What Happens If You Can No Longer Work But Your Long-Term Disability Claim Is Denied?

Facing a denied long-term disability (LTD) claim when you’re unable to work can be overwhelming. This scenario often brings financial uncertainty and emotional distress, as you’re left wondering how to secure the benefits you deserve. At Bartolic Law, we understand this frustration and are here to guide you. If you’ve received a denial, you still have options. Taking the right steps immediately can greatly increase the likelihood of a successful appeal.

Why Claims Are Often Denied

Before moving forward, it’s helpful to understand why claims are denied in the first place. Common reasons include:

• Insufficient Medical Evidence

Some claims are rejected because the submitted medical documents fail to demonstrate how your condition impacts your ability to work.

• Policy Exclusions and Limitations  

Insurance policies often contain fine print that excludes certain conditions or imposes limitations on approval criteria.

• Missed Deadlines  

Submitting incomplete paperwork or failing to adhere to strict deadlines can lead to an automatic denial.

• Misinterpretation of Job Duties  

Insurers might assume your role is sedentary or less demanding than it actually is, undercutting the severity of your condition.

Knowing the reason for your denial is crucial in forming the foundation of a strong appeal.

Steps to Take After Receiving a Denial

The denial of your LTD claim is not the end of the road. Follow these critical steps to build a successful appeal:

1. Carefully Review Your Denial Letter  

• Understand the specific reason(s) for the denial.  
• Take note of the appeal deadline, usually 180 days, listed in your insurer’s denial letter.  
• Look for any requests related to additional evidence that you can submit during the appeal.

2. Gather Strong Medical Evidence  

• Schedule a visit with your treating physician to discuss the details of your denial.  
• Request comprehensive medical reports that clearly outline the severity of your condition and its impact on your job performance.  
• Include specific tests, diagnostic images, and detailed notes to bolster your case.

3. Request a Peer or Functional Capacity Evaluation  

• Obtain documentation from an independent medical expert or functional capacity evaluator to demonstrate physical and cognitive limitations.  
• These objective evaluations carry significant weight in appeals.

4. Document Your Job Duties and Limitations  

• Create a list of job responsibilities that you are unable to perform because of your condition.  
• Where possible, include employer documentation or testimony that supports how your disability has affected your ability to work.

5. Seek Legal Representation  

• Consult an attorney who understands ERISA and disability law.  
• Legal counsel can help prepare a compelling appeal, handle communication with the insurer, and ensure full compliance with policy and legal requirements.

Why Legal Assistance Makes a Difference

Working through the appeals process alone can be overwhelming, particularly if you lack familiarity with the legal and medical intricacies involved. Partnering with an experienced ERISA attorney ensures:

• Better Evidence Presentation  

Your attorney can structure your case with persuasive and policy-specific arguments.  

• Compliance with Deadlines and Procedures  

Legal counsel ensures timely submissions and avoids errors that could delay your claim.  

• Reduced Stress and Emotional Burden  

With a trusted partner handling the process, you can focus on managing your health rather than administrative complexities.

Contact Us

If your long-term disability claim has been denied, don’t lose hope. Understanding the reason for the denial and taking prompt, well-informed steps can help turn your situation around. At Bartolic Law, we craft winning strategies for denied LTD claims. Contact us today for a consultation and allow us to guide you toward the benefits you deserve.