Appealing the Denial of an LTD Claim

There are different reasons why a long-term disability (LTD) claim may fall on deaf ears. Where will you be, however, if your own claim gets denied? If the latter happens, giving up is not an option—at least not yet. All LTD claims allow for at least one (at times even two) levels of administrative appeals, and it is through this that claimants who got denied the first time can get compensated for their trouble.

Appealing a denial requires careful, calculated moves. You’d do well if you get a copy of the policy beforehand so you can go over it and pinpoint the things that went wrong. You can get a copy of the policy from your employer’s HR department (if your employer provides group insurance), or directly from the insurance adjuster.

Among these documents, you’ll find your denial letter. This would address why your initial claim was denied, so keep a sharp eye on the explanation. Next, you’ll have to ‘stack the administrative record’—a task which requires you to collect as much favorable evidence until you’re barred from doing so. Under ERISA, the ‘record’ in your case is closed if you’ve exhausted all your administrative appeals.

If all these sound a little too complicated for you, don’t fret. Hiring an attorney can make things go a lot smoother, as the added expertise can help put your case in a more favorable light and navigate the treacherous legal waters for you.


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