Claims for long-term disability (LTD) benefits are frequently denied, so don't give up hope if your initial claim is unsuccessful. Hiring an experienced attorney to advocate for your interests can increase your chances of winning an appeal.
The Definition of Disability Isn't What You Might Expect
To win your LTD appeal, you must be able to prove that you are disabled. However, there is no single legal definition of disability. Every insurance company, as well as the Social Security Administration and Veterans Health Administration, has a slightly different definition. The insurance company's specific definition is outlined in your policy documents.
The insurance company's representatives will review your medical records—typically a nurse or in-house doctor—to determine if you meet their definition of disability. Since medical professionals don't always agree, it's possible that your doctor might say you are disabled and the insurance company might disagree.
Social Security disability standards are typically tougher to meet, especially for applicants under 50 years of age. However, since the rules for Social Security disability are slightly different, being found disabled under these guidelines doesn't automatically qualify you for LTD benefits.
Vocational Reviews Might Make Unfair Assumptions
If the insurance company determines you don't meet its definition of disability, it will have a vocational analyst determine what jobs you may be able to perform. This is based on the insurance company's description of your limitations, work history, and jobs available in your home region. These reviews are often inaccurate due to false assumptions about your injuries, skills, and the local job market.
How Gibbons Leis, PLLC Can Help
Working with the experienced attorneys at Gibbons Leis, PLLC can address the specific problems that lead to applications being denied. Using the information in your denial letter, we can gather the necessary supporting evidence—including missing medical records, additional tests, and qualified expert testimony—to increase the likelihood of your claim being approved on appeal. Call today to schedule a free case evaluation.