Ontario legal information · Ottawa and Eastern Ontario
Different denial reasons require different proof.
A disability dispute needs medical restrictions and job demands. A calculation dispute needs payroll, tax and employment records. A coverage dispute needs declarations and elections.2
A return-to-work attempt should be documented in context: hours, accommodation, performance, flare, attendance and why it succeeded or ended.
Classify the insurer’s position.
Disability
Does the insurer say the person can perform the required work?
Eligibility or coverage
Does it dispute employment history or purchased benefit status?
Calculation
Does it dispute earnings, deductions, collateral benefits or amount?
Build the response around the stated issue.
Keep the complete reasons, date and review information.
Use actual duties, hours, travel, pace and safety.
Connect restrictions to those demands.
Reconcile employer, payroll, tax and self-employment records.
A request for reconsideration may not pause the LAT deadline.
Calendar the dispute date from the insurer’s complete notice and verify the applicable statutory period.3
Continue documenting work capacity and earnings while the dispute proceeds.
How a personal injury lawyer may help with accident benefits.
A useful review should reduce the file to a defined benefit, disputed period, governing test and evidence problem—then explain the available response in plain language.
- Classify the denial reason
- Apply the correct disability test
- Reconcile earnings and collateral benefits
- Prepare negotiation or LAT evidence
Not every file requires every step or legal representation. The work should respond to the actual dispute, evidence gap or decision that is approaching.
Sources and legal references
These official sources provide the legal and procedural foundation for this page. Their current wording and the facts of the claim control.
View 5 sources
- Ontario — Statutory Accident Benefits Schedule
The current regulation governing Ontario automobile accident benefits.
Back to footnote ↑ - Tribunals Ontario — LAT-AABS
The official service for disputes about statutory automobile accident benefits.
Back to footnote ↑ - FSRA — July 1, 2026 accident-benefit changes
The current mandatory and optional accident-benefit framework.
Back to footnote ↑ - FSRA — OCF-2 Employer's Confirmation Form
The current approved employer form, updated July 1, 2026.
- FSRA — OCF-3 Disability Certificate
The current approved disability certificate.