When you’re too sick or injured to work, short-term disability (STD) benefits are supposed to protect your income. Yet many employees in Ontario and across Canada are shocked when their employer or insurance company denies their STD claim, often without a clear explanation. Can an employer actually deny STD benefits? When is a denial legitimate and when is it unfair, improper, or even a violation of your rights?
This guide explains when an employer or insurer can deny your STD claim, what medical information you must provide, how to appeal the decision, and when you should speak to an employment or disability lawyer. If your STD claim has been denied or your employer is pressuring you to return to work too soon, you don’t have to accept it. You have legal options.
What is short term disability?
Short-term disability (STD) insurance provides a weekly benefit that is intended to replace part of your income when you cannot work due to a non-work-related illness, injury, or medical condition. It is meant for conditions expected to improve so that you can return to work after a limited period, as opposed to permanent or long-lasting disabilities.
Can My Employer Deny My Short-Term Disability Claim?
Yes, but only in specific circumstances, and no, they cannot deny it arbitrarily or as punishment for taking medical leave.
In general, your STD claim can only be denied if:
- Your medical documentation does not support functional limitations
- You did not submit required forms (employee, employer, medical)
- Your doctor’s note is unclear or inconsistent
- Your employer or insurer believes you can still perform essential job duties
- They require additional medical information that was not provided
Your employer cannot deny STD benefits simply because they:
- Don’t like the reason you’re off
- Want you back sooner
- Think you are “faking it”
- Have trouble getting information from your doctor
- Claim they “didn’t receive” updates while your claim is still under medical review
These issues often lead to improper denials, not legitimate ones.
What do I need to provide to get approved for STD?
To get approved for STD, your claim usually has three parts:
- An Employee Statement
This outlines details about your job, when and why you stopped working, and how your condition limits your job duties
- An Attending Physician’s Statement.
Your doctor provides a medical certificate that should describe:
- Your diagnosis or general medical condition
- Functional limitations – what you can and cannot do
- Expected recovery time – how long you will need before returning to work
- Recommended treatment
- Employer Statement
Your employer confirms your job duties, hours, salary and last day worked.
Who actually decides my STD claim?
- If your STD is an insured group plan (Manulife, Sulife, Canada Life)
The insurance company decides your claim. They receives the forms, reviews the medical and employment information, and makes the approval or denial decision.
- If your STD is a self‑insured or salary‑continuance plan
Your employer (often through an internal disability management team) decides on your claim.
Either way, you still require medical documentation from your doctor to support your claim.
What If My Employer Denies My STD Claim?
If your employer’s internal disability management team denies your claim, your options are:
- Internal Appeal
- You have the right to appeal the denial.
- An appeal is done through the internal appeals process.
- The details of what to provide for the appeal are often included on the denial letter.
- Legal Action
You have the right to challenge an improper STD denial.
An employment and disability lawyer can:
- Review the denial
- Requires the claim file
- Communicate with the employer or insurer
- Ensure you rights under the Ontario Human Rights Code and Employment Standards Act are protected
- Pursue compensation or reinstatement of benefits
An employer can deny STD benefits, but only if you’re self-insured or it’s a salary continuation plan and there is a valid medical or administrative reason. They cannot deny your STC claim because they disagree with your leave or fail to request documentation properly. Whether your claim is handled by an insurer or by your employer’s disability team, you are entitled to a fair review, medical privacy, and protection from discrimination.
If your STD claim has been denied, the disability lawyers at Whitten & Lublin can review your denial, explain your rights, and fight to get your benefits approved.
Book a free STD consultation today at 416-640-2667 or contact us online.
Author – Aman Chaggar
Can my employer deny my short-term disability (STD) claim in Canada?
Yes, but only if your plan is self-insured or part of a salary continuation plan. Moreover, there needs to be insufficient medical evidence, missing forms, or a legitimate reason supported by the plan’s requirements. An employer cannot deny STD benefits for retaliatory reasons, to pressure you back to work, or because they disagree with your doctor.
What medical information do I need for my STD claim?
You typically need:
- An employee statement explaining why you stopped working
- An attending physician’s statement describing your diagnosis, functional limitations, and recovery timeline
- An employer statement confirming your job duties and last day worked
Strong, clear medical evidence is critical for approval.
Who decides my STD claim – my employer or my insurance company?
It depends on the plan:
- STD plans insured through work benefits: The insurance company (e.g., Manulife, Sun Life, Canada Life) makes the decision.
- Self-insured or salary continuance plans: Your employer decides, often through an internal disability management team.
What can I do if my employer or insurer denies my STD claim?
You can:
- Submit an internal appeal with updated medical information, getting your doctor to clarify limitations or provide specialist reports
- Hire a disability lawyer to challenge an improper or unfair denial
A lawyer can obtain your claim file, communicate with the insurer, and pursue benefits or compensation.
Can I report my employer for wrongfully denying STD benefits?
Yes. You may have grounds to file a human rights claim, reprisal complaint, or constructive dismissal case if your employer:
- Interferes with your claim
- Fails to accommodate your medical restrictions
- Labels your leave as job abandonment
- Uses medical leave as a reason to discipline or terminate you
Can my employer fire me while I’m on STD?
They cannot terminate you simply because you are on medical leave. Employment laws and human rights protections require employers to accommodate disabilities and hold your position unless there is a legitimate reason unrelated to your disability.
Do I need a lawyer to appeal an STD denial?
You are not required to hire a lawyer, but disability denials are complex. A lawyer can:
- Strengthen medical documentation
- Communicate with the insurer or employer
- Identify human rights or wrongful dismissal issues
- Pursue the maximum compensation available
