Receiving a denial of your long-term disability (LTD) claim can be frightening, especially when you are unable to work and depend on disability benefits to support yourself and your family. You may have expected your insurance company to review your medical records, understand your limitations, and provide the benefits you need. Instead, you may receive a denial letter that leaves you wondering what went wrong and what you can do next. An insurance company may deny an LTD claim for several reasons. It may argue that your medical evidence does not prove that you are disabled, question the severity of your condition, claim that you can perform another type of work, or point to a policy requirement that it says you did not meet. A denial does not always mean that your claim has no merit. You may have the right to challenge the decision through an appeal or another legal process, depending on your policy and circumstances. Because strict deadlines can apply after a denial, you should avoid putting off a review of your claim. If you have received an LTD denial, consider speaking with Findley Law early so you can better understand the decision and your available options.

Your insurance company may use several reasons when denying an LTD claim, but the explanation in your denial letter does not necessarily tell the entire story. You may be told that your medical records do not provide enough support for your disability, even though you are receiving ongoing treatment and dealing with significant limitations. The insurer may also focus on selected statements from your medical records while giving less attention to other evidence that supports your inability to work. In some cases, the insurer may argue that you can perform your occupation or another form of work despite the restrictions caused by your condition. Policy language can also create complications because the definition of disability may change after a certain period of benefits. Understanding exactly why your claim was denied is essential before deciding how to respond. You should carefully review the denial letter, your insurance policy, medical records, and any other documents related to your claim. If the reasoning seems incomplete, inconsistent, or unsupported by the evidence, legal guidance may help you identify issues that deserve further review. You don’t need to figure out the insurer’s reasoning on your own when professional assistance is available.

After an LTD denial, you may be tempted to send a short letter explaining that you still can’t work. Unfortunately, a simple disagreement with the insurance company’s decision may not be enough to reverse the denial. Your appeal may require detailed medical evidence, supporting statements from your healthcare providers, employment information, and a clear explanation of how your condition prevents you from performing the duties required by your occupation. You may also need to address specific reasons listed by the insurer and correct factual errors or missing information. The evidence should connect your medical condition to your actual functional limitations. For example, you may need to explain how pain, fatigue, cognitive limitations, mobility problems, or other symptoms affect your ability to sit, stand, concentrate, lift, communicate, maintain a schedule, or complete other essential work tasks. Your medical providers may need to provide more detail than simply confirming your diagnosis. Because appeal deadlines can be short, you should begin reviewing your denial as soon as possible. If you want help evaluating your options, Findley Law can review the circumstances of your denial and help you understand what you may need to challenge the decision.