When a Long-Term Disability Claim Is Denied, The Process Is Not Over
If your long-term disability claim was denied, do not assume that the decision is final. A denial is often only the first step in the claims process. Many long-term disability denials are incorrect and can be overturned when the claim is properly reviewed and supported with the right evidence.
Insurance companies deny long-term disability claims for many reasons. Some denials are based on missing forms, delayed medical records, or what insurers describe as insufficient documentation. In other cases, insurers rely on selective readings of the medical record or internal reviews that do not fully account for the demands of a claimant’s occupation. A denial does not necessarily mean that you are not disabled or that you are not entitled to benefits owed under your policy.
Common Reasons Long-Term Disability Claims Are Denied
Long-term disability claims are often denied because insurers claim they do not remember receiving certain records or believe additional documentation is required. Even when claimants and their doctors provide ongoing medical support, insurers may argue that the evidence does not meet their internal standards.
Delays can also work against claimants. When records are submitted late or responses to insurer requests are not timely, insurance companies may use those gaps to justify a denial or termination of benefits. Staying organized and responding promptly is critical throughout the claims process.
What to Do After a Long-Term Disability Denial
If your long-term disability claim is denied or terminated, it is important to act quickly. In cases involving ERISA disability denials, claimants typically have a very short timeframe to file an appeal. Missing an appeal deadline can permanently limit your ability to challenge the denial.
After a denial, claimants should keep copies of everything submitted to the insurance company and everything received in return. Treating physicians should be asked to provide updated medical records and respond to insurer requests promptly. Clear documentation of symptoms, functional limitations, and work restrictions can play a key role in correcting an insurer’s decision.
Why the Appeal Stage Matters
The appeal stage is often the most important part of a long-term disability claim. During an appeal, additional medical and vocational evidence can be submitted, and errors in the insurer’s review can be addressed. In ERISA disability denials, the appeal record may determine what evidence can be considered later if litigation becomes necessary.
An attorney can manage the appeal process, gather supporting medical and vocational evidence, and communicate directly with the insurance company. This can help ensure that the claim is properly documented and that insurer missteps are identified and challenged.
How Donahue & Horrow LLP Helps Policyholders
At Donahue & Horrow LLP, our attorneys have helped hundreds of clients overturn long-term disability denials and secure the benefits owed under their policies. We focus on protecting the rights of policyholders and holding insurance companies accountable when claims are improperly denied or terminated.
If your long-term disability claim has been denied, you may still have options. Understanding the process and acting quickly can make a meaningful difference.
To speak with an attorney about your long-term disability denial, call 877-664-5407 or contact us through our website.