own occupation and any occupation. The date itself is written into the policy, so the first step is finding it in the booklet rather than assuming two years.
Why Terminations Cluster on the Change of Definition Date
Insurers work the file toward the switch. A transferable skills analysis, a labour market survey and an updated functional assessment are commissioned in the months before, and surveillance is often ordered in the same window, described in the surveillance chapter. The termination letter then arrives dated to the change, applying material you may never have seen. Requesting the claim file is how you find out what was gathered.
What Reasonably Suited Actually Asks
Courts have not read any occupation as any job that exists. The occupation has to be one your education, training or experience actually fits, and many policies add an earnings threshold, so work paying a small fraction of your former income does not count. A theoretical job in another city, or one requiring retraining you have not had, generally fails the test. The precise wording of your policy controls the argument.
The Evidence That Answers the Second Test
A file built to show you cannot do your old job may be silent on everything the second test asks about. What answers it is functional capacity evidence measured against sustained full-time work, a vocational opinion on transferable skills, and a physician’s opinion addressed to work generally rather than to your former duties. This is covered in the medical evidence chapter, and it takes months to assemble, which is why the work starts before the date rather than after the letter.
The Date Is Contractual, Not Statutory
No statute sets the 24-month point. It comes from the policy, which means an individual policy bought privately may have no change of definition at all, or a different period. A denial dated to the switch starts the same court deadline as any other denial, set out in the deadline to sue. The firm reviews the master policy wording before advising on a change of definition termination, as described on the long-term disability lawyer page. Decisions interpreting the clause are on CanLII.
