What Should I Include in a Long Term Disability Appeal Letter?

A denied long-term disability claim can feel overwhelming, but it’s crucial to remember that a denial is not the end of the road. At Bartolic Law, we’ve guided countless clients through the appeal process. Every appeal demands careful attention to detail, accuracy, and a persuasive approach that challenges the insurer’s decision. Your appeal letter must present strong evidence and a well-constructed argument, as this may be your last opportunity to include critical information before litigation.

1. Medical Evidence is the Foundation

The heart of every successful appeal is solid medical evidence. Insurers often deny claims by arguing that the medical records don’t sufficiently support a disability claim. To counter this, your appeal letter must include:

• Updated and comprehensive medical records from all treating providers.
• Clear statements from your doctors detailing your condition, its limitations, and how it prevents you from fulfilling your job duties. For example, your physician might explain that prolonged sitting exacerbates your chronic back pain or that your mental health condition causes concentration issues incompatible with your role.
• Results from relevant tests, imaging, or studies that validate your diagnosis and impairments.

Insurers rely heavily on the information in your medical file. If gaps or ambiguities exist, we can help you bridge them by working closely with doctors and specialists to ensure their opinions are concise, credible, and tailored to address the insurer’s concerns.

2. Address the Insurer’s Denial Reasons Head-On

One of the most common mistakes people make is ignoring the specifics in the denial letter. Insurers don’t deny claims randomly; they list reasons backed by their interpretation of your records or the policy. A strong appeal rebuts each reason point-by-point.

For instance, if the denial states there is a lack of “objective evidence,” your appeal must demonstrate why the subjective reports of your symptoms are valid, perhaps bolstered by diagnostic tests or functional assessments. If they argue that you can work another job under an “any occupation” evaluation, vocational evidence showing a lack of transferable skills may be crucial.

At Bartolic Law, we understand that these responses require strategic insight. We help clients connect medical evidence to the insurer’s specific language, leaving little room for the insurer to maintain its denial.

3. Tell Your Story

Numbers and diagnostic codes alone don’t humanize your situation. Paint a real picture of how your condition affects your daily life. Include details like how you’ve struggled to complete essential tasks, the physical and emotional toll of managing your condition, and the adjustments you’ve made. For some clients, photo or video evidence demonstrating these struggles can have a profound impact.

This personal narrative is vital because insurance companies often reduce claims to data points. Showing the real-world implications of your condition makes it harder for them to discredit the claim.

4. Submit a Complete, Organized Appeal

Your letter should present all evidence in a well-organized manner—medical records, supporting opinions, denial-specific responses, and your narrative. This makes it easier for the insurer to fully grasp the validity of your claim without sorting through disorganized materials.

5. Use Professionals to Strengthen Your Case

This process isn’t straightforward. Timelines are strict, legal nuances abound, and many claims are denied based on technicalities or policy definitions. At Bartolic Law, we do more than prepare appeal letters—we craft comprehensive strategies to give insurers little choice but to reverse their decisions. Utilizing our team means you’ll submit the most compelling appeal possible, and if necessary, we’ll be prepared to take your case to litigation. Don’t face this alone. Contact us today.