Long-term disability (LTD) insurance generally provides a portion of income to people injured or sick who cannot work for an extended amount of time after Short-term disability ends. Unfortunately, some people find that their insurance provider denies their LTD claim, which can happen for various reasons. If this has happened to you or you have recently applied for LTD and are awaiting a decision, you should know that you have options.
If you have received a denial of your LTD claim, you should contact an experienced disability attorney right away. There are specific rules and procedures in the LTD process that can cause a claim denial if not followed. Deadlines are short and you will need the time to gather the records to strengthen your case. Make sure you speak with an attorney who understands LTD law and procedure. The last thing you want is a claim denial based on a technicality.
Reasons LTD Claims are Denied
An LTD claim can be denied or terminated for a variety of reasons. However, typically LTD claims are denied for reasons that could easily have been prevented.
Even if you plan to work with a disability lawyer, you should be aware of some of the reasons LTD claims are denied, as most can be prevented.
- The Insurance Company claiming that you are not disabled as defined by the policy
- Failure to communicate with the insurer
- Late filing
- Pre-existing condition exclusion clause or other contractual reason
- Lack of evidence or insufficient evidence
- Non-compliance with treatment
- Failure to attend rehabilitation or return to work
- Refusal to attend an independent medical assessment
- Credibility issues
What to do When Your LTD Claim is Denied
If your insurance carrier has denied your LTD claim, it can be highly frustrating. First and foremost, if you haven’t done so already, you should contact an experienced disability attorney.
It is not unusual for insurance carriers to deny a legitimate claim. They will look for any technicality, no matter how narrow, and will use every loophole at their disposal. This is where a disability attorney will be invaluable. An experienced attorney will know LTD law and understand the relevant procedures. Rather than trying to figure out complicated legal matters on your own, let an experienced disability attorney do it for you. Your chances of success will increase exponentially.
How to Appeal an LTD Claim Denial
First, know that you have a legal right to appeal if you received an LTD claim denial. However, it is essential to develop a strong appeal that is airtight. Just as they did with your initial claim, insurance companies will look for any reason to deny your appeal. Make sure to let a disability attorney handle this for you. Filing an appeal on your own can cause you to waste your opportunity to reverse your carrier’s initial decision. A disability attorney can and will ensure that your appeal is a strong one that gives you the best chance of success.
When filing an appeal, meeting deadlines is critical. Missing a deadline can and likely will result in the denial of your appeal. Under the Employment Retirement Income Securities Act, you have 180 days to file your appeal after a denial. It is important to contact us right after the denial. It takes time to obtain copies of all of the medical records and a copy of Insurance Company’s file. And the insurer has 60 days to conduct a review and another 60 days after that if necessary.
Dyson Law, PLLC: Your Delray Beach, Florida Disability Attorneys
Filing for LTD benefits and appealing adverse decisions on your own is complicated and stressful. And to make matters worse, insurance providers will find the slightest reason to deny your claim. Meeting deadlines, proper procedure, and understanding the minutiae of the law is crucial. If that sounds stressful, you don’t have to worry. At Dyson Law, our experienced and successful disability attorneys can handle every step of the LTD process for you. If you’ve been injured or are sick and unable to work, you don’t want to handle complicated legal matters in addition to your recovery. Let us do it for you. Contact Dyson Law at (561) 498-9979 in Delray Beach, Florida, for a free consultation with South Florida’s top disability lawyers. You can also fill out our contact form here.
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The information in this blog post (post) is provided for general informational purposes only and may not reflect the current law in your jurisdiction. No information in this post should be construed as legal advice from the individual author or the law firm, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting based on any information included in or accessible through this post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country or other appropriate licensing jurisdiction.