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Dealing with LTD Claim Denials: How a Disability Insurance Attorney Can Appeal on Your Behalf

A denial of your disability claim from your insurance company can be frustrating and stressful. The denial letter is usually lengthy with information about why your claim was denied and what your appeal rights are under ERISA. A disability insurance attorney from Dabdoub Law Firm can assist with appealing the denial on your behalf.

  1. What happens next after your STD or LTD claim is denied

Once a denial letter is received, you will have 180 days from the date of the denial letter to appeal the decision. That is a hard deadline.

You have the right to obtain a copy of your claim file from the insurance company. The claim file contains all information (ex. medical records, internal notes, clinical reviews) that the insurance company received and generated in connection with your claim.

The first step a disability insurance attorney takes is requesting the claim file from the insurance company and reviewing all documents to understand:

A) why you were denied,
B) what information helped or hurt your claim and
C) what information is needed to have your claim approved once again.

Once the claim file has been reviewed, a disability insurance attorney will get to work on preparing the appeal.

  1. Preparing an Appeal

The appeal will consist of all updated medical records, copies of your prescription history, letters of support from your treating doctors, and any other information that can assist your claim. A disability insurance attorney may want to send you for additional testing depending on your symptoms and conditions.

Some examples of outside testing include:

  • a Functional Capacity Evaluation,
  • a Neuropsychological Evaluation,
  • a Cardio-Pulmonary Exercise Test and
  • an independent medical evaluation.

The comprehensive appeal letter will address all the relevant and important medical evidence that supports your claim for disability benefits. The appeal letter will also address why the insurance company’s reasoning for denying the claim was wrong.

  1. Submitting the appeal to you disability insurance company

When the appeal letter and all additional evidence is submitted to the insurance company, the insurance company has 45 days to make a decision. The insurance company may take an additional 45 days (total 90 days) to make a decision if there are special circumstances that warrant an extension. Special circumstances must be beyond the control of the insurance company and does not include medical or vocational reviews.

After the appeal has been sent to the insurance company, a disability insurance attorney will continue to follow up with the insurance company and continue to submit any updated records that support the claim. The attorney should carefully monitor the deadlines for the insurance company to make a decision and take necessary action, including filing a law suit, should the deadline be blown.

Help from a Lawyer with Expertise in Disability Insurance

Disability insurance law is complex. Hiring an experienced disability attorney is important. Because all disability lawyers at this law firm focus on disability insurance claims, we have expertise in disability insurance law.

That means we have:

  1. Experience with every major disability insurance company;
  2. A proven track record of success by winning major disability lawsuits;
  3. Recovered millions of dollars in disability benefits for clients;

And, we never charge fees or costs unless our clients get paid.

The firm can help at any stage of your disability insurance claim, including:

  • Submitting a disability insurance claim;
  • Appealing a long-term disability denial;
  • Negotiating a lump-sum settlement; and/or
  • Filing a lawsuit against your disability insurance company.

Because federal law applies to most disability insurance claims, our lawyers are able to represent clients across the country.

Call (800) 969-0488 to speak with an experienced disability attorney. Consultations are free.