Long-Term Disability Denial

Long-term disability insurance is intended to help support you if you’re sick or injured and cannot work. Sadly, what should be a straightforward process is anything but simple. Despite paying premiums for years, your insurance company may have unfairly denied your legitimate long-term disability insurance claim, leaving you without a steady income.

Long-term disability denial attorneys with Sokolove Law may be able to help you appeal your insurer’s decision and pursue any benefits you may be entitled to.

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Top-Offending Insurance Carriers

Unum is one of the largest disability insurance carriers and has been fined millions of dollars for wrongfully denying claims. The Unum family includes both Unum and Colonial Life.

A few other insurance companies known for long-term disability denial include:

Lloyd’s of London has similarly been accused of wrongfully denying disability claims as well as neglecting to respond to claims in a timely manner. A variety of different occupations have found their Lloyd’s of London LTD claims unfairly denied, including professional athletes, musicians, doctors and other health care workers, and more.

If you’ve been sold a Lloyd’s of London insurance policy and they’re delaying or denying your lump-sum payment, Sokolove Law may be able to help — contact us today to learn more.

What does long-term disability cover?

Long-term disability insurance covers a variety of illnesses, though many people think that long-term disability only covers injuries that happen on the job. While on-the-job injuries may also be covered, over 95% of long-term disability claims are estimated to be unrelated to work.

For instance, cancer, mental illnesses, chronic illnesses, neurological disorders, certain degenerative diseases, and other medical conditions may all be covered by your long-term disability policy.

Where Are You in the Process?

Sick or Injured, but Haven’t Filed an LTD Claim Yet?

Complex claim paperwork is the last priority on your agenda when you’re struggling with an illness or injury. While you may have a long-term disability policy, you may also be unsure of what that policy covers and what you need to do next. This is where we can help. This site can serve as a resource center for information on:

Applied for and Waiting for a Coverage Decision?

If you’ve applied for coverage and haven’t heard from your long-term disability insurance carrier for an extended period, it may be time to reach out to them for a decision. Intentionally delaying a claim decision is one way that some insurers fail to honor their contract with you. Without an official denial, you’re unable to appeal.

Applied for and Denied Long-Term Disability?

When you receive a denial letter from a long-term disability carrier you’ve paid premiums to for years, it can be frustrating and overwhelming. If this has happened to you and you haven’t worked with an attorney yet, this is a good time to contact a long-term disability denial attorney.

Too often, legitimate claims are denied because insurance companies look for every possible legal and technical angle available that will allow them to deny a valid claim. When an insurer fails to live up to its end of the contract, it’s in your best interest to contact an attorney as soon as possible.

Please know that denials aren’t the end of the claims process. If your claim has been rejected, know your rights and options. Get a free case review today or call (800) 995-1212 to learn more.

Appealed the Denied Claim, but Denied Again?

Even if you’ve started the appeals process and your claim still hasn’t been approved, don’t give up hope. Consider contacting an experienced long-term disability denial attorney who may advise you on your case and potentially represent you.

How to Appeal Long-Term Disability Denial

It’s crucial to understand that long-term disability claim denial is, sadly, a common occurrence. Though millions of workers need and rely on LTD insurance in the event that they become disabled and are unable to perform their job, insurance companies often find ways to wriggle out of paying their insurance holders in the event of a long-term disability.

In fact, around 53% of long-term disability claims are denied, according to data collected by the U.S. Social Security Administration (SSA).

If your long-term disability claim is denied, you have the legal right to file an appeal of the insurance company’s decision. It’s very important to develop a strong appeal that can withstand the scrutiny of your insurance company, which an experienced long-term disability denial attorney can take care of for you.

When you work with Sokolove Law, our lawyers for long-term disability denial may be able to handle the appeals process on your behalf. Our lawyers have experience with denied disability claims, and they know what steps to take — and when — to fight for the benefits you may be entitled to.

Learn More About Your Options

If you believe your long-term disability claim was wrongfully denied, an experienced long-term disability denial attorney can help you understand your legal options.

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Deadlines for Appealing Long-Term Disability Insurance Denial

Deadlines are critical in the appeals process. Missing a deadline can have serious consequences, from frustrating delays to forfeiture of your right to appeal. The deadline for filing a long-term disability appeal should be included in the insurer’s denial of claim letter.

The deadlines for appealing a denial from a group disability insurance plan provided by your employer are set forth in the federal law known as ERISA (the Employee Retirement Income Security Act of 1974). Most (but not all) individual policies also follow ERISA rules which have very tight timeframes.

Under ERISA, you only have 60 days to appeal the denial, and the insurer has 60 days to conduct a review, followed by another 60 days if necessary.

What to Do If Your Long-Term Disability Appeal Is Denied

Depending on your insurance plan and the details of your case, you may be able to file a lawsuit against the insurance company for denying your long-term disability benefits.

If your long-term disability appeal is denied, your legal team may ask your insurer to consider another appeal while they search for new information to change the insurer’s mind. While your second appeal is under review, they may file a complaint with your state’s Insurance Department, which will lay the groundwork for you to file a lawsuit if your appeal is again denied.

Although your insurer may not reverse the denial of your claim as a result of your complaint, you may be required to exhaust all administrative remedies before you file a denied disability lawsuit. Should you fail to exhaust your administrative remedies, your case could be dismissed.

If your policy was purchased individually and is not subject to ERISA, you may not be required to exhaust administrative remedies before you can sue.

Why Hire a Long-Term Disability Denial Attorney?

Many people who have their disability claims denied turn to legal experts for help. Hiring a long-term disability denial lawyer may be one of the best ways to ensure your appeal is complete, thorough, and in the best possible shape before you file.

When you work with Sokolove Law, a long-term disability denial lawyer may be able to help:

  • Strengthen your case by gathering evidence to support your claim
  • File your appeal with the insurance company on your behalf
  • Fight to have your claim overturned in court if your case reaches trial

Get the Help You Deserve

You may be eligible for compensation. We may be able to help.

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Why Did Your Long-Term Disability Claim Get Denied?

While there are many reasons why an individual long-term disability claim may be denied, it’s important to consider that claims administrators often work for your insurance company and therefore present an inherent conflict of interest.

As a result, many disability claims are routinely denied, even when there’s a strong case for disability benefits. Sometimes, insurance companies deny claims for legitimate reasons, but other times, the rationale may simply be unfounded.

Long-term disability claims may be denied due to:

  • Application errors: If the claims application has errors in it, is otherwise incomplete, or isn’t filed in time, it may be denied. Claims administrators may look for any mistakes in the application and use those errors as rationale for denying your claim.
  • Missing or insufficient medical evidence: Long-term disability claims often get denied if they lack sufficient information to justify an approval, usually by not including your medical records as well as a medical statement from your doctor or physician.
  • Not meeting an insurance policy’s definition of disability: Under many insurance policies, a claimant is only considered “disabled” if they meet the specific criteria outlined in their insurance plan. A policy’s summary often includes a list of excluded conditions.
  • Video surveillance that counters a claim of disability: Sometimes, insurance companies work with investigators who conduct video surveillance of a claimant’s daily activities as a way to verify that the claims made in your application are truthful and accurate. They may also check your activity on social media applications to investigate your claims.

If your claim was denied, long-term disability denial attorneys with Sokolove Law may be able to help you appeal the insurer’s decision and pursue any disability benefits you may be entitled to.

See if we can help with your case today by getting a free case review or calling (800) 995-1212.

Occupations Often Affected by LTD Denial

Unfortunately, long-term disability denial doesn’t just affect one community or occupation — it can affect anyone who pays for an LTD insurance policy and has to file a claim.

Occupations affected by long-term disability denial may include:

  • Doctors, nurses, and other medical professionals
  • Immunocompromised workers unable to work due to illness or health issues
  • Professional athletes or musicians who are sick or injured and can no longer perform
  • People who had COVID-19 and experienced long-haul symptoms that interfere with their ability to work

Get Help from a Disability Denial Law Firm

If you’ve had a long-term disability claim denied, an experienced long-term disability insurance denial attorney may be able to help.

At Sokolove Law, our attorneys bring decades’ worth of experience fighting on behalf of hardworking Americans who have had their long-term disability claims denied. Over the last 40+ years, we’ve recovered over $115 Million for clients nationwide who were wrongfully denied long-term disability.

Get a free case review or call (800) 995-1212 today to see if we may be able to help with your appeal.

Long-Term Disability Denial FAQs

What should I do if my long-term disability claim is denied?

If your long-term disability claim has been denied, you should contact an attorney as soon as possible. A legal team may be able to help you gather the necessary medical information you need to build a stronger claim.

Our disability insurance attorneys have decades of experience helping clients whose claims have been denied — we know the ins and outs of the insurance industry and can help identify the best path forward for your case. Learn more about how we may be able to help with your case today.

Can you appeal long-term disability insurance denial?

Yes. If your long-term disability claim was denied, you have the power to file an appeal of your insurance company’s decision — and Sokolove Law may be able to help.

Our attorneys for long-term disability denial may be able to handle the appeals process for you, from gathering the necessary evidence to filing the appeal with the insurance company, while ensuring all your paperwork is submitted on time.

How do I appeal a disability denial?

One of the easiest ways to appeal a denied long-term disability claim is to work with experienced denied disability insurance attorneys who can take care of the appeals process on your behalf. Contact Sokolove Law today to see if we can help with your case.

Why do long-term disability claims get denied?

Long-term disability claims can be denied for a variety of reasons, like if:

  • There’s not enough medical evidence to support your claim
  • Your application isn’t filed on time or has other errors
  • You don’t meet the insurance policy’s criteria for disability

If your LTD claim has been denied, long-term disability appeal lawyers with Sokolove Law may be able to help. Get a free case review today to learn more.

How much does a long-term disability appeal attorney cost?

Long-term disability appeal attorneys with Sokolove Law work on a contingency basis, so there are no upfront fees. We’ll only get paid if your case is successful.

What is ERISA?

The Employee Retirement Income Security Act (or ERISA) is a federal law that was originally designed to protect employee benefits by setting minimum standards for employer-provided pensions and health plans. Depending on how you obtained your long-term disability insurance plan, it may also be subject to ERISA.

Insurance companies often use the rules under ERISA to their benefit and ERISA may actually limit your rights in some situations. This is why it is important to contact an attorney right away if your claim was denied, to ensure you don’t fall victim to any bad tactics by the insurance company. To learn more about your options, contact Sokolove Law today.

What conditions qualify for long-term disability? 

There are a variety of different medical conditions that may qualify for long-term disability — like certain chronic illnesses, neurological disorders, physical disabilities, degenerative diseases, and more — though this depends on the specific terms of your policy.

How do I sue Lloyd’s of London over long-term disability denial?

If you have a Lloyd’s of London long-term disability policy and they’re delaying or denying the lump-sum payment of your claim, you may be able to take legal action to pursue the compensation you may be owed. Contact Sokolove Law today to learn more.

Author:Sokolove Law Team
Sokolove Law Team

Contributing Authors

The Sokolove Law Content Team is made up of writers, editors, and journalists. We work with case managers and attorneys to keep site information up to date and accurate. Our site has a wealth of resources available for victims of wrongdoing and their families.

Last modified: September 20, 2021

View 4 Sources
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  2. Hawaii Tribune Herald. "Couple insured by Lloyd’s of London receives claim denial letter." Retrieved from: https://www.hawaiitribune-herald.com/2018/07/27/hawaii-news/couple-insured-by-lloyds-of-london-receives-claim-denial-letter/. Accessed on August 19, 2021.
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