Hilborn & Konduros Law Firm

10/08/2026

After filling out endless forms and submitting to a variety of interviews, tests and evaluations, you've received a lump sum settlement offer from your Long-Term Disability company.

Having struggled so desperately to keep the bills paid over such a long, dry stretch without benefits, your first instinct was to grab onto this financial lifeline.

The sum, after all, represents more money than you've ever handled at any one time in your life.

Yet, even as you're trying to stay calm and carefully consider your response, you remember: there are repayments you are going to need to make, legal fees to cover, and… you need the answer to the one question that can totally change the value of this settlement offer: are you going to have to pay tax on these dollars?

Learn how Ontario LTD settlements may be taxed, including arrears, future benefits, premium payments, legal fees, and steps to take before signing.

10/07/2026

Your Long-Term Disability claim can run into trouble before you ever apply for LTD. It can start with a short-term disability denial.

If short-term disability benefits are wrongfully denied, I will often look at the long-term disability claim too.

Because if the short-term benefits had continued, and you remained disabled, you may have progressed into long-term disability benefits.

But there is another point in a disability claim that deserves close attention:

Around 18 months.

You may have been receiving LTD benefits every month without major problems.

Then suddenly, the insurer wants more medical records, more testing, a functional abilities evaluation, an assessment of what other jobs you might supposedly be able to perform, comments about 'sedentary work.'

That timing may matter.

Many LTD policies change their definition of disability around the 24-month mark.

Before that point, the question is often whether you can perform your own occupation.

After the change in definition, the test can become whether you are disabled from other suitable employment as defined by your policy.

So the insurer may begin reviewing your ability to work months before the 24-month mark arrives.

If you are approaching 18 to 24 months of LTD and your insurer suddenly starts asking for additional assessments, records, or information about your ability to work, pay attention.

Those requests may be part of a larger review of whether your benefits will continue.

The best time to understand what the insurer is doing is before the cutoff letter arrives.

10/05/2026

When an insurer cuts off someone's long-term disability benefits, it doesn't need everyone to accept that decision.

It only needs enough people to.

I've put it to clients this way for years: for every 10 people an insurer cuts off, maybe five or six will talk to a lawyer. A few years ago I'd have said four or five. More lawyers advertise this work now.

That still leaves four or five people who do nothing.

Most of them don't agree with the decision. They give up because they're sick and worn out, and they've been handed a denial letter by the insurer they counted on.

Every one of those people is money the insurer keeps.

For the people who do push back, the insurer has a second saving: time.

In Ontario, getting a disability case to trial usually takes at least a couple of years, sometimes more. You can have the facts, the law and fairness on your side and still have to go 24 or 36 months without the income you can't work to earn.

People sometimes ask me why anyone would settle for less than full value. Every lawsuit carries some risk. The bigger reason is simpler: the bills don't wait for a trial date. So many people accept a lump sum now, often 50 or 60 cents on the dollar, sometimes less.

That isn't failure. Taking money now instead of waiting three years for a verdict can be the right call. You just deserve to make that trade knowing what your claim is really worth.

The one number you control is whether you end up counted among the people who give up.

If your benefits have been cut off or denied, get clear on your options before you accept, appeal or walk away. There are deadlines, and they keep running while you decide.

10/01/2026

Over these many months since being forced to leave the work force, you've refused to allow despair to rule your life, holding fast to the belief that your ongoing treatments will one day enable you to return to the life you once knew.

Meanwhile, while several of your doctors and therapists have recently complimented you on your efforts to follow their prescribed regimens, you continue to struggle with getting through a full day's activities.

Now, with the letter you recently received from Medavie Blue Cross threatening to cut off the financial support on which you’ve relied, your thoughts are once again consumed by worry and confusion.

Your focus on recovering your physical and mental health has been pushed aside by fears about the future. You're having trouble understanding all the legal terminology in the letter, and feel you have no idea what steps you should take from here…

Denied by Medavie Blue Cross for Long-Term Disability in Ontario? Learn common denial reasons, evidence that helps, and next steps.

09/30/2026

"Insufficient evidence." Two words in a denial letter that can feel like we don't believe you.

When Sun Life denies a long-term disability claim for insufficient evidence, the question is, "Does your file show you can't work, the way your policy defines it?"

If a letter like this just arrived, start small:
- Find your appeal deadline. It's in the letter or your policy.
- Request your full claim file, so you can see what Sun Life relied on.
- Ask your doctors to describe your limits, not only your diagnosis. Can't sit for 20 minutes tells an insurer more than a label does.

One more thing: in Ontario you generally have 2 years to start a lawsuit, and appealing again and again doesn't always pause that clock.

A first 'no' is common. It doesn't have to be the last word.

I've written a full guide to Sun Life denials. The link is in the first comment.

09/28/2026

Around month 18, your LTD insurer may already be thinking about month 24.
There are certain points in a disability claim when insurance companies often create more resistance.
One can happen before long-term disability benefits even begin.
If your short-term disability benefits are denied, that can prevent you from progressing to long-term disability benefits at all.
In cases where I believe the short-term disability denial was wrongful, I often consider whether the claim should also include the long-term disability benefits the person would have received had the initial denial not occurred.
Another important point comes later.
If you have been receiving LTD benefits for roughly 18 months, you may notice the insurer becoming more active.
They may request additional medical records.
They may send you for testing or a functional abilities evaluation.
They may suggest that you are capable of sedentary work or identify other jobs they believe you could perform.
Why does this often happen before the two-year mark?
Because many LTD policies change their definition of disability around 24 months.
During the first period of the claim, the question is generally whether your disability prevents you from performing your own occupation.
After the definition changes, the test can become broader. Depending on the wording of the policy, you may have to establish that your disability prevents you from performing other suitable employment.
That makes the months leading up to the 24-month mark especially important.
If an insurer continues paying benefits well beyond the definition change, it may become more difficult for them to explain a later decision to terminate benefits when your medical condition and functional limitations have not materially improved.
So if you are approaching 18 to 24 months on LTD and suddenly receiving more requests, assessments or questions about your ability to work, pay attention to the timing.
It may be connected to what happens next under your policy.

09/24/2026

A woman was assaulted by a violent patron who’d been allowed by the café owner to remain on the premises and consume alcoholic beverages past the point of inebriation.

For the next thirteen years, this poor woman struggled to get financial help to pay for medical treatment for the injuries she’d suffered because of that attack: one hip requiring replacement, concussion-related cognitive issues, jaw problems, and vision loss in one eye. Was anyone ever going to be held accountable?

Over those many years, represented by a series of lawyers, sometimes forced to represent herself, this woman continued to seek help, only to face denial after denial from the business owner's powerful insurer.

09/23/2026

Your Long-Term Disability benefits can be in danger months before the insurer tells you they are.

In fact, one of the biggest warning signs can show up around month 18.

You may have been receiving monthly LTD benefits without much trouble.

Then the tone changes.

More medical records.

More testing.

A functional abilities evaluation.

Questions about whether you could do 'sedentary' work.

Assessments designed to identify other jobs you may be able to perform.

Why now?

Because many LTD policies change their definition of disability around the 24-month mark.

Before that point, the issue is often whether your disability prevents you from doing your own occupation.

After the definition changes, the insurer may assess whether you can perform other suitable work under the wording of your policy.

So those requests at month 18 may be connected to a decision the insurer is preparing to make at month 24.

And there is an even earlier roadblock I see.

Sometimes the LTD problem starts before someone ever applies for LTD.

Their short-term disability benefits are denied.

When I believe that denial was wrongful, I also look closely at the potential LTD claim.

Because if the short-term benefits should have been paid, and the person remained disabled, they may have progressed into long-term disability benefits.

Pay attention to timing.

A denial at the STD stage matters.

A sudden increase in testing and requests around 18 months matters.

And waiting until the 24-month cutoff letter arrives can leave you reacting to a process that may have started months earlier.

If your disability insurer suddenly seems much more interested in what work you 'could' do, look at where you are in the timeline.

09/22/2026

You've been off work because your health won’t let you do your job reliably.
Your doctor knows you’re struggling.

You’ve gone to appointments. Tried treatment. Filled out the forms.
Then the OTIP denial arrives:

"Insufficient medical evidence."

For many Ontario education workers, that sentence is hard to understand.
Because you have medical evidence.

The problem may be what that evidence actually proves.

A diagnosis tells the insurer what condition you have.

An LTD claim also needs to show what happens when you try to function at work:

Can you concentrate through a full day?
Can you supervise students safely?
Can you tolerate noise and constant interruptions?
Can you maintain attendance week after week?
How long does it take you to recover after your symptoms flare?

That distinction matters.

Your diagnosis and your ability to work are two different parts of the evidence.

If OTIP has denied your LTD benefits, start by finding out exactly what they say is missing before you respond.

Read the full guide here:

If OTIP denies your long-term disability claim in Ontario, save the denial letter, record every deadline, and request the policy terms and reports used to make the decision.

09/21/2026

When it comes to long-term disability denials or being cut off, there're typical times when the insurance company puts roadblocks in your way. Sometimes they cuff you off even before you apply for the long-term disability benefit by denying your short-term disability. I've often taken, I always take the approach actually, that if you're denied, short-term disability wrongfully, we can also sue for long-term disability as well because the test is almost always the same. And if they hadn't wrongfully denied your short-term benefits in the first place, you would have graduated to the long-term disability benefit if you'd still been disabled. So that's a very common thing.