Fighting a Denied Long-Term Disability Claim

When a disability claim has been denied, you can choose to appeal the decision. The way you go about the appeal is very delicate and should be handled with care and consideration. We know that it can be tempting to act out of haste and worry, but it is more important to consult legal representation before throwing out a quick appeal letter. Being patient and weighing all of your options will help you in the long run. Insurance companies make it seem like a quick and easy process, but this is almost never the case. Don’t fall for these claims from your insurance provider. Always consult the opinion of a legal representative first and foremost. The trusted attorneys at Sutton & Lovette are here to represent you in your fight to gain coverage. 

Why Are Long-Term Disability Claims Denied So Much?

You might be wondering why this experience is so common. Long-term claims most often get denied because of a “lack of medical evidence” or a “failure to meet the policy’s definitions of the disability.” A lot of these denials come from a place of motivation to save money and cut costs. While this can be a frustrating situation for you and your loved ones, there are attorneys that can help. They know what these companies look like on the inside and they can stand up for you against them. 

The Appeal Process

With these denials, you are usually only granted one opportunity to appeal. If your appeal is then denied, you are able to file a follow-up lawsuit. The problem here is that once the insurance company sends you a denial letter for your appeal, nothing new can be added to your claim file. When the judge is presented with your case, they will be tasked with making the decision of whether the denial was just or not. This is why it is so important that all of the information that can help you in a legal battle is included in your disability claim before your appeal gets denied. This is where a lawyer would come into play to help you make sure all of this information is included.

The insurance system is set up to evaluate the information that your doctors provide regarding your claim. They are not emotional institutions and they are not moved by personal anecdotes or information. Medical records and the opinions of doctors are the most important evidence you must provide to win an appeal or a subsequent lawsuit against an insurance company. 

Important Steps to Take After Your Claim is Denied

Pay Close Attention to Your Denial Letter

When reading this letter, there are a few things that should be included. First and foremost, your insurance policy’s definition of disability should absolutely be included. This is because this can vary depending on the year and who your insurance provider is. Most insurance policies protect you for some period of time if you are unable to work. After whatever that period of time is, depending on your insurance provider, you can only extend these protections if you are unable to return to work, which is where the long-term-disability claim denials come into play. The medical records that your insurance company reviewed should also be included in this letter along with the “why” the company provided that you are able to work. The final, and most important part, to find is the amount of time that you have to appeal. This is often 180 days from the date you received the letter, but it varies so make sure you’re clear on that. 

Plan Your Appeal

With all of the information you gained inspecting your denial letter, you are ready to craft a plan for your next step. It is important that you know what you’re trying to prove here Based on the definition of “disabled” your insurance company is working with, what do you need to prove? Maybe that you cannot do your own job, or that you cannot do any job, no matter the demands. This is important in trying to win your case because it will change what evidence you try to provide and what you bring to your appeal letter. Are there more medical records that would help you win your case? Do you have more information to work with based on the feedback the insurance company gave you? Ask yourself these questions and bring them to an attorney for a second opinion. 

Write Your Appeal Letter

Your appeal letter is the ideal place to lay out all of the information you have, even the more emotional stuff. The letter is supposed to explain why you can’t work in all of the detail that you can. This can include both hard evidence and personal experience. Write about your test results and mention the support you’ve gotten from multiple different doctors. Explain why the restrictions placed on you disqualify you from any job that would be reasonable given your skill set. Mention any legal arguments that apply to your situation and keep in mind that this information will also be presented to a judge if your appeal gets denied as well. 

Sutton & Lovette Is Here to Help You

A lot of the time, denied disability claims can be handled by people themselves, however, sometimes it is beneficial to involve an attorney to make sure that you are doing all you can do to win your appeal or your lawsuit. If you are wondering whether it would be worth your time and investment to work with Sutton & Lovette on your Long-term disability case, you can always schedule a consultation. In the consultation, we will discuss your case and the best next steps. Contact us today at (814) 471-7702 or suttonandlovette@gmail.com.