What to do If Your Long-Term Disability Claim is Denied

Knowing what to do after your LTD claim has been denied can be confusing. Your denial letter probably told you that you can appeal the decision if you remedy the issues they had with your application. But what if you’ve already given them everything they asked for?

Regardless of the reasons they give you, speak with a long-term disability lawyer as soon as possible. A reputable LTD lawyer will discuss your case with you, look at your documents, give you an honest assessment of how strong a claim you have, and advise you of your best option.

After an LTD denial, you have two options: using the insurance company’s appeal process or filing a claim against them. Keep reading to learn about each.

The Insurance Company’s Appeal Process

There may be situations when using the insurance company’s appeal process might make sense, such as:

  • Your condition has drastically changed since you filed the claim.
  • They asked for specific information/documentation in the denial letter that you can now provide them with.
  • There were clerical errors in your claim that prevented an approval.

Should you choose to use the insurance company’s appeal process, it can expedite getting your benefits. However, insurance appeals take time and your window to file a court case against the insurance company is 2 years from the date you received your denial letter. If they deny you again, you may not have time left to file a claim with the court.

Unless there’s a strong probability that the insurance company will change its mind, filing an appeal with the insurance company is usually too risky.

Filing a Claim in Court

Many LTD lawyers would recommend filing a claim in court against the insurance company to protect yourself from losing the ability to get the benefits you deserve. This is especially true if your denial was based on:

  • You missing the deadline to apply for benefits.
  • A decision that you don’t meet the definition of totally disabled.
  • The insurance company decided that you had a pre-existing condition.
  • You failing their medical assessment.
  • Evidence the insurance company has that contradicts what you said in your application.
  • You not receiving reasonable medical care.

Often, the only way to ensure that your application is reviewed fairly and for you to receive the support you are entitled to is to file a lawsuit with the courts. Using the courts to address your claim for LTD benefits also gives you the opportunity to claim the benefits you should have received between the denial and when the case settles or a trial is completed. You can also apply for costs and possibly damages if the insurance company acted in bad faith.

The vast majority of cases settle because an LTD lawyer knows how to submit an application the insurance company has to take seriously.

Img Credit: National Cancer Institute via Unsplash

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