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When you’re too sick or injured to work, applying for disability benefits should be straightforward. However, for many people, the process feels overwhelming—especially if you haven’t been able to see a doctor regularly because:
Whatever the reason, you may be wondering: Can I still get disability benefits if I haven’t been seeing a doctor?
The short answer is: it’s possible, but it’s much harder. Many people believe it is impossible to get disability benefits without a family doctor, and while it is difficult, it is not impossible. Medical evidence is the backbone of any disability claim in Canada, whether you’re applying for long‑term disability (LTD) benefits, the Canada Pension Plan Disability (CPP‑D) benefit, or Ontario Disability Support Program (ODSP). Disability benefits are awarded based on the effects of a medical impairment on your ability to function and work, not just the presence of a diagnosis. Without consistent medical documentation, insurers and government decision‑makers often deny claims—not because they think you are lying, but because they don’t have enough medical evidence to approve your claim.
That said, a lack of regular medical care does not automatically disqualify you. With the right strategy, the right support, and the right documentation, you can still build a strong claim.
Below, I break down what you need to know, what to expect, and how to protect your rights.
Every disability benefits system—insurance companies, CPP‑D, ODSP—relies on medical evidence to answer three key questions:
In Canada, disability programs focus on the impact of a condition rather than the specific diagnosis, but still require professional support.
Without medical records, insurers and adjudicators have no objective way to verify your symptoms or limitations, or to document when medical conditions are present and ongoing. Even if your condition is very real, the absence of medical information creates a gap in supportive evidence and your insurance company will deny your application. Medical records must be as recent as possible, detailed, accurate, and provided by a licensed healthcare provider to support a disability claim.
Denials due to insufficient medical evidence are common for conditions that are “invisible,” fluctuating, or subjective—such as chronic pain, depression, anxiety, fibromyalgia, migraines, or long COVID.
A doctor’s report is necessary to establish a medically determinable impairment, provide objective evidence to support subjective symptoms, document treatment history, and show that the condition prevents substantial gainful work. Medical documentation must be accurate, recent, and accepted by insurers, and detailed and accurate records from licensed healthcare providers are crucial.
When applying for disability, it is important to have healthcare professionals involved in documenting the medical evidence for your claim. You will need to develop a credible timeline of care by systematically gathering medical records, notes, and reports. Seeking consistent care from the same clinic or practitioner helps develop this timeline and allows for strong clinical notes that support your case. You can also request detailed medical reports that explain how your condition impacts your ability to perform work tasks and ask for specific documentation relating to your disability claim.
Long‑Term Disability (LTD) Benefits
Most LTD policies require:
When making a claim for LTD, it is crucial to provide proper medical documentation, as this significantly influences the likelihood of claim approval.
If you haven’t been seeing a doctor, insurers often argue that:
Disability benefits denied are often the result of insufficient medical evidence provided during the claim process.
These arguments are common in LTD denials. The Canadian Life and Health Insurance Association (CLHIA) outlines how insurers assess claims and the importance of medical documentation: CLHIA Consumer Guide to Disability Insurance
Reports from specialists carry more weight than those from family doctors in disability claims. The Attending Physician Statement is a key document in proving disability to the insurance company.
CPP‑D requires that your disability be:
Medical reports are mandator – CPP disability forms. You cannot be approved without a medical practitioner completing the medical form. However, this practitioner does not have to be a family doctor. Nurse practitioners can complete the form, and specialists can provide supporting evidence.
ODSP also requires medical forms completed by an approved health professional. Again, this does not have to be a family doctor. Nurse practitioners, psychologists, psychiatrists, and others can complete the forms depending on your condition.
This is extremely common in Ontario. The system recognizes this reality, and there are alternatives to seeing a family physician in a traditional clinic setting:
Nurse practitioners can diagnose, treat, and complete disability forms for LTD, CPP‑D, and ODSP.
While not ideal, walk in clinic physicians can:
For example, clinic notes or lab results from a walk-in clinic can serve as alternative sources of medical evidence to support your disability claim.
If you’ve seen a specialist even once, their notes can be important in showing that your physician referred you for further investigation and to provide missing evidence of the gravity of your condition.
Community Health Centres are not-for-profit community governed organizations with a primary focus on improving the health and well-being of populations who have traditionally faced barriers accessing health services, including:
These centres often accept patients without a family doctor and provide multidisciplinary care.
Telemedicine appointments can help establish a treatment history when mobility or access is an issue. Many counsellors see patients virtually which can be very helpful if you have a mental health condition which makes it difficult for you to leave the safety and comfort of your home.
You can still apply, but your claim will be denied without medical evidence. It is important to let the insurer know about your potential claim in order to make sure that they have notice under your policy. You should advise them that you are having difficulty accessing treatment and that this is the reason that you have been unable to submit a medical report.
The better strategy is:
As you move forward, it’s important to develop a strong case by systematically gathering medical records, notes, and reports to support your disability claim. Try to collect a lot of detailed information and documentation, as insurance companies closely scrutinize the volume and accuracy of your medical evidence. If your claim is denied, gathering new or better medical evidence can strengthen your case for appeal.
Applying for disability benefits in Ontario can be a complex process, and even small missteps can lead to delays or denied claims. To improve your chances of success and ensure you receive the benefits you deserve, it’s important to be aware of the most common mistakes people make when filing a disability benefits claim.
If you’re applying for disability benefits without a strong medical history, getting legal advice early can prevent avoidable denials. A disability lawyer can:
The insurer’s decision will depend on whether they are satisfied with the medical evidence you provide. If your disability benefits claim is denied, you should consider hiring a long term disability lawyer to determine whether you should appeal or start a legal claim. Contact us today for a free consultation – we will help you decide how to prove that your illness or injury qualifies as a payable long term disability claim.
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