Long-Term Disability Denial
Your long-term disability insurance benefits should provide you with compensation if you can’t work because of an illness or injury. However, unfair denials are common, leaving many policyholders and their families struggling to get by. An experienced lawyer can challenge a wrongful long-term disability denial and fight for the money you deserve. Get legal help now.
Why Take Legal Action?
By challenging a wrongful disability insurance denial, you can pursue the benefits and justice you deserve.
Results Secured
- $1.36 million for a New York man whose Aetna long-term disability claim and appeal were denied
- $1.21 million for a California worker denied disability benefits
- $975,000 for a physician who lost his hearing and was denied long-term disability benefits by Unum
Denied Long-Term Disability Insurance Coverage
Disability insurance denials often stem from insufficient medical evidence, problems with your application, or not meeting the specific criteria outlined in your insurance policy.
In some cases, insurance companies may even deny valid claims to avoid paying benefits and boost their profits.
1 in 4 Americans will become disabled before age 65, yet the majority of long-term disability claims are denied.
Whatever the reason, receiving a long-term disability (LTD) denial can be frustrating, especially when your injury or illness prevents you from working and getting a paycheck. A long-term disability appeal is a way to seek the compensation you’re owed.
Approved LTD claims lead to monthly benefits until you recover from your disability or reach a specific age. You’ve paid for these benefits and deserve to use them.
If you’re facing a long-term disability denial, LawFirm.com may be able to help you fight back. Get started right now with a free case review.
Appealing a Long-Term Disability Claim Denial
The best way to appeal a long-term disability claim denial is to work with an experienced LTD lawyer. These legal professionals have the skills, knowledge, and resources to take on powerful insurance companies and reach a favorable outcome.
A long-term disability appeal lawyer can:
- Help you understand your disability insurance policy
- Figure out why your LTD claim was denied
- Collect evidence to prove you meet long-term disability qualifications
- Communicate with your insurance company on your behalf
- Work to secure compensation as quickly as possible
Your lawyer will handle all of the paperwork involved in a long-term disability appeal, so you can focus on your health.
LawFirm.com works with a network of long-term disability attorneys who’ve secured over $130 million for clients wrongfully denied LTD benefits.
Call (888) 726-9160 right now or chat with our team to see if one of our trusted legal partners may be able to help you, too.
Long-Term Disability Denial Settlements
If a company continues to wrongfully deny your LTD benefits, a lawyer may be able to file a lawsuit and fight for compensation on your behalf.
Settlements for long-term disability denials can provide individuals and their families with the financial relief they need during this challenging time.
Long-term disability denial settlements secured by our legal partners include:
- $1.36 million to a New York client with chronic fatigue syndrome and fibromyalgia
- $800,000 in California for a denied Unum long-term disability claim
- $450,000 for an Alabama client who was denied disability benefits
- $400,000 in Ohio for a long-term disability insurance denial
- $395,000 for a denied long-term disability claim in Georgia
- $1.15 million to a California woman with a denied disability insurance claim
“Now, I have the support and financial security I need to focus on my health and well-being. I’m grateful for the law firm’s help and would recommend them to anyone facing a similar struggle.”
– An engineer with a claim denial who worked with one of our partner firms
Settlement amounts may vary based on your occupation, duration of disability, earning capacity, and other factors. Regardless of the facts of your case, a long-term disability denial lawyer will fight to secure as much money as possible on your behalf.
Get a free, no-obligation case review now to see if you may be able to pursue a long-term disability denial settlement.
Deadline for a Long-Term Disability Appeal
You only have a limited amount of time to appeal a long-term disability denial. Missing a deadline can be a critical mistake that can cause you to forfeit your right to appeal.
The deadline to appeal a long-term disability denial should be noted in the denial of claim letter sent by your insurer.
A federal law called ERISA (the Employee Retirement Income Security Act of 1974) typically gives claimants 180 days from the date they received a written denial letter to file a long-term disability appeal.
While most individual policies follow ERISA law, others may not. To ensure that you don’t miss the cut-off in your case, it’s important to contact an LTD lawyer as soon as possible.
An attorney can explain the timeframe that applies to you and act quickly to ensure your long-term disability appeal is filed in time.
Companies Known for Long-Term Disability Insurance Denial
Many long-term disability insurance companies are known for denying valid claims and depriving policyholders of the benefits they’re entitled to.
Insurance companies with high LTD denial rates include:
- Aetna
- Allstate
- Anthem
- Cigna
- Disability Management Services
- Guardian Life
- The Hartford
- Liberty Mutual
- Lincoln Financial
- Lloyd’s of London
- MetLife
- Northwestern Mutual
- Prudential
- The Standard
- State Farm
- Sun Life
- UnitedHealthcare
- Unum
This is not a complete list — other long-term disability insurance companies have a history of wrongfully denying claims. If you’re facing a long-term disability denial, an ERISA lawyer can fight for the benefits you’re owed, regardless of your insurance carrier.
Occupations Affected by Denied Long-Term Disability Coverage
Long-term disability denials impact workers across all industries, meaning anyone who pays premiums for an LTD insurance policy and has to file a claim may be affected.
Workers impacted by denied long-term disability coverage may include:
- Cashiers and stockers
- Construction workers
- Doctors, nurses, dentists, dental hygienists, and other medical professionals
- Government employees
- Hairdressers, barbers, and cosmetologists
- Immunocompromised workers unable to work due to illness or health issues
- Mechanics
- Office workers
- Professional athletes or musicians
- People who had COVID-19 and experienced long-haul symptoms
- Restaurant workers and bartenders
- School teachers and professors
- Truck drivers
This is only a partial list. LawFirm.com works with lawyers who may be able to help anyone facing a long-term disability denial, no matter their occupation.
Find out if one of our legal partners may be able to fight for compensation on your behalf during a free case review.
The Long-Term Disability Appeal Process
LTD denial lawyers strive to make the long-term disability appeal process as easy and stress-free as possible. No matter where you are in the appeal process, they can jump in and handle all communications and paperwork going forward.
Here’s how to appeal a long-term disability denial with the help of a lawyer:
- Get a free case review to see if you may be able to work with an LTD denial attorney.
- Your lawyer can gather evidence, like your medical records and letters from your treating physicians, to prove you’re entitled to benefits.
- This information will be used to file an appeal with your insurance company to convince them to reverse their decision or a second appeal if your first one was rejected.
- If the insurer still won’t pay the benefits you’re owed, your attorney may file a complaint with your state’s Insurance Department.
- Depending on your insurance plan and the facts of your case, you may be able to file a long-term disability denied lawsuit against the insurance company.
Your attorney will create a legal strategy with the goal of securing the compensation you deserve.
You may be entitled to additional compensation if the insurance company acted in bad faith by deliberately or unreasonably denying your long-term disability claim.
Why Hire a Long-Term Disability Law Firm?
Enlisting the expertise of a reputable long-term disability law firm can significantly improve your chances of success, especially when you’re ill or injured and need to focus on your health.
Reasons to hire a long-term disability law firm include:
- Avoid mistakes: Insurance documents are written to be confusing. A long-term disability denial lawyer can read your claim file, take action to protect your legal rights, and ensure that all policy requirements and deadlines are met.
- Even the playing field: Long-term disability law firms have access to vocational experts and other resources they can use to go head-to-head with powerful insurance companies.
- Free up your time: Filing a long-term disability appeal can be overwhelming and time-consuming. With a top law firm handling all aspects of an appeal on your behalf, you’ll have time to dedicate to your health.
A successful appeal can be a lifeline for you and your family, ensuring you receive the financial support you need. You don’t have to face the appeals process alone.
LawFirm.com works with long-term disability law firms that have secured over $130 million for claimants across the country. See if one of our legal partners may be able to help you during a free case review.
8 Common Reasons for a Long-Term Disability Denial Appeal
Insurance companies deny LTD benefits claims for many reasons. The top 8 reasons for disability denial are listed below.
- Adjuster mistakes: An insurance adjuster may be overwhelmed with claims or fail to review all of your documentation, leading to denied long-term disability insurance coverage.
- Independent medical exam results: An insurer may require you to get an independent medical exam (IME) by a non-treating health care provider. IMEs are known to be biased since insurers often pick doctors who have supported their decisions in the past.
- Insurance investigation findings: When an insurance company investigates your disability claim, they may use intrusive tactics, like performing video surveillance or analyzing your social media accounts, to find a reason to deny LTD policy benefits.
- Invisible health conditions: Insurance companies require concrete evidence about a disability and may deny claims when this information is lacking. Conditions like chronic fatigue syndrome, fibromyalgia, and migraines are often difficult to prove.
- Lack of documentation: An insurance carrier may deny your claim if you don’t provide enough evidence about your injury or illness. However, an insurer that demands an unreasonable amount of documentation may be acting in bad faith.
- Non-covered health condition: Each insurer has its own definition of a qualifying health condition. You may receive a denial of long-term disability if your condition doesn’t meet the policy’s definition of disability.
- Not filing your claim on time: Injuries and illnesses can make it harder to meet deadlines, especially if you’re hospitalized or bedridden. However, if you don’t file your claim on time, your insurance provider will reject it.
- Pre-existing health conditions: If you had a health condition, received treatment for it, or consulted a doctor before your long-term disability policy took effect, you may be facing a denial for a pre-existing condition.
Insurance companies have policies and procedures that are designed to minimize valid long-term disability claims and protect their profits.
An experienced disability lawyer can review the reason for your claim denial and take action to secure the results you deserve.
Get Help Appealing a Long-Term Disability Denial
LawFirm.com understands the stress and uncertainty related to long-term disability denials. Having someone on your side who can fight powerful insurance companies to get you the money you’re owed is crucial.
We’ve partnered with experienced disability lawyers who:
- Can help clients in all 50 states
- Handle all of the paperwork related to a long-term disability appeal
- Have secured over $130 million for victims of disability denials
- Never charge any upfront or hourly fees
Call (888) 726-9160 right now or fill in our contact form to see if they can fight hard for everything you deserve.
Long-Term Disability Denied FAQs
Why would long-term disability be denied?
Possible reasons for a long-term disability denial include:
- A claim filed after the deadline
- An error by the insurance adjuster
- Disputed findings during an independent medical exam
- Insufficient documentation
- Pre-existing disability exclusions
If you’re facing a long-term disability denial, contact an experienced attorney as soon as possible. They may be able to file an LTD appeal on your behalf and fight for the money you’re entitled to.
What happens if long-term disability is denied?
If your long-term disability (LTD) claim is denied, you can appeal your insurance company’s decision.
In the event of a wrongful claim denial, a disability denial lawyer may be able to file an appeal on your behalf or take legal action to secure the benefits you’re owed.
Call (888) 726-9160 now to see if we may be able to connect you with a top LTD lawyer near you.
What percentage of long-term disability claims are denied?
Over 60% of long-term disability insurance claims are denied for various reasons, including insurance adjuster mistakes, missing deadlines, and insufficient documentation.
An experienced long-term disability lawyer can evaluate your case and improve your chances of a successful long-term disability appeal.
Why is it so hard to get long-term disability?
Insurance companies purposefully make it difficult to get long-term disability benefits in order to boost their bottom line. They do this by making policy documents hard to read, rejecting valid claims, and using other tactics.
What should you not do in a long-term disability interview?
During a long-term disability interview, you should avoid falsifying information or minimizing the impact of your disability. Instead, be honest and explain how the condition affects your life.
The insurance company investigator may try to trip you up, so it’s always best to attend a long-term disability interview with an experienced lawyer by your side. An attorney can help you prepare, redirect the interviewer, and advocate for your legal rights.
Get a free case review to see if you may be able to work with one of our trusted legal partners.
How do I write an appeal letter for a long-term disability denial?
To write an appeal letter for a long-term denial, you must include the following:
- Contact information for you, your treating physician, and others who can validate your disability
- The insurer’s reason for denial
- New evidence supporting your medical condition
- Policy language that supports your disability claim
- Why you believe your disability claim is covered
A top-rated lawyer can help you write a strong appeal letter for your long-term disability denial claim.
Fact-Checked and Legally Reviewed by: Rae Theodore
Rae Theodore is a writer and editor with more than 30 years of experience in legal publishing. She earned a bachelor’s degree in English from Pennsylvania State University.
- HealthCare.gov. (n.d.). “Grandfathered health plan.” Retrieved August 13, 2024, from https://www.healthcare.gov/glossary/grandfathered-health-plan/
- Mayo Clinic. (2021, October 26). “Fibromyalgia.” Retrieved August 13, 2024, from https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780
- Nelson, Luke (2023). “Denying the disability: The phrase ‘Regular Occupation’ in long-term disability benefit plans.” Penn State Law Review: Vol. 127: Iss. 3, Article 6. Retrieved August 13, 2024, from https://elibrary.law.psu.edu/pslr/vol127/iss3/6
- Social Security. (n.d.). “How you qualify.” Retrieved August 13, 2024, from https://www.ssa.gov/benefits/disability/qualify.html
- Sokolove Law. (2024, August 1). “Long-term disability denial.” Retrieved August 13, 2024, from https://www.sokolovelaw.com/disability-insurance-denial/long-term-disability-denial/
- U.S. Department of Labor. (n.d.). “Disability insurance denial.” Retrieved August 13, 2024, from https://www.dol.gov/general/topic/safety-health/disabilityins
- Wisconsin.Gov: Department of Workforce Development. (n.d.) “Independent medical examination.” Retrieved August 13, 2024, from https://dwd.wisconsin.gov/wc/medical/ime.htm#