At the Law Office of Justin C. Frankel, P.C., we understand how devastating it can be to receive a denial letter after filing a long-term disability (LTD) claim. You’ve paid your premiums, followed the rules, and now you’re being told your benefits won’t be paid. But a denial is not the end — it’s the beginning of your appeal.
Here’s how to take control of your claim and fight back effectively.
Step 1: Understand Why Your Claim Was Denied
Before you can appeal, you need to know what went wrong. Common reasons for denial include:
- Lack of objective medical evidence
- Missed deadlines or incomplete paperwork
- Surveillance or social media activity contradicting your claim
- Insurer’s interpretation of policy language
Tip: Review the denial letter carefully. Under ERISA, the insurer must explain the specific reasons for denial and cite the evidence they relied on.
Step 2: Request Your Claim File
You have the right to request a complete copy of your claim file, including:
- Medical records
- Internal notes and communications
- Vocational assessments
- Surveillance reports
This file is the foundation of your appeal. It reveals what the insurer saw — and what they ignored.
Step 3: Build a Comprehensive Appeal
Your appeal must be more than a rebuttal. It should be a strategic, evidence-based presentation that:
- Addresses every reason for denial
- Includes updated medical records and physician statements
- Provides functional capacity evaluations or neuropsychological testing
- Adds vocational expert opinions if relevant
Warning: ERISA limits your ability to add new evidence after the appeal. This is your last chance to build the administrative record before litigation.
Step 4: Meet the Deadline
Most LTD policies governed by ERISA give you 180 days to file an appeal. Missing this deadline could permanently bar your claim.
Pro tip: Don’t wait until day 179. Start early to allow time for gathering records, expert reports, and legal review.
Step 5: Consider Legal Representation
Appealing a denied LTD claim isn’t just paperwork — it’s legal advocacy. Insurers have teams of lawyers reviewing your file. You deserve the same.
At the Law Office of Justin C. Frankel, P.C., we’ve helped thousands of claimants nationwide overturn denials and secure the benefits they deserve. We know how insurers operate — and we know how to fight back.
Final Thoughts
A denial doesn’t mean you’re not disabled. It means the insurer didn’t see enough evidence — or chose to ignore it. With the right strategy, documentation, and legal support, you can turn a denial into an approval.
Need help with your appeal? Contact the Law Office of Justin C. Frankel, P.C. today for a free consultation. We fight for claimants — and we win. Call 888-583-4959 or use our contact form to schedule a free consultation and discuss your options.
Latest Blog Posts
Client Testimonials
5.0 Average on Martindale & AVVO