Navigating long term disability insurance: Get help filing or appealing a denial

Get help with long term disability insurance

Do you want to file a claim for long term disability benefits? Was your previous LTD claim denied?

Navigating the complex world of long term disability insurance can be overwhelming, especially when you’re already dealing with health challenges. If you’re unable to work due to a disability, you may be entitled to benefits that can provide crucial financial support. 

Unfortunately, the application process can be daunting, and many initial claims are denied. Whether you’re considering filing for long term disability or facing a denied claim, understanding your rights and options is essential. An experienced long term disability attorney may be able to help guide you through the process of applying for benefits and appealing a denial.

What is long term disability insurance?

Long term disability (LTD) insurance is a crucial safety net for workers who become unable to perform their job duties due to illness or injury. This type of coverage provides financial support when disabled workers are unable to earn an income for an extended period.

Key features of LTD insurance

LTD policies typically replace a portion of your income, usually 60-80%, if you’re unable to work for an extended amount of time. The benefit period can range from a few years all the way to retirement age, depending on your policy. It’s important to note that there’s often a waiting period, known as the elimination period, before benefits kick in.

Common misconceptions

Many people confuse LTD insurance with workers’ compensation or Social Security Disability Insurance (SSDI). Unlike workers’ comp, LTD covers disabilities occurring outside of work. And while SSDI is a government program, LTD is private insurance that can provide more comprehensive coverage.

Why LTD insurance matters

For those in physically demanding jobs or industries with higher injury rates, LTD insurance can be a lifeline. It can help maintain financial stability during recovery or in cases of permanent disability. Understanding your policy details, including coverage limits and exclusions, is crucial for maximizing this valuable protection.

How to file a long term disability claim

Filing an LTD claim can be a complex process, but understanding the steps involved can help ensure a smoother experience. A long term disability lawyer is not required to help an individual receive LTD benefits, but these professionals may be able to help you build a strong case and try and secure the benefits you are owed under your policy coverage.

To receive long-term disability benefits, policyholders must go through the following steps:

1. Wait out the elimination period: Most LTD policies have an elimination period, which is a period of time that must pass before you can file a claim. The elimination period starts when an injury occurs or when an illness is diagnosed. These periods will vary by policy and typically range from 30 days to a year, but may be supplemented by short-term disability.
2. File a claim: After waiting out the elimination period, you can file a claim for long term disability benefits. An LTD claim can be an arduous process since claimants need to obtain as much documentation as possible from doctors, other professionals, loved ones and other sources. An experienced LTD attorney may be able to help you collect and organize this information to file a claim.
3. Wait for a decision: After submitting your claim, you will have to wait for the insurer to make a decision. If your insurer deems you eligible for LTD benefits, you will start receiving these benefits. If the insurer deems you ineligible, you may need to take additional steps.
4. File an appeal: If your long term disability claim was denied, you may want to file an appeal. An appeal addresses deficiencies or issues brought up by the insurer and, if successful, can result in benefit payments.
5. File a lawsuit: If your appeal is denied, you aren’t necessarily out of luck. You may be able to take legal action through arbitration or a lawsuit. These actions may be able to help you recover retroactive and future benefits.

Steps to take after a long term disability claim denial

Being denied long term disability benefits can feel overwhelming, but it’s important to remember that this isn’t the final say. Many initial claims are rejected, and you still have the opportunity to appeal. Getting support from an experienced long term disability lawyer may be able to provide valuable help during this process.

Identify the reason for the denial

Start by reviewing the denial letter from your insurance provider carefully. This document should outline the specific reasons for rejecting your claim. Common reasons might include:

• Insufficient medical documentation
• Missed submission deadlines
• Failure to meet the policy’s definition of disability
• Pre-existing conditions exclusions  

Knowing the reason for denial will help guide your next steps and allow you to gather the right evidence for a stronger appeal.

Strengthen your appeal with additional evidence

To improve your chances on appeal, you’ll need to compile additional, targeted evidence such as:

• Comprehensive medical records
• Detailed statements from your doctors
• Functional capacity evaluations
• Expert opinions on vocational limitations  

This new evidence can address any deficiencies in your initial application, filling in gaps that led to the denial.

Submit a persuasive and well-organized LTD appeal

When preparing your appeal, ensure your letter is organized, concise, and addresses each denial reason with solid evidence. Include all supporting documents and explain why the initial denial was wrong. Craft a clear, compelling case to persuade the insurance company to reconsider its decision.

Can an LTD attorney help me with my claim?

Navigating the appeal process can be challenging, so partnering with an experienced long term disability attorney may increase your likelihood of success. An attorney may be able to:

• Clarify the policy language and requirements
• Help gather and organize relevant evidence
• Prepare a thorough appeal package
• Represent you in court, if necessary  

With legal support, you may have a stronger chance of overturning the denial and securing your benefits.

Time is critical when appealing a long-term disability denial, so act quickly to safeguard your rights and the benefits you’re entitled to by contacting a lawyer.

Fill out the form on this page to see if you qualify for a free case evaluation.