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Why Choose Ortiz Law Firm for Your Principal LTD Denial?
Reasons for Principal Disability Insurance Denials+−
Appealing a Denied Principal Financial Disability Claim+−
How the Ortiz Law Firm Can Help+−
- Request a Free Consultation

Are you struggling after Principal Financial denied your long-term disability (LTD) claim? You’re not alone—nearly 1 in 5 U.S. workers becomes disabled for a year or more before age 65, and many find their legitimate claims unfairly denied by insurers like Principal Financial Group.

At Ortiz Law Firm, we help policyholders nationwide fight back when Principal Life Insurance Company refuses to pay disability benefits. Our experience with Principal’s denial tactics means you won’t face the appeals process alone.

Why Choose Ortiz Law Firm for Your Principal LTD Denial?

No fee unless we win your case—risk-free help.
Free, no-obligation consultation to review your denial letter and explain your options.
Additional resources: Get Your Free Book or Free Denial Letter Review.

Don’t let a denied claim threaten your family’s financial security. Call us today at (888) 321-8131 or email [email protected] to schedule your free consultation with a dedicated long-term disability attorney.

Ortiz Law Firm—Standing up for the disabled and their families nationwide.

Reasons for Principal Disability Insurance Denials

There are a variety of reasons that Principal or any other major disability insurance company might cite for denying your claim. Any disability insurance denial letter should state why the claim was denied. Below are some of the most common reasons disability insurance claims are denied:

Non-Medical Requirements

For each claim, Principal Financial Group must verify that the employee is eligible for disability insurance benefits. To qualify for disability insurance benefits, an employee must meet certain non-medical requirements, such as working a certain number of hours per week prior to the onset of disability or being an “active employee”. The term “active employee” is defined in each individual’s policy. If you do not meet the non-medical requirements in your disability insurance policy, Principal Financial will deny your disability claim.

Medical Requirements

Principal Financial disability insurance policies also have specific medical requirements that a claimant must meet in order to receive disability benefits from the insurance company. Many resources are used to help verify disability claims, such as a statement from the claimant, doctor and hospital records, Attending Physician’s Statements (APS), and home visits or field interviews conducted by the insurance company. Failure to provide the necessary medical records and documentation to support your insurance claim will result in a claim denial.

Medical Reviews and Independent Medical Examinations

In some cases, Principal Financial may conduct a more thorough investigation of a disability claim. It is not uncommon for the insurance company to request a consultation with a vocational expert or a medical review of your file by the Principal’s medical director. Your claim may be denied if they determine that the evidence does not support your reported symptoms and limitations.

Principal Financial Group may also have you undergo an “independent” medical examination by an “independent” physician. However, this “independent” doctor is paid by Principal Financial, so the doctor has a motive to side with the insurance company. We believe a more accurate name for this part of a disability claim would be a mandatory medical exam.

Video Surveillance

Insurance companies like Principal Financial have also been known to conduct surveillance on claimants, often hiring investigative firms to follow a claimant and record their activities, especially if they have scheduled an IME that you are required to attend and they know that you will be out and about. This surveillance video becomes part of your claim file and is used to justify a claim denial.

Another common surveillance tactic in disability claims is to review the claimant’s social media accounts. Any social media posts, photos, or video surveillance that contradicts your reported symptoms and limitations could be used to deny or terminate your claim. You should check your privacy settings and ask friends and family not to tag you in any photos.

The frequency with which an insurance company verifies a claimant’s current disability status depends on the applicable policy’s definition of “disability,” the claimant’s medical condition(s), and the prognosis of the claimant’s medical condition(s). Most insurance companies, including Principal Financial, will contact claimants at least once every 18-24 months to verify that their condition has not changed.

Appealing a Denied Principal Financial Disability Claim

Do not lose hope if you have received a claim denial letter from Principal Financial. When an insurance company denies your claim, you have the right to appeal the decision. Many claimants are already overwhelmed by the claims process and choose to hire an experienced attorney for legal advice and assistance with the administrative appeal process.

Under most policies, you or your attorney only have 180 days to file an appeal, so you need to contact an attorney as soon as possible. Most attorneys offer a free consultation to help you determine if the attorney-client relationship is right for you.

Do I Need to File an Appeal?

If you have a group insurance policy through your employer, your claim is likely governed by the Employee Retirement Income Security Act (ERISA). Under ERISA disability law, you must exhaust your administrative appeal rights with the insurer before filing an ERISA lawsuit.

However, the claims of those with in Individual Disability Insurance or those with a government or church employer are not governed by ERISA law but are governed by state law. In a non-ERISA case, you may be able to file a lawsuit without going through the administrative appeals process.

Why Accessing Your Full Claim File Matters

Before you can build a strong appeal, it’s critical to get your hands on the complete claim file from Principal Financial. Why? Because your claim file is essentially the playbook the insurance company used to deny (or stop) your benefits—it includes every piece of evidence, every report, every email, and even those surveillance videos they might have used against you.

That’s why requesting and thoroughly combing through your claim file is a key first move in an appeal. It lets you:

See exactly what information Principal used (or ignored) to make their decision.
Identify mistakes, missing documents, or misinterpretations in the record.
Gather any medical or vocational evidence that needs clarification or rebuttal.

Remember, you typically only have one shot at an administrative appeal, and the evidence you put forth here often sets the boundaries for any future legal action. This is why it’s so important to start strong—with a clear understanding of everything in your claim file.

What Information Is Included in a Claim File Under ERISA?

If your disability claim falls under ERISA, you have the right to request your complete claim file from Principal Financial Group. When you make a written request, Principal is required to provide all of the documents and records they used when evaluating—and ultimately denying—your benefits application, typically within 30 days.

But what exactly makes up this claim file? You can expect it to include:

All medical records Principal relied upon when reviewing your claim
Financial documentation connected to your benefits
Plan documents outlining your coverage
Copies of internal communications, such as emails, memos, and notes
Any reports from medical, vocational, or occupational experts
Surveillance footage or investigator’s notes, if any were gathered during the process

Having access to this entire file is crucial. It allows you—and your attorney, if you choose to hire one—to examine the reasoning behind Principal’s decision, identify any missing pieces, and build the strongest possible appeal.

What Does “Reasonable Review” Mean Under ERISA for a Principal Appeal?

In ERISA disability appeals with Principal Financial, the idea of a “reasonable review” is front and center. But what does it actually mean? Simply put, it refers to the standard a court uses when looking at an insurance company’s decision to deny disability benefits. Instead of starting from scratch, the court asks: Did Principal handle your claim in a fair and considered way, given all the facts and evidence?

If your appeal escalates to a lawsuit, the judge won’t automatically decide if they would have made the same call. Instead, they must decide if Principal’s review process was unreasonable. Here’s the catch: even if the judge personally believes you are disabled, your denial will only be reversed if there’s clear evidence that Principal’s review was arbitrary, capricious, or otherwise outside the bounds of rational decision making. If the insurance company followed a reasonable process—even if they reached the wrong result—the court is usually required to uphold their decision.

What does this mean for you? It raises the bar for overturning a denial. That’s why it’s so important to build a thorough and robust administrative appeal. Anticipate where Principal might challenge your evidence, address any possible inconsistencies, and provide as much clear, objective medical documentation as possible. The goal is to leave no room for a “reasonable” justification for denial, making it harder for the insurance company—and the court—to say the process was fair if it truly wasn’t.

When Should I Consider Hiring a Lawyer?

Our team typically receives a call from a claimant who has received a denial letter from Principal Life in their claim for long-term disability benefits and wants to appeal. The denial could be from the initial application where no benefits were ever paid, or the denial could be a termination of benefits (also called a cessation or cut-off of benefits). Cessation claims can also be appealed.

Best Practices for Documenting Medical Evidence in a Disability Appeal

One of the most critical factors in a successful disability appeal—whether you’re up against Principal Financial or any insurer—is having ironclad medical evidence that clearly demonstrates your limitations. Insurance companies frequently question the sufficiency of medical documentation and often lean on the assessments of their in-house doctors instead of the opinions of your own treating physicians. To level the playing field, you’ll want to build a thorough, well-documented case.

Here’s what we recommend to maximize your chances:

Get Detailed Medical Records: Ask your doctors to provide comprehensive documentation, not just standard visit notes. These records should explain your symptoms, diagnosis, treatment efforts, and—most importantly—how your condition interferes with your ability to work. Be sure they capture even the day-to-day functional limitations you experience.
Bridge the Communication Gap: Most doctors are focused on your care, not the needs of insurance paperwork. Educate your providers about what the insurance company is specifically looking for. Encourage them to spell out the impact of your condition in terms the insurer understands and to use language consistent with your policy’s definition of disability.
Secure Written Support from Your Treating Providers: Insurance companies are skeptical unless they see strong statements from your own doctors. Consider asking your provider to fill out a custom statement (often called an Attending Physician Statement) that goes beyond the generic forms insurance companies provide. These personalized statements should address your unique medical issues and directly tie them to your inability to perform your occupational duties.
Coordinate Among Multiple Providers: If you’re treating with different specialists, make sure each is on the same page regarding your limitations. Collect statements from all relevant physicians—internists, neurologists, orthopedic doctors, psychiatrists—so the insurer can’t argue that the documentation is incomplete or inconsistent.
Be Proactive with Updates: Don’t rely on old records. Submit recent documentation, including updates on new treatments, test results, or progression of your symptoms. The goal is to demonstrate an ongoing inability to work as clearly as possible.

Remember, the more precise and persuasive your medical documentation, the stronger your appeal will be. Solid, unified statements from your treating doctors can make the difference between another denial and a successful outcome.

What Types of Occupational Evidence Can Strengthen Your Appeal?

When preparing an appeal for a denied disability claim, providing detailed occupational evidence can make a significant difference in the outcome. Helping the insurance company clearly understand how your condition affects your ability to work is critical. Consider gathering the following materials to support your case:

Written statements from your supervisor or colleagues describing your daily duties and any changes they’ve observed in your work performance.
A current copy of your official job description, highlighting the essential functions and physical or cognitive demands of your position.
Your own written account outlining a typical workday, including challenges or limitations you experience due to your condition.
Documentation of performance evaluations, productivity reports, or examples of your work output that illustrate the impact of your symptoms.
Any industry-specific data or job analyses that reinforce the skill level, physical requirements, or mental demands associated with your role.

Collecting and submitting this type of occupational information not only demonstrates the specific requirements of your job, but also helps connect the dots between your diagnosis and your functional limitations.

Preparing for a Change in Disability Definitions

It’s important to be aware that your disability policy may change how it defines “disability” as your claim progresses—often shifting from an “Own Occupation” standard to an “Any Occupation” standard after a set period, like 24 months. This means, at first, you may only need to prove you can’t perform the duties of your specific job. But later, you might have to show you’re unable to work in any job for which you’re reasonably qualified based on your education, training, and experience.

To put yourself in the best position:

Gather comprehensive medical evidence: Continually update your records to show ongoing limitations that would impact any job, not just your own.
Get detailed doctor statements: Ask your healthcare providers to address both the “own occupation” and “any occupation” definitions directly in their reports.
Document all work-related limitations: Keep a journal or log of activities you have difficulty performing—whether on or off the job—to help illustrate the widespread impact of your condition.
Consider vocational evaluations: Independent assessments can help demonstrate how your medical conditions would affect your ability to work in other occupations.

Preparing your appeal with these changes in mind can help ensure your claim is ready for the insurer’s evolving requirements—reducing the risk of future terminations or denials.

What Strategies and Evidence Are Most Effective in Overturning a Principal Financial Group Disability Denial?

Challenging a disability denial from Principal Financial Group requires more than just resubmitting the same paperwork. You need a tactical, evidence-based approach tailored to the details of your policy and medical situation.

1. Gather Robust and Relevant Medical Documentation

First, ensure your medical records provide a full, accurate picture of your limitations—not just a summary of your diagnosis. Principal may lean on opinions from their own in-house medical staff, who can overlook or minimize your physician’s assessment. Work closely with your treating doctors to document how your condition impacts your daily life and job duties. Providing clear, specific details about your restrictions, functional limitations, and symptoms is critical.

Ask your doctor to address not only your diagnosis but also your functional capacity (what you can and cannot do).
If Principal provides you with a generic attending physician form, supplement it with a tailored, condition-specific statement. This can outline nuances that standard forms miss.
Encourage your physician to use the precise language found in your policy’s definition of disability.

2. Secure Comprehensive Support from Treating Physicians

Many physicians aren’t familiar with insurance jargon or the importance of highlighting specific limitations for disability claims. Educate them about the process and ask them to address any questions or claims made by Principal’s medical consultants. A strong, well-explained letter from your treating physician—focused on how your medical conditions limit your ability to work—is a powerful asset.

3. Utilize Vocational Evidence

Principal often takes a broad view of job requirements, sometimes relying on in-house vocational experts who use generic national descriptions instead of recognizing the specific way you performed your job. Counter this by:

Submitting your official job description and, if possible, a statement from your employer confirming your actual duties.
Requesting a vocational evaluation by an independent vocational expert. This evaluation can explain why your specific medical and functional limitations prevent you from returning to your prior job—or to any “alternative occupations” the insurer suggests.
Including a personal statement that describes a typical workday and the ways your impairment affects your performance.
Including industry reports or work product samples to demonstrate the complexity and demands of your occupation.

4. Present Additional Occupational Evidence

If Principal suggests you can perform other jobs, challenge these assumptions with detailed evidence:

Show why proposed “alternative jobs” are not realistic or available in your region. Labor market analyses and salary surveys can help.
Explain, using concrete evidence, how your medical restrictions are incompatible with these other positions.

5. Plan for Changes in Policy Definitions

Most long-term disability policies shift from an “own occupation” to an “any occupation” standard after a certain period (often 24 months). When appealing, include evidence that not only demonstrates your inability to perform your prior job but also shows you would not be able to transition into any reasonable alternative role as defined by your policy.

Address both standards in your appeal to preempt future challenges from the insurer.

6. Be Thorough, Timely, and Persistent

Appeals succeed when every facet of the case is addressed with clarity and supporting evidence. Organize your materials, meet the deadlines (usually 180 days), and support each point with objective documentation—whether it’s a medical report, vocational evaluation, or employer statement.

By following a strategic approach, gathering robust documentation, and enlisting the support of both your treating physician and vocational experts, you greatly increase your chances of persuading Principal Financial Group to reverse their denial and approve your disability benefits.

Why a Strategic Appeal Matters

When challenging a denial from Principal Financial, the way you draft your appeal can make all the difference. Most Principal policies include a “discretionary clause.” This legal provision gives Principal significant leeway in interpreting the terms of their policy and deciding whether you qualify for benefits. In these cases, courts will often uphold Principal’s decision unless it is entirely unreasonable—even if you disagree with their reasoning.

Because of this, your appeal should go beyond simply pointing out errors or expressing frustration. It’s crucial to build a case centered on objective, well-documented medical evidence that aligns with your policy’s specific definition of disability. Focus on providing records, physician statements, and other proof that clearly demonstrate your inability to perform the duties of your own (or any) occupation as defined by your plan.

There’s another layer to consider: in some states, discretionary clauses are not allowed. If that applies to your policy, the court will review your case more strictly and independently. However, for most group policies under ERISA, careful preparation is essential, as the strength of your appeal largely shapes the outcome should litigation become necessary. By planning your approach and prioritizing solid medical documentation over criticism of the insurer’s process, you preserve your best chance at overturning a denial—regardless of Principal’s initial position.

Pitfalls of Pointing Out Errors in Principal Financial’s Review

It may seem like a smart move to point out every mistake in Principal Financial’s claim review. However, there is a potential downside. When you highlight minor errors or inconsistencies, you might inadvertently give the insurance company a chance to correct those issues before a lawsuit ever gets to court. This can end up making their denial look more thorough and convincing in front of a judge.

Instead, it’s often more effective to focus your appeal on substantial deficiencies—such as missing medical evidence, unfair evaluations, or procedural errors that genuinely impacted your claim’s outcome. By concentrating on the key weaknesses, you avoid helping Principal “clean up” their file and shift the focus back onto why your disability claim deserves approval.

Common Mistakes to Avoid in Your Disability Appeal Letter

When preparing an appeal letter to Principal Financial Group, it’s important to proceed with caution. One pitfall to avoid is simply outlining every error you believe the insurance company made in denying your claim. While it may be tempting to point out every flaw, providing a point-by-point list can inadvertently help the insurer by showing them exactly how to shore up their arguments in the next round of review.

Instead, focus your appeal on supplying strong, supportive medical evidence and clarifying any misinformation. Be sure your letter:

Clearly explains how your condition meets the policy’s disability definition
Includes updated medical records, statements from your treating providers, and any new test results
Addresses any alleged inconsistencies or issues raised in the denial letter without giving a detailed roadmap for the insurer to fix their case
Remains professional and fact-based—avoid emotional language or personal grievances

A strategic and evidence-based approach gives you the best chance of success on appeal. If you’re not sure how to craft your response or what evidence will carry the most weight, don’t hesitate to consult an attorney familiar with disability insurance claims for guidance.

Understanding the “Abuse of Discretion” Standard in Principal Financial Disability Appeals

The “abuse of discretion” standard is a critical legal hurdle for those appealing a denied Principal Financial disability claim—especially under a group policy governed by ERISA. Here’s what this means for your case, and why the way you approach your appeal is so important.

When you challenge a denial in court under this standard, the judge won’t simply substitute their judgment for the insurance company’s decision. Instead, the court asks whether Principal Financial acted reasonably when it denied your claim—even if that denial was ultimately wrong. If Principal’s review process is found to be reasonable—even if you and your doctor believe you meet your policy’s definition of disability—the court must uphold the decision.

What does this mean for your appeal? Essentially, it’s not enough to point out every mistake or argue the company was wrong. You need to build a strong case that focuses on clear medical documentation, proving you meet the specific criteria of your policy. Be mindful: focusing only on Principal’s technical errors may give them a chance to correct those mistakes and make a stronger argument for why their denial was still “reasonable.”

There are exceptions: some states do not allow discretionary clauses in disability insurance policies. In those cases, the court can make a new determination without giving Principal’s decision any extra weight.

Understanding these legal nuances is key. A skilled disability attorney can develop an appeal that anticipates Principal’s arguments and presents solid, policy-specific evidence to maximize your chances of success.

Responding to Unreasonable Job Suggestions from Principal Financial Group

If Principal Financial Group has denied your claim and included a list of jobs they believe you can perform, don’t be discouraged—these suggestions are often generic, outdated, or simply not a good fit for your circumstances. It’s quite common for insurance companies to reference occupations that either don’t exist in your local job market or require skills and abilities you simply do not have given your medical situation.

To effectively challenge these job recommendations:

Gather Evidence from Your Workplace: Obtain statements from your current or former employer, co-workers, or supervisors describing the physical and mental demands of your actual job duties.
Review Your Official Job Description: Supply a copy of your formal job description, highlighting the essential tasks you performed and emphasizing any accommodations or modifications you needed.
Document Your Functional Limitations: Provide an updated statement from your treating physician that captures your medical restrictions and how they prevent you from working in either your own or the suggested alternate occupations.
Submit a Personal Statement: Write out what a typical workday looks like for you post-disability, focusing on the specific activities that are impossible or significantly limited because of your condition.
Use Labor Market Information: Reference local employment data or industry reports showing that the recommended positions are not reasonably available where you live or are not a match for your background, education, or health limitations.

Anticipate that your policy may eventually shift from an “own occupation” to an “any occupation” definition of disability (typically after 24 months). When appealing, ensure you are building a case that accounts for both—demonstrating not only why you can’t perform your prior work, but also why any alternative job suggested by Principal isn’t appropriate for you.

Ultimately, the key is to present a comprehensive, clear, and evidence-backed response that leaves no room for interpretation. Taking these steps will strengthen your appeal and help protect your benefits as your policy’s definition of disability changes.

Challenges in Appealing Principal Financial Group Mental Health Disability Denials

Appealing a mental health-related disability denial from Principal Financial Group comes with its own set of hurdles. Unlike claims involving visible or well-documented physical injuries, mental health claims are often met with increased skepticism and a demand for clear, ongoing documentation.

Common Obstacles

Insufficient Medical Records: One of the biggest issues claimants face is a lack of consistent medical treatment or documentation. Many individuals delay seeking treatment for mental health concerns, which results in gaps or sparse records—something Principal Financial (and most insurers) may quickly seize upon as grounds for denial.
Requirement for Objective Evidence: Insurance companies often expect not just self-reported symptoms but also objective clinical assessments. If your medical chart contains mostly subjective complaints without psychological testing or evaluations, your claim is at greater risk of being denied or terminated.
Misunderstanding of Mental Health Conditions: There’s a persistent bias that symptoms must be documented at each stage, and delays in treatment can undermine your credibility in the insurer’s eyes, even though delayed care is typical for many suffering from mental illness.

Overcoming These Challenges

Successfully appealing requires both a strategic approach and strong evidence. Here’s what our experience shows is most effective:

Arrange for Comprehensive Testing: Seek independent, objective assessments—such as neuropsychological testing or evaluations by mental health specialists. These reports provide concrete, clinical data insurers can’t easily ignore.
Document Ongoing Treatment: Regular follow-ups with your treating providers not only support your claim but also help fill any potential gaps in your medical history. After each visit, request copies of your records and ensure they accurately describe your symptoms and functional limitations.
Explain Gaps in Treatment: If your claim involves delays in seeking care, it’s critical to address these directly in your appeal letter. We emphasize to Principal (and any insurer) that delays are common with mental health conditions and don’t diminish the legitimacy of your disability.
Build a Detailed Appeal: Assemble a thorough appeal package that weaves together your medical records, specialist evaluations, and any relevant testing. Clearly connect how the evidence supports your diagnosis and ongoing limitations, and directly refute any reasons cited in the denial letter.

By proactively gathering objective medical data and maintaining clear documentation at each stage, many claimants are able to overcome initial denials and ultimately secure the benefits they deserve.

How the Ortiz Law Firm Can Help

Nick Ortiz is an experienced disability attorney and the founder of the Ortiz Law Firm. Mr. Ortiz has provided and offers the following legal services for disability claimants who have a group long-term disability insurance policy purchased through an employer or an individual disability income policy purchased from Principal Group:

The appeal of a Principal Life denial of disability benefits;
The appeal of a Principal Life termination of disability benefits;
An ERISA appeal of a Principal Life denial of disability benefits; and
A federal lawsuit or complaint against Principal Life for the wrongful denial of disability benefits.

Request a Free Consultation

If you have a claim against Principal Life for the wrongful denial or termination of long-term disability benefits, call the Ortiz Law Firm today at (888) 321-8131 for a free consultation with an experienced disability attorney.

Denied Principal Disability Benefits? Get Legal Help to Secure Your Income