Timing matters. Knowing what to expect helps you plan medical visits, gather evidence, and decide when to escalate. Here’s how New York Life typically handles long-term disability (LTD) appeals under ERISA and what can speed things up — or slow them down.
The Standard ERISA Timeline
For most employer-sponsored LTD plans governed by ERISA, the appeal decision window is 45 days from the date New York Life receives your appeal. If there are “special circumstances,” the insurer may take one additional 45-day extension, and they must tell you in writing why the extra time is needed.
Why the Clock Sometimes Pauses
Under the 2018 ERISA rules, if New York Life obtains new medical or vocational reviews during your appeal, you’re entitled to see that material and submit a rebuttal before they issue a final decision. The timeline can be tolled while you review and respond. Prompt, focused responses help keep things moving.
What Can Delay an Appeal (and How to Avoid It)
Some slowdowns are avoidable with planning:
- Incomplete Records: Missing treatment notes or imaging forces extra requests. Ask providers early for complete, legible records and keep a simple sent/received log.
- New Test Results: Useful, but if results arrive at the eleventh hour, NYL may need more time to review them. Coordinate dates with your doctors.
- IMEs or Peer Reviews: You cannot prevent NYL from scheduling an exam or ordering a peer review, but responding quickly can keep things moving.
- Vocational Issues: Transferable skills analyses or labor market surveys can add time to the appeal. A precise job description may help you avoid these extra steps.
RELATED POST: New York Life’s Independent Medical Reviews and How to Respond
What You Control vs. What You Don’t
You can’t control the insurer’s internal pace, but you can submit a single, complete, well-organized appeal. Open with a brief letter that lists each denial reason and points to the evidence that disputes it. Place treating-provider RFCs and targeted testing up front, then recent records, vocational materials, and any rebuttals to IMEs or peer review reports.
RELATED POST: What Evidence Can Help Overturn a Denied New York Life Disability Claim?
Non-ERISA and Individual Policies
If your LTD policy is an individual policy (not through an employer) or otherwise not governed by ERISA, timelines are set by the contract and state law, not ERISA regulations. Many carriers still aim for a similar 30–90 day range, but it varies. Check your policy for specific deadlines.
If You Haven’t Heard Back
If a deadline passes without a decision or valid extension notice, request a written status update and a copy of any new evidence. Keep communications in writing and add them to your file.
How Ortiz Law Firm Manages New York Life Appeals
We focus on LTD appeals and lawsuits. Our team works with your providers to gather medical evidence and prepare responses to New York Life’s medical or vocational reviews, so they land inside the appeal window. We track every deadline, so you don’t have to.
Do you want help with your New York Life appeal? Call (888) 321-8131 for a free case review.
RELATED POST: Steps You Can Take to Prepare for a New York Life Appeal
