As we tell our clients, we wouldn’t be handling disability insurance claims if the insurance company paid on all of the claims that it should. Many legitimate claims are denied from the outset, and many other claims are terminated too soon.
Many people who go through the process of applying for long term disability insurance benefits will be approved… at first. The real issue is how long the benefits continue. We have many clients where their legitimate LTD claims have been prematurely cut-off.
The chances of getting approved for benefits go up for those who take the time to appeal. If your long-term disability claim has been denied, you should get to understand how the appeals process works, because you only have a small chance of winning disability benefits if you don’t appeal the initial denial and know the steps to take to win the appeal. Learn more about LTD appeals below.
Please note that because every claim is unique, this list of “Do’s and Don’ts” is not an exhaustive list. It is merely to serve as a reminder of the most important things you should and should not do in an appeal.
Unhelpful or inaccurate statements on your application or in your medical records can be harmful to your Long Term Disability Insurance claim.
If you are denied on your LTD benefit claim, you should request an appeal immediately, within the deadline set out in your disability policy or in your denial letter (typically 90 or 180 days).
An LTD denial doesn’t necessarily mean you’re not disabled — look at your denial notice to see the specific rationale for the denial in your individual claim.
A technical denial of Long Term Disability benefits occurs when an applicant does not meet the non-medical requirements to qualify for LTD benefits.
Learn about common reasons cited by insurance companies as to why they are denying long term disability benefits.
The doctrine of “bad faith” only applies to state law claims against an insurance company based on the company’s conduct in handling a claim for individual disability insurance benefits.
The primary reason why benefits are cut off after two years is that under most policies, not every policy, but most policies, there’s a change in the way that they’ve defined the term disability.
Disability Appeals Process: Overview
Most people, when they file an appeal, it’s really basic. We’re talking a one or two paragraph appeal. Now, that is wholly insufficient.
All LTD policies provide for at least one level of administrative appeals. In fact, many have two levels of appeal. Many workers eventually receive their benefits only after winning a claim on appeal from a denial.
There are typically several levels of appeal that are offered to Long Term Disability claimants after a denial or termination of benefits.
Too many claimants make the critical mistake of not even filing an appeal after they’ve been denied their disability benefits or after their benefits have been terminated.
Do I just send the Insurance Company a handwritten letter that I want to appeal the denial of my long-term disability benefits?
Here’s a timeline for how long a long term disability appeal with an insurance company might take.
If your initial application for Long Term disability benefits has been denied or if your benefits have been cut-off too soon, it may be a good time to talk to a lawyer.
These advanced strategies can be expensive and are not used in every case, but can be highly effective in select cases.
If you’re denied Long Term disability insurance benefits by the insurance company, you may be eligible to file a lawsuit in federal court.