If you applied for STD benefits from your group disability insurance carrier and were denied, your next step is to file an appeal. It is also possible the insurance company may not initiate or approve a long-term disability claim because the short term was denied.
This does not mean you should not do it yourself. After receiving the STD denial, you will want to prepare an appeal of the denial and prepare to file an initial LTD claim.
Here is a checklist to help prepare your STD appeal:
Carefully review the denial letter
As soon as you receive the denial letter, you should review it carefully to understand why your claim was denied. From there, you can make a list of items you want to gather in support of your appeal. Look for the appeal rights toward the end of the denial letter—this explains the time frame under which you have to submit your appeal.
The deadline for the appeal is strict. Do not miss it or you may be precluded from pursuing your claim further. Under ERISA, the deadline is typically 180 days from the date of the denial letter.
- Gather all your medical records
The insurance company may have collected all your relevant medical records. But there is also a chance they did not. It is best to request all your medical records relevant to your disability and include them with your STD appeal.
- Request a supporting letter from your treating physician.
Your claim should have a questionnaire or letter from your doctor supporting your disability. With your appeal, you should submit a letter or questionnaire from your doctor detailing:
- Your medical condition(s)
- Any physical exam findings or objective testing
- The restrictions and limitations your doctor placed on you
- Your treatment plan and prognosis
- Obtain any testing you have had done.
With your appeal, you should include any objective testing or outside testing you have had done. This could include:
- Neuropsychological evaluation
- Functional capacity evaluation
- MRI, X-rays, or other imaging
These tests can objectively establish restrictions and limitations and support what your doctors have reported about your medical condition and disability.
- Gather letters of support from friends, family, former colleagues detailing your disability’s impact on your life.
Statements from those familiar with your condition and how it prevents you from functioning normally can be impactful. These are good pieces of evidence to include with your appeal to corroborate your complaints of pain, cognitive impairment or other symptoms. The letter will help boost your credibility, as well.
- Submit your appeal in writing with the additional evidence gathered.
Your appeal must be submitted to the insurance company timely and in writing. With the appeal letter, you should include all the medical and non-medical evidence you have gathered in support of your disability. The appeal letter should outline why the insurance company was wrong and highlight the medical and non-medical evidence that supports your claim.
It is important to keep in mind that the appeal may be your last chance to build up your file. In an ERISA governed claim, once the appeal is denied, you may not be able to enter new evidence in litigation. Because the appeal process is so crucial, you want someone who understands the process and what is needed to prove your claim.
The attorneys at Dabdoub Law Firm specialize in disability insurance. We have a track record of getting appeals approved using our winning strategy.
Lawyers with Expertise in Disability Insurance Claims
This law firm has always focused only on disability insurance law.
Because we specialize in long term disability, our clients get the benefit of:
- Having an attorney who is an expert in long term disability claims;
- Having an attorney who has experience with every major disability insurance company;
- Being backed by a law firm that has a proven track record of winning tough disability lawsuits.
Call Dabdoub Law Firm to get experienced disability lawyers on your side.
We can help with:
- Submitting a disability insurance claim,
- Appealing a long-term disability denial,
- Negotiating a lump-sum settlement, and
- Filing a lawsuit against your disability insurance company.
The firm represents clients nationwide with disability claims governed by federal law, even if we are not located in your state.
Call (800) 969-0488 or send us a message online to speak with an experienced disability attorney. Pay no fees or costs unless you get paid.
