Six months into 2026, the disability claims landscape in Canada looks different than it did at the start of the year.
Look at four trends we are seeing across the IME, MCR, and FCE volume coming through SOMA's national practice - and what each means for the second half.
What is changing is the proportion of long-duration mental health files where substance use is also part of the clinical picture. In the files crossing our desks in H1 2026, the most consistent pattern is the gradual layering of substance use onto an initially mental-health-only file.
The operational consequence: long-duration mental health files are increasingly two-condition files by the time they reach plateau. RTW planning built on the original single-condition picture is unlikely to succeed. We expect this pattern to accelerate in H2.
Pre-existing condition questions are appearing earlier in the file lifecycle, more aggressively, and more often as the central point of dispute. Some of this is rational claims management. Some reflects the growing complexity of medical histories in an aging workforce.
For H2, this puts new pressure on the assessment process. Pre-existing contribution is fundamentally a clinical question - one that requires careful methodology and a willingness to engage with genuine complexity rather than defaulting to either-or answers.
A pattern we are hearing consistently: the file is medically stable, treating providers have plateaued, and yet no one can describe with confidence what the claimant can actually do at work.
This is the gap between diagnostic and functional clarity. It is widest in mental health and chronic pain files, but it is appearing across the IME spectrum. For H2, the teams that resolve this gap earlier — through structured functional assessment alongside the medical picture - will operate with significantly better outcomes.
In contested files, defensibility - the clarity, structure, and evidentiary rigour of the medical assessment - has become the most consistent predictor of outcome. Adjudicators, tribunals, and courts are reading IME reports more carefully, more comparatively, and with more skepticism of opinion-led conclusions.
For H2, this pattern will deepen. Reports that document methodology, separate diagnostic and functional analysis, address comorbidities directly, and are written for the audience that needs to act on them will outperform reports that rely on clinical reputation or assertion alone.
SOMA's national practice has been structured around exactly these trends. Our IME, MCR, FCE, and specialised substance use and cannabis assessment services are built to provide defensible, functionally-grounded, and clinically rigorous evidence on the files where the medical picture is most complex.
Our Enhanced Medical Consultant Review Service, launched in early 2026, was specifically designed to address the specialist capacity bottleneck. Turnaround is within five business days, and our national specialist roster spans the high-demand disciplines where wait times are longest.
If you would like to discuss what these trends mean for your H2 priorities, or for files on your team's desk right now, reach out at referrals@somamedical.com.