When you apply for either short-term disability (STD) or long-term disability (LTD) benefits, it’s not a guarantee that you will be approved. While you may pay into this insurance policy, the insurer reserves the right to deny your benefits.
When should you get a lawyer involved? If you apply for and are denied STD or LTD, you should contact an attorney for a free evaluation of your denial.
Consultation with an attorney
When you contact a disability lawyer, you will need to provide a copy of the denial letter. The denial letter should include:
- The reason your claim was denied
- Insight to the Policy language governing the denial
- A timeline of how long you have to appeal
Most short- and long-term disability claim denials provide you with 180 days to appeal the decision. This does not mean you should wait 180 days before contacting an attorney. As soon as your claim is denied, call an attorney.
Building up your appeal
If an attorney agrees to appeal the denial on your behalf, it can take a few months for the appeal to be ready. For example, your lawyer will need to obtain the claim file from the STD/LTD insurer. Once the claim file has been received, the attorney will review its contents and then request additional medical records from your providers. Often times, report requests will be sent to your providers asking for them to clarify your functional limitations. Gathering this information can take several months. This is why you should contact a lawyer as soon as you hear your claim was denied.
Once an appeal is submitted, the STD/LTD insurer typically has 45 days to review the appeal and make a determination. However, this 45 days is often delayed because the insurer will frequently send the new and updated information contained in your appeal documents to an independent medical reviewer. This means, you will wait longer than 45 days for a decision.
While it is within your right to appeal the denial by yourself, the chances of overturning your STD/LTD denial is much higher when you have retained a qualified attorney.