How to Appeal a Long Term Disability Denial

How to appeal a long term disability denial is not a simple process, adding an unneeded layer of complexity for those struggling or adapting to their disability.

With millions of Canadians coping with disabilities and private insurers often looking to deny claims or remove people from their benefit plans, it’s more important than ever to understand the appeals process and how to position your appeal to have the best chance of being successful. 

Understanding Long Term Disability Denial

Receiving a denial for a long term disability claim can be a distressing experience, especially when you are dealing with a significant medical condition that leaves you unable to perform your job duties.

Unfortunately, it is not uncommon for disability insurance companies to deny legitimate claims. This denial can be based on various reasons, such as discrepancies in the medical records, interpretations of “total disability,” or even simply the insurance company’s stringent policies.

The Complexity of Long Term Disability Insurance Denial

The laws surrounding long term disability insurance are complex. Insurers have developed rigorous criteria and processes that can make navigating a claim incredibly challenging without in-depth legal and regulatory knowledge.

Many individuals find themselves unprepared for the amount of detailed documentation required, from compiling exhaustive medical records to providing evidence of education, training, or experience that prevents them from working due to their disability.

Appealing Long Term Disability Denial

When you find your claim has been denied or terminated, the appeal process is your next step. This process involves submitting a formal challenge to the insurance company, often requiring a comprehensive review and presentation of additional evidence.

It’s crucial to understand the grounds on which the insurance company is denying your claim. Commonly, this involves a disagreement over the nature of your medical condition or whether your documentation fulfills the definition of “total disability” under your policy.

More often than not, the denial of your benefits are upheld when a claimant appeals internally with the insurance company, unless new and compelling medical evidence are submitted.

How to Appeal a Long Term Disability Denial

Review the Denial Letter

The first step in appealing a long term disability denial is to thoroughly review the denial letter from the insurance company. This letter should state the reasons why your claim was denied. Understanding these reasons is crucial as it will guide your subsequent actions.

Gather Comprehensive Medical Evidence

Your appeal should include comprehensive medical records that not only document your medical condition but also how it impacts your ability to work. It is essential to show a link between your condition and your incapacity to perform your job duties or any job, considering your education, training, and experience.

Consult a Long Term Disability Lawyer

Hiring a lawyer experienced in long term disability insurance can significantly enhance your chances of a successful appeal. A long term disability denial lawyer understands the intricacies of insurance policies and the tactics employed by insurers. They can help assemble a robust appeal that addresses each point of contention.

Long Term Disability Denial Lawyer: Your Advocate

A long term disability lawyer plays a critical role in the appeal process. They can help interpret the complex language of your life insurance policy, ensure that all necessary documentation is correct and complete, and advocate on your behalf. If your appeal involves legal arguments or disputes over insurance law, having a skilled attorney can be indispensable.

Unified’s Experience with Long Term Disability Denial Claims

At Unified LLP, we have extensive experience helping clients navigate the frustrating experience of an insurance company denying their long term disability claims. Our team is adept at managing every aspect of the appeal process, from the initial review of your denial letter to the final stages of securing your rights to benefits. We understand that this is not just a legal process but a crucial part of your life during a challenging time.

Why Choose Unified for Your Long Term Disability Insurance Denial?

Unified LLP offers a free consultation to anyone whose claim has been denied. This initial meeting allows our team to assess your case and provide you with an understanding of your legal options. We operate on a contingency fee basis, which means you do not pay unless we help you recover your benefits. Our commitment to our clients is backed by a deep understanding of disability law and a strong track record of challenging denials effectively.

When dealing with a long term disability insurance denial, remember that you are not powerless. With the right guidance and support, you can challenge the denial and access the benefits you rightly deserve. 

Contact Unified LLP today, and let us help you secure the full extent of benefits you are entitled to. We can help you determine if you qualify for long term disability benefits, file your benefits, appeal a denial, and more. 

We offer free, no-obligation consultations and work on a contingency fee – we don’t get paid unless we win. 

We’re proud to serve as your:

Frequently Asked Questions About Appealing Long Term Disability Denials

How long does the appeal process for a long term disability denial typically take?

The amount of time required to appeal a long term disability denial can vary significantly based on several factors, including the complexity of your case, the speed of response from your insurance company, and whether additional medical evaluations or legal proceedings become necessary. Generally, the initial appeal process can take anywhere from a few months to a year.

The first step, which involves preparing and submitting the appeal documentation, is crucial and can be time-consuming. During this phase, your long term disability lawyer will collect all relevant medical records, expert opinions, and evidence supporting your inability to work. This preparation is key to building a strong foundation for your appeal.

Once the appeal is submitted, the insurance company has a set amount of time, usually 30 to 90 days, to make a decision. If your appeal is denied and further appeals are warranted, the process can extend further, potentially leading to litigation, which can last several months or even years. Throughout this time, ongoing communication with your lawyer is essential to ensure that your appeal progresses efficiently and your rights are protected.

What can I do to help ensure my appeal is processed as quickly as possible?

To help speed up the appeal process, ensure that all documentation and evidence are complete and thoroughly prepared before submission. This includes detailed medical records, statements from your healthcare providers, and any other documentation that supports your claim of disability. Additionally, responding promptly to any requests for information from your lawyer or the insurance company can prevent delays.

Working closely with a long term disability lawyer who has experience in efficiently handling these cases is also crucial. An experienced lawyer will understand the best strategies for navigating the appeals process and can anticipate potential delays, working proactively to address them.

Are there any deadlines I should be aware of when filing an appeal for a long term disability denial?

Yes, there are critical deadlines involved in the appeals process that you must adhere to. The initial deadline to file an appeal after receiving a denial notice is typically within 60 to 180 days, but this can vary depending on your policy. Missing this deadline can result in the loss of your right to appeal the decision, making it crucial to act promptly.

Additionally, there may be subsequent deadlines throughout the appeal process, such as those for submitting additional evidence or for filing further appeals if the initial one is unsuccessful. Your disability lawyer will keep track of these deadlines and ensure that all necessary actions are taken on time to protect your claim.

Understanding the amount of time involved in each step of the appeal process and the importance of deadlines ensures that you can navigate your long term disability appeal with clarity and purpose. Having the support of a knowledgeable lawyer can significantly influence the outcome, helping to streamline the process and increase the chances of securing your rightful benefits.