Fighting a long-term disability claim denial

Suffering from a long-term disability (LTD) means you already have enough to deal with. You do not want to add fighting with an insurance company to the list. All too often, insurance companies try to avoid paying for coverage. That could leave you vulnerable both physically and financially.

There are actions you can take to fight for LTD coverage. Most insurance policies allow for one or two levels of appeals, after their claim denial. These appeals go to different departments than your original claim, so these may prove successful. If you are on an employee plan, you have to go through the appeals process before you can take steps toward filing a lawsuit.

Before you appeal

Thoroughly read your denial letter. You want to make sure you understand exactly why the insurance company denied your claim. If the letter states you are missing documentation of your condition, you may want to seek out medical records or perhaps have a doctor complete more tests.

This letter will also detail deadlines for response and any requests for specific paperwork. Make sure you meet all deadlines and provide the documentation requested. You do not want an appeal denied because you missed a deadline. You can also ask for a copy of the claim file from your insurance company. This may help you better understand how to respond.

Provide absolutely everything that supports your claim

If you end up filing a federal lawsuit later, you want to have accumulated all possible evidence in your favor during the appeals process. Employer LTD insurance usually falls under ERISA, or the Employee Retirement Income Security Act. With ERISA, when the insurance company denies all appeals, you cannot introduce any new evidence because the record is closed. That means the only evidence you can introduce in your lawsuit is the evidence you presented while you were appealing to the insurance company.

That is why it is so crucial you provide a thorough and comprehensive defense of your claim. Other than medical records, you may want to contact a doctor who will write an opinion about your diagnosis. You want to find any possible way to document your disability. Some experts even suggest keeping a journal to document how your condition and how it affects your life.

Sometimes contacting an attorney earlier on in the process is beneficial. They can help you accumulate evidence and walk you through the appeals process. Additionally, if you are already dealing with a serious disability, you may not be physically able to provide the rigorous defense you deserve. Asking for help is okay.

No Comments

Leave a comment
Comment Information
Email Our Attorneys

Our Insurance Lawyers Can Help

Bold labels are required.

Contact Information
disclaimer.

The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

close

Privacy Policy

  • American Board of Trial Advocates
    American Board of Trial Advocates A prestigious national association of experienced trial lawyers and judges. Membership is by exclusive invitation only. All members shall have completed 10 civil jury trials to jury verdict or hung jury as lead counsel.
  • Best Lawyers
    Best Lawyers The oldest and most respected peer-review publication in the legal profession. A listing in Best Lawyers is widely regarded by both clients and legal professionals as a significant honor, conferred on a lawyer by his or her peers.
  • AV | PeerReviewRated | Martindale-Hubbell | For Ethical Standards and Legal Ability
    Martindale-Hubbell Peer Review Ratings An objective peer review rating indicator of a lawyer's high ethical standards and professional ability, generated from evaluations of lawyers by other members of the bar and the judiciary. Pillsbury & Coleman founding partner Philip L. Pillsbury Jr. is rated “AV Preeminent.”
  • Super Lawyers
    Super Lawyers A peer-review rating service of outstanding lawyers from more than 70 practice areas who have attained a high-degree of peer recognition and professional achievement.
  • Best Lawyers | Best Law Firms | U.S.News & World Report | 2018
    Best Lawyers Best Law Firms U.S. News 2017
  • American Association for Justice | Formerly the Association of Trial Lawyers of America (ATLA)
    American Association for Justice (AAJ) Founded in 1946, AAJ is the world’s largest trial bar and supports the work of attorneys to ensure that injured plaintiffs can obtain justice.
  • American College of Coverage Counsel
    American College of Coverage and Extracontractual Counsel Composed of preeminent insurance coverage counsel in the United States and Canada, representing the interests of both insurers and policyholders. The minimum membership requirement is the practice of insurance law for at least fifteen consecutive years.
  • Association of Business Trial Lawyers | abtl
    Association of Business Trial Lawyers Founded in 1972, ABTL is dedicated to connecting litigators and judges to address issues important to trial lawyers.
  • Consumer Attorneys of California
    Consumer Attorneys of California The only California-wide unified trial bar for plaintiffs lawyers who represent consumers harmed by powerful foes such as insurance companies, pharmaceutical companies, automobile manufacturers and banks.
  • SFTLA | San Francisco Trial Lawyers Association
    San Francisco Trial Lawyers Association For over 60 years, this prestigious bar association has educated and trained trial lawyers and supported and passed critical legislation to protect and advance individuals’ rights.
  • United Policyholders | Empowering the Insured
    United Policyholders A non-profit group dedicated to providing trustworthy and useful information and an effective voice for insurance consumers in all 50 states.
  • America's Top 100 High Stakes Litigators | 2018 | Top 100
    ACCEC | American College of Coverage and Extracontractual Counsel | Fellow