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Receiving a long-term disability denial from Great-West Life can be deeply unsettling. Most people apply for long-term disability benefits only after their health has declined to the point where working is no longer sustainable. When Great-West Life denies a claim, it often creates immediate financial pressure and uncertainty at a time when stability is most needed.
What many claimants do not realise is that Great-West Life long-term disability denials are frequently challenged and reversed when approached strategically. However, Great-West Life is a sophisticated insurer with internal medical consultants, vocational specialists, and experienced claims staff. The process is not designed to be claimant-friendly, particularly for individuals dealing with serious illness or injury.
At JEWELL RADIMISIS JORGE LLP, our Toronto long-term disability lawyers have over 100 years of collective experience handling complex long-term disability disputes across Ontario. We regularly represent clients whose Great-West Life claims were denied despite genuine disabilities and strong medical support. This guide explains the steps to take after a denial, while clearly identifying where experienced legal representation becomes essential.
Step 1: Understand That a Great-West Life Denial Is Not a Medical Verdict
A denial from Great-West Life does not mean you are capable of working. It reflects the insurer’s interpretation of your claim based on its internal review process.
Great-West Life denials often rely on:
- Paper-based file reviews rather than in-person assessments
- Narrow interpretations of medical notes
- Emphasis on perceived improvement without context
- Allegations that restrictions are self-reported
- Strict readings of policy definitions
Many claimants mistakenly accept the denial as final. This is often where valuable rights are lost. Early legal advice helps you understand that a denial is the beginning of a dispute, not the end of the claim.
Step 2: Break Down the Denial Letter With Legal Precision
Great-West Life denial letters are carefully drafted to justify the insurer’s position. They often contain selective references to evidence and omit important context.
When reviewing the letter, focus on:
- Whether the denial is based on own occupation or any occupation criteria
- Which medical evidence was relied upon and which was ignored
- Whether functional limitations were properly addressed
- References to vocational opinions or transferable skills
- Any mention of surveillance or credibility concerns
At JEWELL RADIMISIS JORGE LLP, we dissect Great-West Life denial letters to identify flawed reasoning and unsupported assumptions. This analysis shapes the strategy for appeal or litigation.
Step 3: Identify All Deadlines and Protect Them Immediately
Great-West Life policies often include internal appeal deadlines. At the same time, Ontario limitation periods may apply even while an appeal is ongoing.
Key risks include:
- Assuming internal appeals stop legal time limits
- Missing appeal submission deadlines
- Waiting too long to seek legal advice
One of the most common and costly mistakes claimants make is delaying action. Protecting deadlines is one of the most important roles a long-term disability lawyer plays.
Step 4: Obtain the Full Policy and Complete Great-West Life Claim File
You cannot challenge a denial without knowing what Great-West Life relied on. This includes internal materials that are not always shared automatically.
Essential documents include:
- The full long-term disability policy and all amendments
- Internal adjuster notes
- Medical consultant and reviewer reports
- Vocational assessments
- Surveillance reports, if any
- Correspondence with your employer
When we represent clients, we formally request the entire claim file and review it for errors, bias, and omissions that can be challenged effectively.
Step 5: Rebuild the Claim Around Functional Capacity and Sustainability
Great-West Life often denies claims by focusing on diagnosis alone or by suggesting that restrictions are insufficiently documented. Disability under most policies is about function, not labels.
Strong evidence should clearly explain:
- Physical limitations such as sitting, standing, lifting, or repetitive use
- Cognitive limitations including concentration, memory, and processing speed
- Psychological symptoms affecting interaction and reliability
- Fatigue, pain variability, and symptom flare-ups
- The inability to sustain consistent attendance
At JEWELL RADIMISIS JORGE LLP, we work with treating providers to ensure evidence speaks directly to functional limitations and policy requirements.
Step 6: Accurately Document the Real Demands of Your Occupation
Great-West Life often relies on generic job descriptions that do not reflect the true demands of a role. This is especially problematic for professionals and cognitively demanding positions.
Employment evidence should include:
- Actual daily tasks
- Physical and mental demands
- Productivity and pace expectations
- Safety-sensitive responsibilities
- Attendance and reliability requirements
Legal representation helps ensure Great-West Life cannot rely on simplified job descriptions to justify denial.
Step 7: Anticipate Common Great-West Life Denial Strategies
Great-West Life uses consistent tactics across many disability claims. Without experience, claimants often respond in ways that unintentionally strengthen the insurer’s position.
Common tactics include:
- Cherry picking favourable medical comments
- Overreliance on internal medical reviews
- Alleging lack of objective findings
- Questioning treatment compliance
- Suggesting alternate employment without real analysis
Our firm anticipates these strategies and addresses them directly, reducing the insurer’s ability to rely on them to maintain a denial.
Step 8: Prepare a Clear, Structured, and Strategic Appeal
An effective appeal is not simply a bundle of additional records. It is a carefully organised submission that addresses Great-West Life’s reasons for denial point by point.
A strong appeal includes:
- A detailed written submission
- Direct responses to each denial reason
- Updated medical and functional evidence
- Vocational analysis where appropriate
- A clear narrative explaining why work is not sustainable
This is where experienced legal preparation can significantly improve outcomes.
Step 9: Know When Legal Action Must Be Considered
If Great-West Life upholds its denial after appeal, litigation may be necessary. At this stage, strategic legal advice is essential.
Our lawyers can help assess:
- Whether the denial was reasonable
- What further evidence is needed
- Litigation risks and timelines
- Settlement versus trial strategy
With over 100 years of collective experience, JEWELL RADIMISIS JORGE LLP understands how to pursue resolution effectively while protecting clients from unnecessary risk.
Frequently Asked Questions About Great-West Life LTD Denials
Does Great-West Life deny many claims?
Yes. Denials are common, particularly for chronic pain, fatigue-based, and mental health claims.
Can I appeal a Great-West Life denial myself?
You can, but early missteps often weaken claims. Legal guidance helps avoid this.
What if Great-West Life says I can work another job?
This usually relates to any occupation definition and requires vocational and functional evidence.
Does Great-West Life use surveillance?
Yes. Surveillance and social media monitoring are commonly used.
How long do I have to sue Great-West Life?
Limitation periods vary. Legal advice should be obtained promptly.
Why Hiring JEWELL RADIMISIS JORGE LLP Matters After a Great-West Life Denial
Great-West Life is a large insurer with significant resources. Navigating a denial without experienced representation places claimants at a serious disadvantage. At JEWELL RADIMISIS JORGE LLP, we combine over 100 years of collective experience with personalised, client-focused representation. We understand how Great-West Life evaluates claims and how to challenge denials effectively.
If your Great-West Life long-term disability claim has been denied in Toronto or anywhere in Ontario, contact JEWELL RADIMISIS JORGE LLP for a free consultation. We will review your denial, explain your options, and help you take the next step toward the benefits you deserve.