Long-Term Disability Claims, Denials and Appeals

myths and facts about long term disability denials claims appeals.jpgBelow are some of the myths we often hear at our long-term disability law firm about LTD claims, denials and appeals. Each of these statements is false, and they are perpetuated by those who simply do not know the truth about long-term disability insurance.  

You may have heard some of these myths from your human resources department, employer, other lawyers, or your friends or neighbors. The fact that these myths are false may surprising or even scary if you are facing denial and don't know what to do next. 

Don't be scared - be smart.  The first step in empowering yourself to take on the insurance company is educating yourself about facts and falsehoods surrounding long-term disability claims, denials, and appeals.  Our long-term disability lawyer is ready to assist. If you have questions or want to discuss your LTD claim, call us at 816-203-0143.

13 Myths About Long-Term Disability Insurance

  1. If you apply for long-term disability benefits and fill out all the insurance company's forms, you will be treated fairly and awarded benefits.
  2. If you were denied benefits, just write a lengthy letter to the insurance company that explains in great detail how you are disabled and why you should receive benefits. The insurance company likely will be persuaded.
  3. If the insurance company sends you additional forms or wants you to submit an "activity log", it's because they intend to pay your benefits and simply need more information. 
  4. If you have already been awarded social security disability benefits, you are automatically entitled to receive long-term disability benefits. 
  5. You don't need a lawyer to appeal a denial of an ERISA long-term disability claim. 
  6. Any lawyer can effectively represent you in a long-term disability claim because these cases are just like any other legal case. 
  7. You do not need to submit all information in your appeal and should withhold information that you may want to present at trial. 
  8. A jury will be sympathetic to your testimony.
  9. Your doctors will be allowed to attend the trial, and their testimony will be very persuasive. If your doctor says you are disabled, then you cannot lose. 
  10. If your employer says you're disabled, then the insurance company will always pay. 
  11. The appeal process of earning ERISA long-term disability denials is fair, and you are on a level playing field with the insurance company. 
  12. Mental or cognitive disabilities are treated like any other disability under your policy. 
  13. If you can't do your job but can do other part-time work, you are still entitled to benefits. 

13 Truths About Long-Term Disability Insurance

While the above statements are myths about long-term disability, below are statements that accurately describe how long-term disability claims, appeals and insurance companies operate. 

  1. Long-term disability insurance companies are in business to make money. They make money by denying claims and paying claimants as little as possible. 
  2. Being reasonable or writing long, detailed letters usually won't get you long-term disability benefits. 
  3. If the insurance company sends you additional forms or wants more information, it is usually trying to find a reason to deny your claim.  
  4. Insurance companies' long-term disability policies are not bound by the decision made in awarding social security disability benefits
  5. You need to hire an ERISA long-term disability lawyer because these appeals are complicated and the law is written in a way that strongly favors insurance companies.  
  6. Very few lawyers handle ERISA long-term disability claims and appeals. These cases and the lawyers that handle them are different.
  7. You should not hold back any evidence in your appeal because new information cannot usually be submitted in court. 
  8. If your case goes to court, you won't testify, and your doctors won't testify. No one will testify because there is no trial. 
  9. The judge will decide your case on the documents submitted. There are no juries so it doesn’t matter whether a jury would be sympathetic. 
  10. It doesn't matter if your doctor or your employer says you are disabled. Instead, the insurance company wants “objective proof” that you are disabled. 
  11. The insurance company's appeal process is not fair, and the law of ERISA is written in a way that gives the insurance company the benefit of the doubt in court.  This is not a "level playing field."  Even if the judge finds that you are disabled, he or she may still find that you are not entitled to benefits. That's right, in ERISA long-term disability claims, the legal system is rigged against you. 
  12. Many conditions may be considered disabling, but most long-term disability policies treat mental illness and cognitive challenges as different. You aren't entitled to benefits in the same way you are with other conditions. 
  13. If you can't perform your job but you can do other part-time work, you may be not entitled to disability benefits. Some long-term disability policies require you to be unable to work any job, even on a part-time basis, to be entitled to benefits.

Call Our Long-Term Disability Attorney

Still, have questions about your long-term disability policy or claim?  Perhaps you have received a denial letter in the mail and are wondering what to do next.  Our long-term disability attorney is ready to answer your questions and guide you through the process.  

Let us review your denial letter for free.  You may contact us using the form below or reach us at 816-203-0143.  You can also download our free LTD appeal guide right now to find out what you can do to protect your rights and win your appeal.  Whatever you do, don't wait -- there are strict deadlines that apply to these cases!


Kevin J. McManus
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Kevin McManus is an accident injury and disability lawyer in Kansas City, MO, and Overland Park, KS
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