Change of Definition in Nova Scotia LTD Claims

September 3, 2025

When you’re receiving long term disability benefits, few things are as nerve-wracking as a notice from your insurance company saying your claim is under review for a change of definition. This is the moment when your long term disability claim faces one of its biggest tests. If you live in Nova Scotia, understanding what happens next can help you protect your rights and keep the benefits you rely on.

This guide walks you through the process, explains how independent medical examinations work, and shows why working with an experienced disability lawyer can make all the difference.

Approaching Change of Definition: What Happens After Two Years?

In most long term disability policies, the first two years are called the own occupation period. During this time, the definition refers to whether your medical condition prevents you from performing the essential duties of your specific job.

After this period, the insurance provider applies a different occupation test. To dive deeper into the difference between “own occupation” and “total disability,” visit Own Occupation vs Any Occupation or Total Disability Benefits: Key Differences.

They look at whether you are totally disabled from performing any occupation for which your education, training, and experience reasonably suit you. If they decide you can work in another job, your LTD insurer might cut off your benefits.

This is why the months leading up to the change of definition matter so much. It’s the qualifying period when medical assessments, updated medical records, and other evidence become crucial.

Understanding the Role of an Independent Medical Examination

The insurance company often requests an independent medical examination (IME) during this stage. Although it’s called “independent,” the doctor is chosen and paid by the insurance provider. Their goal is to assess your current abilities, review your medical records, and provide an opinion that could influence whether you still qualify for benefits.

Generally speaking, the IME looks at:

• Your functional abilities and limitations
• The severity of your illness or injury
• Whether your disability prevents you from performing a specific job or other occupations
• Any transferable skills that could allow you to work elsewhere

How Independent Medical Examination (IME) Results Affect LTD Benefits

The assessment results can be a turning point in your claim. If the doctor concludes that you can perform other work, your benefits may be at risk. If the report supports your case, it can strengthen your position with the LTD insurer.

Not all policies require you to attend an IME, but most policies include a clause allowing the insurer to request one. If you refuse without a valid reason, your benefits could be suspended.

Because the stakes are high, it’s in your best interests to prepare carefully. Bring all relevant medical evidence, including recent medical documentation, and be ready to explain how your condition affects your daily life.

The Definition of Total Disability

In long-term disability LTD claims, “totally disabled” doesn’t necessarily mean you can’t work at all. The policy’s definition matters. In the own occupation period, it’s tied to your ability to perform your specific job. After the change of definition, it shifts to whether you can do any occupation that fits your background and skills.

This definition clause is central to every long term disability policy. Knowing exactly how it’s worded gives you a better understanding of your legal options if the insurance company denies your claim. You can learn more about common denial reasons in our article: Possible Reasons Your Long-Term Disability Claim May Be Denied in Nova Scotia.

Why Disability Law Firms Focus on Accurate Definitions

An experienced disability lawyer spends time dissecting your disability policy to see how the occupation definition applies to you. They compare it with your medical condition, the essential duties of your previous role, and the results of any transferable skills analysis.

They also know that not all policies are written the same way. Some definitions are broader, others narrower. This difference can determine whether you still qualify for benefits after the first two years.

Own Occupation and Disability Claim

During the first two years, your LTD claim revolves around proving that your medical condition makes you unable to do your occupation. This usually requires:

1. Detailed medical records from your treating physicians
2. Functional capacity evaluations
3. A clear explanation of your job duties and how your disability prevents you from meeting them

If your insurance provider questions your claim, they might ask for an IME to get their own understanding of your limitations. This is why it’s important to be prepared and consistent when describing your symptoms and restrictions.

Any Occupation and Disability Benefits

Once you enter the any occupation stage, the insurer will look at whether you can work in other jobs. They might commission a vocational capacity evaluation to determine if there are other occupations that you could pursue with your education and training.

For example, if you were a construction foreman but can no longer handle physical labour, they may argue that you could work in an office-based role. The problem is that the law requires the other job to be reasonably suited to you, not just any job you could technically perform.

What Happens in the Months Leading to the Change of Definition Date

The months before your change of definition date are critical. Your LTD insurer might:

• Request updated medical records
• Schedule medical assessments or an IME
• Send questionnaires about your daily activities
• Begin reviewing whether another occupation could replace your pre disability earnings

If you notice this activity, it’s a sign your claim is under scrutiny. This is the time to work closely with your lawyer and ensure your evidence is strong.

The Importance of Keeping Medical and Legal Documentation

Keeping organized medical records and correspondence with your insurance company is essential. This includes:

• All diagnostic reports and test results
• Notes from specialists and therapists
• Copies of every letter from your LTD insurer
• The full text of your disability policy

These documents help your lawyer determine whether the insurance company is acting within the policy’s definition and whether you have grounds for legal action if they deny your claim.

Can My Disability Benefits Be Cut Off After Two Years?

Yes. If the insurance company determines you can work in another occupation, your benefits can stop at the change of definition. As explained, this decision often hinges on the IME report and whether the insurer believes you can perform the core job tasks of another job.

However, you have legal options. You can appeal internally, provide additional medical evidence, or take legal action with the help of injury lawyers who understand long term disability policies in Nova Scotia.

Denied at Change of Definition LTD in Nova Scotia? Our Disability Lawyer Will Help You Win Your Disability Case

If your insurance company denies your claim after the definition changes, don’t assume it’s the end. Many claims are wrongly rejected at this stage. An experienced disability lawyer can challenge the insurer’s decision, negotiate on your behalf, and, if needed, file a lawsuit to protect your rights.

At Preszler Injury Lawyers, we’ve helped many Nova Scotians fight unfair denials. Whether facing an aggressive LTD insurer, conflicting medical evidence, or misapplied occupation definitions, we’re here to protect you. Call us to review your claim, discuss your policy, and plan your next steps.