Depression is a leading cause for disability leave and income replacement claims. Approvals turn on functional capacity and program‑specific definitions—not diagnostic labels alone. This guide summarizes the principal pathways for financial support and benefits (EI Sickness, CPP‑Disability, LTD insurance, and the Disability Tax Credit), the evidence that carries weight, and practical steps if your claim is denied. It also outlines workplace accommodation obligations that may intersect with your benefits claim.

Introduction to Disability Benefits

Disability benefits in Canada are designed to provide crucial financial assistance to individuals who are unable to work due to a medical condition, such as depression. There are several types of disability benefits available, including long term disability (LTD) benefits, short term disability (STD) benefits, and Employment Insurance (EI) sickness benefits. Each program has its own criteria and application process, but all require a medical assessment to determine eligibility. This assessment is typically conducted by a licensed mental health professional, who evaluates how the condition affects the individual’s ability to work. Whether you are seeking LTD, STD, or EI sickness benefits, the goal of the application is to ensure that you receive essential financial support so that you can focus on treatment and recovery.

Understanding Depression

Depression, also known as major depressive disorder, is a serious mental health condition that can deeply affect an individual’s quality of life and ability to work. Common symptoms include persistent feelings of worthlessness, hopelessness, and a loss of interest in daily activities. Depression may be caused by a combination of genetic, environmental, and psychological factors, and its severity can range from mild to debilitating. The effects of depression can make it difficult to function at work and home and to maintain employment. Diagnosis and treatment are typically provided by a psychiatrist or other qualified medical professional, who can offer a range of options such as therapy, medication, or a combination of both. Recognizing the symptoms and seeking professional help is the first step toward managing the condition and exploring available supports.

When does depression qualify as a “disability”?

Under Canada’s human rights framework, mental health conditions are protected. Employers and service providers have a duty to accommodate to the point of undue hardship—often by providing modified duties, flexible scheduling, or gradual return‑to‑work (RTW). The legal standard is functional and contextual, not diagnosis‑driven.

Across benefit programs, eligibility similarly hinges on whether symptoms reliably prevent you from performing work (or daily mental functions, for tax purposes) despite appropriate treatment.

Core disability pathways (what they are—and are not)

A) Employment Insurance (EI) Sickness — short‑term bridge benefits

• Up to 26 weeks of temporary income replacement when you cannot work for medical reasons (including depression). Benefit rate 55% of insurable earnings, maximum $729/week (2026). A medical certificate is required, and you should apply as soon as you stop working.
• Suitable when your clinician expects weeks to months off work; if incapacity persists, consider LTD (if insured) and/or CPP‑Disability.

B) Canada Pension Plan Disability (CPP‑D) — severe and prolonged illness

• For contributors under 65 whose disability is severe and prolonged—i.e., regularly prevents any substantially gainful work and is long‑term or of indefinite duration. The program publishes maximum and average monthly payments (2026: max $1,741.20; average $1,191.72). Service Canada also sets work‑earnings benchmarks tied to “substantially gainful” employment and requires notification if you work. If you have taken time off work to raise a child, this period can help you qualify for CPP disability benefits by earning necessary credits.
• CPP‑D definitions and forms specify how adjudicators assess severity, duration, and contributions; evidence must show functional incapacity at the time you last met contribution requirements. When you fill out your application forms, it is important to complete every section thoroughly and double check all information for accuracy before submission. You must also meet all deadlines for submitting your application and supporting documentation to avoid disqualification. Following up on your application status is important to ensure all additional information requested is provided promptly.

C) Long‑Term Disability (LTD) Insurance — private/group coverage

• Most group insurance policies assess disability in two stages: Own occupation (often first 24 months): can you perform substantially all essential duties of your own job? Any occupation (after the change of definition): can you perform any occupation for which you are reasonably suited by education, training, or experience? Insurers are responsible for providing LTD benefits and require detailed documentation to support your claim.
• The majority of group insurance plans in Canada are paid for by employers and typically replace 60–70% of an individual’s salary. Courts interpret these tests pragmatically: you need not be incapable of every task; inability to perform substantially most essential duties reliably is sufficient.

D) Disability Tax Credit (DTC) — for income tax relief

• In order to obtain income tax relief, apply for the disability tax credit (DTC).
• The DTC is intended to provide tax assistance where you can prove you have marked (or cumulatively significant) restrictions lasting 12+ months in the mental functions necessary for everyday life (attention, memory, judgment, regulation of behaviour/emotions, communication, etc.). Canada Revenue Agency evaluates effects, not diagnoses; approval can be retroactive and can allow you to open a Registered Disability Savings Plan.

F) Ontario Disability Support Program (ODSP)

The Ontario Disability Support Program (ODSP) is a provincial initiative that offers financial assistance to individuals living with disabilities, including those affected by depression. To qualify for ODSP, applicants must demonstrate through a medical assessment that they have a substantial impairment that significantly limits their ability to work and earn an income. The application process involves submitting detailed medical and financial information to determine both the severity of the condition and the level of financial need. If approved, ODSP provides monthly financial assistance to help cover essential living expenses and can also provide some financial supports such as prescription drug coverage and rent assistance.

Evidence that adjudicators require

Across programs and policies, the focus is on function.

• Longitudinal medical record: clinician notes, psychiatric assessments, psychotherapy records, hospitalizations; show sustained limitations despite appropriate care. If depression is caused or exacerbated by a workplace or service-related injury, it is important to document this connection.
• Treatment history: medication trials/titration, side‑effects, therapy participation, reasons for delays or accessing treatment (wait‑lists, adverse effects). Trying other medications or alternative treatments, as recommended by your provider, can demonstrate compliance and improve your claim.
• Work sustainability: failed RTW attempts, attendance issues, accommodation outcomes.
• For DTC: concrete examples of how mental‑function impairments impede daily life, consistently and markedly.

Claims for long term disability for depression can be denied if there is insufficient documentation to support the claim, including medical records and treatment history.

Workplace accommodations (and why they matter)

Employers must accommodate disability needs to the point of undue hardship; this can include flexible hours, modified duties, or graduated returns to work. Good‑faith participation is expected from both sides. If an insurer determines your inability to work is solely due to a toxic work environment, they may deny your claim, stating it is a workplace issue rather than a disability. Document accommodation efforts and outcomes—if accommodations fail, that evidence supports disability severity in LTD and CPP‑D contexts.

Common pitfalls—and how to avoid them

• Relying on diagnosis alone: approvals turn on function and sustainability, not labels. Align evidence to essential job demands and daily mental functions.

• Sparse or inconsistent documentation: explain gaps in care and treatment(access to treatment barriers, side‑effects, symptom volatility) and maintain a clear treatment plan.
• Under‑preparing for the 24‑month LTD shift: develop vocational/functional evidence early to address the any occupation definition change in most group insurance policies.

Common reasons for denial of depression disability claims include insufficient medical evidence, incomplete applications and inadequate evidence of treatment.

If your disability claim is denied, you can appeal the decision. Consulting a disability lawyer or firm can improve your chances of approval, especially if your claim has been denied.

Practical evidence checklist

• Treating physician/psychiatrist letter tied to essential duties (attention, pace, stress tolerance, attendance) and reliability.
• Psychotherapy summaries; medication trials and adverse effects.
• Employer records: job description, performance notes, failed RTW, accommodation correspondence.
• Daily‑function examples for DTC (cueing/supervision, memory/attention limits, safety risks).
• For EI: insurable hours/ROE and medical certificate.

How much could you receive?

• EI Sickness: up to 26 weeks at 55% of insurable earnings, max $729/week (2026).
• CPP‑Disability: taxable monthly benefit; 2026 max $1,741.20, average $1,191.72 (indexed to the cost of living).
• LTD Insurance: amounts are policy‑specific and may be reduced by other income (e.g., CPP‑D) depending on contract language; check your policy or benefits booklet.
• DTC: non‑refundable credit reducing income tax; may be retroactive and enables RDSP eligibility if approved.

How to Deal with a Denial of Long‑Term Disability (LTD) Benefits)

A denial is not the end of your claim. Concentrate on: policy text, functional evidence, and documented treatment.

1) Start with the denial letter—and the file. Note the insurer’s reasons (e.g., “fit for own occupation,” “non‑compliance”). Request the complete claim file (adjuster notes, consultant reviews, surveillance, vocational reports).

2) Map their rationale to the policy definitions.

• Own occupation (≈ first 24 months): can you perform the essential duties of your job, reliably and predictably?
• Any occupation (thereafter): can you engage in any occupation reasonably suited by education, training, and experience on a sustained basis?

3) Internal appeal vs. legal action. Internal appeals are usually only successful if are able to add new, material evidence (e.g., treating psychiatrist’s report, proof that you are in supportive counselling, updated medication information). If you don’t have new information to provide, seek legal advice about proceeding with litigation rather than cycling through multiple internal reviews.

4) Upgrade the record where it’s thin.

• Specialist report: tie symptoms to essential duties; explain why intermittent “good days” don’t equate to sustainable work.
• Treatment evidence: document psychotherapy, medication trials, side‑effects, and clinical reasons for changes; reasonable engagement is expected.
• Accommodation record: document attempts to return to work and outcomes; failed accommodations support ongoing unsustainability.
• Vocational/functional capacity (for “any occupation” definitions of disability): address cognitive load, predictability, absenteeism risk, and the lack of realistic, sustainable alternatives.

5) Anticipate insurer positions.

• “Subjective condition”: use longitudinal notes, standardized measures (e.g., PHQ‑9 if available), and task‑based examples (attention limits, panic during client contact, unscheduled absences)
• “Non‑compliance”: provide clinical rationale for therapy changes or pauses (inefficacy, side‑effects, access barriers) and set out the current plan.
• Surveillance/social media: contextualize snapshots; isolated activities are not proof of sustained work capacity.

6) Coordinate with CPP‑Disability. Many LTD policies require a CPP‑D application or offset CPP‑D benefits. A CPP‑D approval can be persuasive because it applies a strict “severe and prolonged” test and monitors substantially gainful earnings thresholds.

7) Control process and timelines. Diarize internal appeal deadlines and provincial limitation periods; communicate in writing; keep an indexed evidence brief.

8) Consider an IME—strategically. A targeted psychiatric or neuropsychological IME can rebut paper reviews and address the policy test directly—especially at the “any occupation” stage.

9) Don’t abandon accommodation during appeal (if clinically appropriate). Good‑faith participation in rehabilitation efforts of your insurer or accommodated work trials supports your claim and aligns with human‑rights expectations.

Frequently Asked Questions

Q: What are the common reasons for denial of long term disability benefits for depression?

A: Common reasons include insufficient medical evidence to prove that you satisfy the insurer’s definition of disability, and lack of documentation showing how symptoms affect your ability to work. It’s important to provide thorough medical records and clear evidence of how your condition impacts your employment.

Q: How long do I have to wait to apply for long-term disability benefits after being diagnosed with depression?

A: The waiting period depends on your insurance provider and the specific policy. Typically, you may need to be off work for several months before you can apply, but it’s important to check your policy for exact timelines.

Q: Can I work while receiving long term disability benefits for depression?

A: Some insurance policies allow for part-time or modified work, depending on your condition and the terms of your coverage. However, others may require you to stop working entirely. Always review your policy and consult your insurance provider to understand what is allowed.

Q: How do I appeal a denial of long term disability benefits for depression?

A: If your claim is denied, carefully read the denial letter to understand the reasons. Gather additional documentation, such as updated medical assessments and evidence of how your symptoms affect your ability to work, and submit an appeal to your insurance provider. You may also consider seeking legal advice to strengthen your case.

Q: What are the options for individuals who are denied long term disability benefits for depression?

A: If you are denied, you can appeal the decision, seek legal assistance, or explore other sources of financial assistance such as provincial disability programs or Employment Insurance sickness benefits. It’s important to review all available programs and determine which options best fit your financial and medical needs.

Why Legal Assistance Matters

When you are suffering from depression and your claim is denied, you can feel overwhelmed by the decision. Disability claim denials take a significant financial and emotional toll. Dealing with the insurer can feel like an impossible task. We can take over that process, give you peace of mind and allow you to focus on your treatment and recover.

Our experienced disability lawyers are practical and know how to approach the legal process efficiently. We are a firm of six women who dedicate our practices to litigating cases for injured and disabled plaintiffs. We have four senior lawyers who have 20 to 30 years of experience representing clients and two bright, hard working and committed young lawyers who handle their own files and support the more senior lawyers when necessary.

Reach out to us today to schedule a free consultation and determine if we are the right law firm for you.