Claims and appeals for long-term disability benefits are not often a straightforward or claimant-friendly process. Aside from ongoing documentation and required attendance at various medical assessments, insurance companies often use unfamiliar terminology which can make the process even more complicated.

Terms and key phrases may vary between insurers. However, it remains important for claimants to be aware of the definitions of specific terminology to understand their claim and appeal process. Part 1 of this glossary previously covered terminology starting with the letters A through M. Part 2 will cover common keywords starting with the N through Z.

Long-Term Disability Phrases and Keywords

The maximum time period, often defined in the Policy, which an insured can receive benefits for. Common benefit periods include age-limited policies, which entitle an insured to benefits up to a specified age and time-limited policies which last for a set time period, such as two years. 

Net Benefit Amount

The monthly benefit payment amount after tax and other applicable deductions have been made.

Maximum Benefit Date

The maximum time period, often defined in the Policy, which an insured can receive benefits for. Common benefit periods include age-limited policies, which entitle an insured to benefits up to a specified age and time-limited policies which last for a set time period, such as two years.


A Policy provision allows an insurer to reduce an insured’s monthly benefit amount based on other sources of income that the insured t is eligible to receive or is receiving. Examples of offsets may include Canada Pension Plan Disability benefits, retirement income, and Workers’ Compensation benefits.


Occurs when an insurer overpays an insured their monthly disability benefit amount. 

Own Occupation Test

Related to the Change of Definition Date. The test of disability often applies during the first two years of a long-term disability claim. To meet the “own occupation” test, an insured must prove that they cannot complete the essential job requirements of their occupation.  

Partial Disability Benefit

A disability benefit paid every month, which is less than a total disability benefit amount, to an insured who is unable to perform one or more important tasks required by their occupation but is not considered disabled as defined in the Policy. 


The written legal agreement or contract between an individual and their insurance company. The Policy outlines the terms, conditions and obligations of both parties. The insurer has a legal obligation to provide an insured with a copy of the Policy.

Policy Holder

An individual who owns an insurance policy.

Pre-Existing Condition

An injury or illness an individual had before being insured or before a new injury or illness occurred. Insurers may deny an insured’s benefits based on a pre-existing condition. If this happens, it is important to speak with a disability lawyer.


Occurs when a claim has previously been approved, but benefits were stopped, and the claim is subsequently approved again with benefits continuing as though the claim had not been closed. 

Recurrent Disability

A Policy provision which may protect an insured who returns to work but becomes disabled again from the same, or related, cause. An insured may not be subject to a new elimination or qualifying period if the recurrent disability occurs within a specified time. 


An extra agreement or contract that expands the terms and conditions of the Policy’s coverage or benefits.

Regular Occupation

The occupation that an insured held at the date the disability became known.

Statutory Limitation Period

A statute prescribed a timeframe in which an insured must commence a lawsuit. Claimants typically have to start a claim two years from the date they were made aware of the loss. For example, an insured may have two years from the date they were advised that their benefits would be denied or terminated. If a claim is made before the end of the Limitation Period, an insured will likely be allowed to commence an action. 

Termination Letter

A letter was issued to an insured who was initially approved to receive benefits but was later deemed not disabled by the insurer. Often, an insured will receive this letter after 24 months from the date of the disability. 

Total Disability 

An insured must meet their Policy’s definition of “totally disabled” and prove that they are unable to work to be eligible to receive long-term disability benefits. This may be applied against both the “own occupation” and “any occupation” tests. 

Transferable Skills Analysis

An assessment is arranged and paid for by an insurer, typically close to the Change of Definition date, to assist the insurer in determining whether an insured may be able to work in other occupations based on their education, skills, training, experience, and considering their limitations and restrictions. 

Waiver of Premium Provision

If an insured’s Policy includes a Waiver of Premium provision for a specific type of insurance and the insured meets the applicable criteria, their premiums for that type of insurance will be waived.

Workplace Accommodation or Modification

Accommodations or modifications are made to assist a disabled individual when they require special equipment or a schedule to return to work. 

Cuming & Gillespie LLP Disability Lawyers in Calgary Guide Clients Through the Long-Term Disability Appeals

At Cuming & Gillespie LLP, our disability lawyers are experienced in helping clients through the long-term disability appeals process. Our lawyers advocate on behalf of injured clients and protect their rights, whether dealing with appeals or lawsuits. Our office is conveniently located in Calgary, and we proudly represent clients throughout Alberta. Contact us online or call our office at 403-571-0555 to schedule a confidential consultation.