What Happens When Your LTD Insurer Applies the “Change of Definition” in Alberta?

Published: November 7, 2024 | Last Reviewed: September 10, 2026

If your long-term disability benefits have been active for a while, you may get a letter from your insurer announcing that your claim is being reassessed under a new definition of disability. This is the “change of definition,” and for a lot of Albertans on LTD, it’s the moment their benefits are put at real risk.

If you’d like to speak to an LTD lawyer, contact us today for a free consultation.

If you’re still researching, then below, we’ll walk through what the switch actually involves, what your insurer owes you during the process, and what steps to take if your benefits are reduced or cut off.

Key Takeaways:

• Many LTD policies change from an “own occupation” definition to an “any occupation” definition after approximately 24 months, although the timing and wording vary by policy.
• LTD benefits do not automatically end when the definition changes. You may continue to qualify if your condition prevents you from performing suitable work under the new definition.
• Insurers may request updated medical records, an independent medical examination, or a vocational assessment before deciding whether benefits should continue.
• “Any occupation” does not necessarily mean any job whatsoever. The proposed work generally needs to be suitable for your education, training, experience, medical restrictions, and the income requirements set out in your policy.
• If your benefits are terminated, do not assume that an internal appeal pauses Alberta’s legal limitation period.

What Is the “Change of Definition” in an LTD Policy?

Most LTD policies use two different tests for disability.

For roughly the first two years of a claim, insurers apply the “own occupation” test. “Can you do the specific job you held before you stopped working?” After that point, most policies switch to the “any occupation” test, which asks whether you’re able to do any job reasonably suited to your training, education, and experience. That switch is the change of definition.

The tests aren’t as simple as they sound, and the gap between them is where a lot of disputes come from. For a full breakdown of how “own occupation” and “any occupation” are actually defined and applied, see our related article on the difference between any occupation and own occupation in Alberta LTD claims.

How Insurers Use the Change of Definition to Cut Off Benefits

The change-of-definition date gives the insurer an opportunity to reassess whether you continue to meet the requirements of the policy under the new, broader test.

The insurer may accept that you cannot return to your previous position but argue that you could perform another role instead. For example, it might agree that a construction worker can no longer complete physically demanding work but conclude that the same person can manage a sedentary position.

That conclusion isn’t automatically correct.

A job that looks suitable on paper may still be incompatible with your actual symptoms, qualifications, or ability to work consistently, and “any occupation” isn’t as unlimited as the name suggests. It’s still bounded by what’s reasonable given your background and, in many policies, a comparable income threshold.

Re-Investigating Your Claim: Medical Records, IME, and Surveillance

As the switch approaches, expect your insurer to reopen your file. That typically means requesting updated medical records or a questionnaire from your treating doctors, having an in-house medical consultant review your file, or ordering an independent medical examination (IME) with a third-party doctor. Some insurers also review social media activity or commission surveillance, looking for anything that could be framed as inconsistent with your reported limitations.

Why the Switch Is a Common Point of Denial

Because “any occupation” is a broader standard, insurers can point to jobs well outside your previous field, provided they’re a reasonable fit for your skills and pay in a similar range to your former income.

A heavy equipment operator, for example, generally can’t be denied on the basis that they could do minimum-wage work, but they could be denied if the insurer identifies a comparably paid role it believes is within reach. This is where insurers most often decide a claim no longer meets the test, even when the claimant’s actual condition hasn’t changed.

What Can I Do If My Insurer Wants to Stop My Benefits?

If your insurer is reviewing your eligibility under the “any occupation” definition, don’t wait for your benefits to be terminated before taking action.

The steps below can help you understand the insurer’s position and protect your claim.

1. Keep all correspondence from your insurer

Save every letter, email, form, and medical request you receive. Make notes of phone conversations too, including the date, the person you spoke with, and what was discussed.

This record can help establish when the change of definition takes effect, what information the insurer requested, which assessments were arranged, whether the insurer raised concerns about your claim, and when and why your benefits were terminated. If an important decision is communicated by phone, ask for written confirmation.

2. Obtain your complete LTD policy

Request the full policy document from your insurer or your employer’s HR/benefits department, not just the summary booklet employees are usually given, which often leaves out the specific language that actually decides these disputes.

The full policy will spell out exactly when the change of definition takes effect, the precise wording used to define “any occupation” for your plan, and whether an alternative occupation needs to meet a particular income threshold (many policies require the alternate job to pay a set percentage of your former income, not just “any job” in the loosest sense).

It will also show whether other benefits, like CPP disability, are meant to offset your LTD payments, and what elimination periods or exclusions might apply. Having this exact wording in hand matters if you ever need to challenge the insurer’s interpretation of what “suitable” work means for your situation.

3. Use the internal appeal process, but know how it works

The insurance company must offer a process to dispute or appeal its findings.

This process is organized internally, meaning rules such as how many times you can appeal, accepted grounds for an appeal, and ultimately whether to reverse its previous denial are largely in the insurer’s control.

Unless there is new and important medical evidence, the appeal process does not usually change an insurance company’s decision, the appeal doesn’t go to a third party, it simply goes back to the insurer to reconsider its own denial. It’s worth speaking with a lawyer before you even start the appeal, since they can help you assess whether an internal appeal is worth pursuing at all or whether it makes more sense to move straight to escalation.

4. Consider hiring a lawyer and filing a lawsuit

This is often a more effective approach than an internal appeal, since it brings the denial before a court instead of back to the insurer.

In Alberta, LTD claims are generally subject to a two-year limitation period.

That clock typically starts running from when you knew, or should have known, that you had a claim worth pursuing, often the denial date, not automatically the date you became disabled. Waiting too long can bar you from taking legal action, so it’s worth confirming your actual deadline with a lawyer rather than assuming a fixed countdown.

If you want to learn more, read our article on the steps you should take specifically after an LTD claim denial.

5. Know that your insurer can’t end your coverage without reasoning or evidence.

Legal advice from a capable professional experienced with long-term disability claims may be useful to find weak points in your insurer’s argument and ways to bolster your own case.

A vague statement that you’re “no longer considered totally disabled” isn’t enough on its own. This is where a lawyer’s review is often most useful: checking whether the insurer’s own evidence actually supports its conclusion, whether it relied on an IME from a doctor outside your area of condition, whether it ignored input from your treating specialists, or whether the “suitable” job it identified is realistic given your restrictions, location, and skills.

We Can Answer Your Questions About Long-Term Disability

Preszler Injury Lawyers serves Albertans across the province. If your change of definition date is approaching, your benefits have been terminated, or you have questions about any part of your LTD policy, we offer a free initial consultation. Call us at 1-888-494-8191 or contact Preszler Injury Lawyers online.

We’re here to help.