Steps for Appealing a Denial of Long-Term Disability Insurance


Giving up following the denial of your long-term disability (LTD) claim would be a grave mistake. You should know that the majority of LTD claims that ultimately succeed were turned down initially; in fact, most insurance companies do not accept any claim at the initial level, irrespective of their merit. You should, therefore, expect some resistance and if you receive an initial denial, handle the matter with patience and perseverance. More importantly, engage the services of a reputable and experienced disability lawyer to significantly enhance your chances of a successful appeal.

The initial steps of appealing a denial consist of the following:

Getting a Copy of the Policy

Obtaining a replica of the LTD policy plan document is an important initial step towards appealing a denial. You will also want to get a copy of the summary plan description. All these documents should be available at your company’s human resource department, which is especially true if your employer offers group insurance. You could also get a copy directly from the disability insurance company.

Getting a copy of the policy is often not straightforward; sometimes your disabilities insurer or HR department could refuse to provide you with the plan documents. It is imperative that you make your request in writing, in which case the plan administrator at your insurance company will be compelled by ERISA federal law to provide them to you. Just like any other correspondence with your insurance company, requests for plan documents ought to be sent through certified mail, with requested return receipt.

Studying the Denial Letter

A careful review of the denial letter after receiving it from your insurance company is recommended. This will allow you to identify the reasons for the refusal of your initial claim while noting what other information might be required to approve your appeal. Moreover, studying your denial letter will give you some insight pertaining to how and when you should file your appeal. Since missing a deadline could be detrimental to an otherwise worthy claim, ensure to mark any deadlines on your calendar. Check out the website to learn more information with their online resources.

If you have a disability or chronic pain that prevents you from obtaining full-time employment, you could be eligible for long-term disability benefits. Hiring an attorney to handle your LTD case will not only expedite the process, but it will also enhance your chances of victory. You must, however, ensure to do it as soon as possible as opposed to waiting until you receive your denial letter before rushing to hire an attorney. Also, ensure that your prospective lawyer specializes in ERISA law to get exceptional assistance with collecting medical evidence and soliciting opinions from vocational experts or your doctor.

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