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If New York Life denied your long-term disability (LTD) claim, submitting the right evidence on appeal may change the outcome. You need to gather as much evidence as possible, as this could be your one chance to stack the record that a court may later review. The focus should be on documenting your functional limitations, not just your symptoms.
Start With Why New York Life Denied Your Claim
Read the denial and list the reasons for the denial in plain language. Then match each reason with the evidence that counters it. For example, if the denial says there are “no objective findings,” testing that speaks to your symptoms and limitations can dispute it.
Medical Evidence That Actually Helps
Medical evidence is key to winning any disability claim. Your appeal should include:
- Residual Functional Capacity (RFC) Forms: Have providers quantify limits on sitting, standing, walking, lifting, fine motor use, concentration, pace, persistence, attendance, and breaks. For example: “must recline 2 hours in an 8-hour day,” or “off-task more than 15%.”
- Targeted Testing (When Available): Use tests that speak to your symptoms and limitations, such as imaging for spine or joint disorders, EMG/nerve conduction for neuropathy, CPET for exertional intolerance, tilt-table for orthostatic issues, or neuropsychological testing for cognitive deficits.
- Consistent Treatment Notes: Regular notes that track variability, flares, and recovery windows can establish reliable functional limits, even when diagnostic tests are inconclusive or unavailable.
Detailed and specific medical evidence improves the chance that your claim will be approved on appeal.
RELATED POST: Residual Functional Capacity Forms [Download a Free RFC Form]
Own Occupation vs. Any Occupation
Most group LTD policies first ask if you can perform your own occupation, then switch to any occupation that you’re reasonably fitted for by education, training, or experience. Your supporting documentation should match the definition of disability that applies to your claim.
During the “Own Occupation” Period
Show why the actual demands of your job exceed your functional capacity. Don’t rely on generic titles—document production pace, quotas, computer/phone intensity, fine-motor work, public contact, lifting/carrying, postural tolerance, and schedule rigidity. Correct any DOT/SOC misclassification and explain essential functions that can’t be reasonably accommodated.
After the Change to “Any Occupation”
Connect your limitations to off-task time, unscheduled breaks, and expected absences. Make clear why sedentary does not equal easy. Prolonged sitting, bimanual tasks, screen exposure, cognitive load, and attendance demands can all be too much when measured against your RFC.
RELATED POST: Own Occupation vs. Any Occupation
Vocational Evidence to Support Your Claim
You can better support your claim with:
- Documentation of failed return-to-work attempts (including the duration, flare triggers, and recovery time) or accommodations to establish real-world unreliability.
- A vocational expert report that rebuts transferable-skills analyses and labor-market surveys and explains why proposed jobs aren’t sustainable given off-task time and attendance limits.
This framing moves the discussion from “what is your diagnosis?” to “can you perform your own occupation—and later any occupation?” That’s the core question New York Life will ultimately decide.
Reliability and Day-to-Day Function
Work is about showing up reliably, staying on task, and maintaining pace. Evidence that illustrates reliability is often decisive.
- Symptom Journal: Brief daily entries about pain, fatigue, brain fog, or post-exertional crashes can tie doctor notes to lived experience. Note medication side effects that affect safety, attention, or stamina.
- Third-party Observations: Short statements from people who see you most days or from coworkers or employers can confirm variability, flare patterns, and the need for rest.
Address Video and Social Media Surveillance
You should assume that New York Life monitors your activities both on and offline. Keep daily life consistent with medical advice. If New York Life cites surveillance as a reason for the denial, respond with context. A short clip of a single task does not show changes in pace, recovery time, or whether you could repeat the task five days a week.
Evidence That Rebuts Common New York Life Arguments
- “No objective findings.” Submit the results of tests appropriate for your condition and provider letters explaining why some conditions are diagnosed clinically. Tie test results to concrete limits.
- “Our doctor disagrees with your doctor.” Provide detailed RFCs, clarify ambiguous chart notes, and include a point-by-point response to unfavorable independent medical exams or peer review reports.
- “You can do other work.” Supply a detailed job description, vocational analysis, and documentation of off-task time, absences, and need for unscheduled breaks.
- “Improvement” or “inconsistency.” Use timelines to show waxing and waning symptoms, therapy attempts, and why small gains do not equal an ability to work.
RELATED POST: How to Respond to a New York Life Independent Medical Review
How Ortiz Law Firm Can Help with Your LTD Denial
We focus on long-term disability appeals and lawsuits. Our approach emphasizes:
- Clear, quantifiable restrictions and limitations documented by treating providers
- Office visit notes and targeted testing that answers the insurer’s objections
- Vocational analyses that address reliability, pace, and attendance
- A complete, litigation-ready administrative record that preserves the issues for court
We can help you identify missing pieces, coordinate with your providers, and prepare a strong appeal package to reverse New York Life’s denial of your claim. We represent clients nationwide from our office in Pensacola, Florida.
If you want a long-term disability attorney to prepare your appeal, call (888) 321-8131 today for a free case review.
