How to File for Long-Term Disability Benefits After a Stroke in NY

Key Takeaways

• A stroke can result in long-lasting physical, cognitive, and communication impairments that may qualify you for long-term disability benefits if they prevent you from working.
• Strong medical documentation is critical. Detailed records from neurologists, therapists, and other providers help establish eligibility and support your claim through every stage of the process.
• The Law Office of Justin C. Frankel, P.C., can help. We handle the legal and insurance complexities so you can focus on recovery.

A stroke is life-altering, damaging brain cells, causing impairments like aphasia, and often leaving stroke patients unable to return to work. For many in New York and across the country, the path to recovery is filled with medical treatments, neurologist visits, and the need for ongoing stroke care or long-term care. The emotional and financial strain affects both the survivor and their loved ones.

Yet when long-term disability benefits are most needed, insurance companies often deny valid disability claims, citing issues with medical records, “insufficient” medical evidence, or vague definitions of residual functional capacity. That’s where we come in.

At the Law Office of Justin C. Frankel, P.C., our disability attorneys collaborate with your healthcare providers to present a comprehensive picture of your medical condition and functional impairments. We help claimants prepare detailed claims and, when necessary, build strong appeals to protect their rights. If you or a family member has suffered a stroke and been denied disability benefits, contact us for a free consultation today.

What Qualifies for Long-Term Disability Benefits in New York?

Long-term disability benefits are typically governed by private insurance policies and ERISA, not New York State disability law. To qualify, you must show:

• Your stroke prevents you from performing essential job duties
• Your medical records document your physical or cognitive limitations
• Your condition is expected to last twelve months or longer
• You cannot perform your current job or similar work within your field

Your disability claim requires:

• Detailed medical documentation from your healthcare providers
• Employment history showing your work capabilities
• Evidence of ongoing treatment and rehabilitation efforts
• Proof that you meet the specific disability definition outlined in your insurance policy

Your insurance policy determines the amount and duration of benefits. State laws may also apply in limited circumstances.

Understanding the Impact of a Stroke

A stroke occurs when blood flow, which brings oxygen to an area of the brain, stops. Without oxygen, brain cells begin to die, leading to potential impairments in various bodily functions.

There are different types of strokes:

• An ischemic stroke occurs when a blood clot blocks a blood vessel carrying blood to the brain. The blockage can result from a clot formed elsewhere in the body or within the arteries of the brain. About 87% of all strokes are ischemic, with high blood pressure being a leading cause.
• A hemorrhagic stroke happens when a weakened blood vessel in the brain bursts or leaks. Although this type of stroke is less common, it often leads to more severe outcomes.

Strokes can lead to a range of challenges, including:

• Physical impairments: Paralysis or weakness on one side of the body, difficulty with coordination and balance, and challenges in performing daily activities.
• Cognitive and emotional effects: Problems with memory, attention, and problem-solving, as well as emotional changes like depression or mood swings.
• Communication difficulties: Issues with speaking, understanding language, reading, or writing, often due to conditions like aphasia.

How severe a stroke is depends on where it occurs and how much damage is done. According to the American Stroke Association, stroke is the leading cause of adult disability in America. People think of strokes happening to older adults, but nearly a third of all strokes happen to people under age 65.

When Does a Stroke Qualify for Disability?

A stroke meets disability requirements when it creates impairments lasting twelve months or more. Your condition must show:

• Severe communication difficulties from expressive or receptive aphasia
• Limited control of two or more limbs after three months of treatment, making it hard to walk or use your arms
• Significant mental changes affecting memory, reasoning, or behavior

Medical documentation needed includes:

• Brain imaging results (CT scans, MRIs)
• Neurological exam findings
• Physical therapy assessments
• Speech and language evaluations
• Cognitive testing results
• Physician statements outlining your functional limitations

Your medical records must clearly show how these impairments prevent you from working. Insurance companies review this evidence to determine if you meet their specific disability definitions.

When Should a Stroke Victim Apply for Long-Term Disability Benefits?

You should file for long-term disability benefits as soon as possible after your stroke. Early action helps protect your rights and avoids missing important deadlines. You must:

• File your claim immediately after your doctors indicate lasting impairments
• Notify your employer about your condition right away
• Begin collecting medical evidence from the start of treatment
• Document your progress—don’t wait for complete recovery
• Submit your application before insurance deadlines expire

Delayed filing may result in:

• Loss of benefits
• Denial of claims due to missed deadlines
• Incomplete medical documentation
• Insurance coverage complications
• Lower chance of approval

Contact your HR department or insurance provider to understand specific filing deadlines. Starting the process early allows time to gather strong medical evidence and meet insurer filing requirements efficiently.

What Is Required to Prove Eligibility for Long-Term Disability Benefits After a Stroke?

To prove eligibility for long-term disability benefits after a stroke, you must provide:

Medical documentation such as:

• Hospital admission and discharge records
• Brain imaging results (MRI, CT scans)
• Treatment plans and progress notes
• Rehabilitation assessments
• Neurological exam findings

Professional evaluations, including:

• Functional capacity assessments
• Physical therapy reports
• Speech and language evaluations
• Cognitive testing results
• Mental health assessments

Supporting statements and additional documentation, such as:

• Detailed physician reports outlining limitations
• Specialist opinions about the recovery outlook
• Occupational therapist recommendations
• Statements from previous employers
• Documentation showing how your impairments prevent you from returning to work

Your evidence must show that your condition meets your insurance policy’s definition of disability. Most policies require proof that you cannot perform your job duties or any occupation based on your education, training, and experience.

Remember to keep copies of all records and maintain consistent medical care to support your claim.

How to Get Long-Term Disability Benefits After Suffering a Stroke

More than two-thirds of people who experience a stroke never fully recover and must cope with some kind of disability. Most stroke victims would love nothing more than to return to their pre-stroke lives, including returning to work, but it is not always possible. When this happens, they need to file a claim for long-term disability insurance benefits.

Filing for long-term disability benefits after a stroke can be a challenge. One person may have a stroke and be able to return to work after undergoing rehabilitation, while another never recovers. A person with a job that requires making complex decisions quickly, such as a stock trader, may no longer have the cognitive functioning necessary to perform the tasks and duties of their job.

To file a successful long-term disability claim after a stroke, we recommend doing the following:

• Submitting your application promptly
• Gathering comprehensive medical records
• Following up with the insurance company consistently

Remember to keep copies of everything submitted and maintain a file of all correspondence with the insurance company.

Working with a disability claims attorney can support proper documentation and timely filing of your claim. The Law Office of Justin C. Frankel, P.C.’s long-term disability insurance attorneys have represented many claimants who have suffered a stroke or an aneurysm and need help pursuing the benefits available under their policy. We understand the challenges facing claimants and how dealing with a large insurance company bureaucracy can be frustrating and overwhelming. Our clients benefit from our management of their claims, oversight of all daily details, collaboration with their physicians, and negotiation with the insurance company on their behalf.

What Are the Common Challenges in Stroke-Related Disability Claims?

Insurance companies often dispute stroke disability claims, creating obstacles for benefit approval. Some of the common challenges in stroke-related disability claims include:

Documentation Issues

Insurance companies often deny benefits due to improper documentation, which may include:

• Medical records lacking specific functional limitations
• Missing test results or treatment records
• Unclear statements from healthcare providers
• Gaps in medical treatment history

Insurance Company Tactics

Many insurance companies employ unfair tactics, such as:

• Denying claims based on expected recovery
• Using surveillance to question disability severity
• Citing pre-existing condition exclusions
• Disputing cognitive impairment evidence

Policy Requirements

Each insurance provider establishes its own policy requirements, which can present challenges, including:

• Meeting specific disability definitions
• Proving ongoing medical care
• Demonstrating an inability to work in any occupation
• Meeting the elimination period outlined in your policy

To address these challenges:

• Keep detailed records of all medical visits
• Follow treatment plans consistently
• Document daily activity limitations
• Consider working with a disability attorney experienced in stroke-related claims
• Respond promptly to all insurance company requests
• Submit updated medical evidence regularly

A disability claims attorney can help anticipate and counter these common obstacles while protecting your rights throughout the claims process.

How Much Disability Benefit Can You Get for a Stroke?

Long-term disability benefits after a stroke typically provide 50–70% of your pre-disability monthly income. The exact amount depends on:

• Your insurance policy terms and coverage limits
• Your pre-disability salary amount
• Other offsets listed in your policy that may reduce benefits
• Length of time you’ve been disabled
• Duration specified in your policy

Most policies provide benefits until one of the following occurs:

• You reach age 65
• A specified number of years passes (often 5-10 years)
• You return to work
• Your medical condition improves

Review your policy carefully to understand specific benefit calculations and payment durations. Your monthly benefit amount will be clearly stated in your policy documents.

Why Clients Trust the Law Office of Justin C. Frankel, P.C.

At the Law Office of Justin C. Frankel, P.C., we provide personal attention and committed legal representation for individuals facing challenges with disability insurance claims. With decades of experience, we’ve represented thousands of clients against every major disability insurance company, securing over $250 million in benefits on their behalf.

Working with us means working directly with an attorney who is well-versed in disability law. We guide you through every stage of your claim. From filing an appeal to litigation, offering clear communication, strategic support, and relentless advocacy, we’re there. We protect your rights when benefits are wrongfully denied, and we’re prepared to challenge insurance companies that use delay or denial tactics to avoid paying valid claims.

Whether you’re preparing to file or responding to a denial, we handle all aspects of your case. Our results reflect our commitment, which has been recognized by Super Lawyers since 2013, with a 4.8+ star rating on Google, a perfect AVVO rating, and successful appeals across all major insurers.

If your stroke has left you unable to work and you’re facing challenges securing long-term disability benefits, contact us for a free consultation. We’ll deal with the insurance company so that you can focus on your health and recovery.

Testimonials

“Unlike most lawyers I interviewed, Justin’s approach to explain and make sure I understood the process really helped; others didn’t give me the time of day and just wanted me to sign a hefty retainer agreement. Justin hung in there with me and resolved my disability issue.” — Joe S.

Need Help With Your Stroke Disability Claim? Consult Our Disability Claims Lawyers.

Securing long-term disability benefits after a stroke can be overwhelming, but you don’t have to do it alone. At the Law Office of Justin C. Frankel, P.C., we assist stroke survivors in building strong claims, challenging unfair denials, and protecting their financial stability. With more than $250 million secured for clients and decades of experience fighting major insurers, we know how to guide you through the process.

We offer direct access to a senior attorney, clear case analysis, and up-to-date guidance on what your policy requires. Call us at 888-583-4959 or use our contact form to schedule a free consultation and let us help you focus on recovery while we handle the insurance company.