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The long-term disability process can be complex and overwhelming, especially when faced with the challenges of a denied claim. Sun Life is a prominent provider of long-term disability insurance, and understanding the ins and outs of the denial and appeal process is critical for policyholders.
When Sun Life denies a claim for long-term disability benefits, it can leave individuals uncertain and financially distressed. Knowing how to effectively navigate the appeals process is key to potentially overturning the denial and securing the benefits you rightfully deserve.
A long-term disability attorney like Nick Ortiz knows the ins and outs of long-term disability appeals. He can help you navigate the Sun Life appeals process and get your benefits back. If you’ve already tried to appeal on your own (which we don’t recommend), we may still be able to file a lawsuit against Sun Life.
Time is of the essence here as there are short deadlines. Call us now at (888) 321-8131. We are here to help.
About Sun Life Long-Term Disability Insurance
Sun Life Financial Inc. is a global insurance company known for its life and disability insurance. They offer short- and long-term disability insurance that your employer may offer as a group policy. Most Sun Life disability policies from are governed by ERISA, a federal law that often favors insurance companies. This can lead to aggressive denials of LTD claims by Sun Life.
If Sun Life is your long-term disability insurance company, pay special attention to the paperwork the insurance company requires you to fill out for LTD claims. The applications are not designed to be easy to fill out. In fact, it would not be much of a stretch to say that the sheer length and difficulty of the application is designed to overwhelm claimants from the very beginning of the application process.
FREE RESOURCE: Top Ten Mistakes That Will Destroy Your Long-Term Disability Claim
The bottom line is this: Sun Life does not like to pay long-term disability claims. Sun Life has a track record of delaying or denying claims to avoid paying benefits. They may try to get you to settle for less than your plan promises. So, please don’t agree to any offers from Sun Life before you talk to an attorney who can run the numbers for you.
If Sun Life has denied your long-term disability claim, our attorney has experience handling ERISA LTD appeals and lawsuits. He’ll review your Sun Life denial letter and develop a strategy to help you fight a wrongful denial. We will guide you through the process to get the benefits you deserve. Call us today at (888) 321-8131.
Understanding Sun Life Long-Term Disability Denials
Facing a Sun Life long-term disability denial can be overwhelming and frustrating. Sun Life often writes lengthy denial letters that can be over 20 pages long. Our theory is that the long denial letter intimidates the claimant into thinking that the negative evidence is so overwhelming that the unfavorable decision must be correct. The insured may be so discouraged or intimidated that they believe that appealing the denial is pointless.
In other words, if the insurance company took twenty pages to deny the claim, Sun Life may be right. Understanding the reasons behind these denials can shed light on your next steps. Claimants must fight “tooth and nail” to collect LTD benefits under these policies. Here are some common reasons why Sun Life may deny your LTD claim:
Sun Life’s Medical Consultant Says You Are Not Disabled
Sun Life often relies on the opinion of its medical consultants, who may disagree with your doctor’s assessment of your disability. These consultants may argue that your medical condition does not meet their criteria for disability benefits, creating a discrepancy that results in a denial. It’s important to understand the specific criteria Sun Life uses to assess disability in order to effectively counter such claims.
Sun Life’s medical “peer reviews” are so biased against claimants as to be absurd. Yet, Sun Life relies on its doctors’ reports to deny claims. The disability insurance company remains steadfast in its denials, forcing all too many claimants to hire an attorney to file lawsuits to get payments they should already be receiving.
Sun Life’s Surveillance Tactics
Sun Life’s claims investigation tactics are extreme. They may conduct investigations, including video surveillance or social media monitoring, to gather evidence that contradicts your disability claim.
The investigation often extends beyond the individual disability claimant. Claimants and their families have been known to be investigated by private investigators. Sun Life will also directly attacks a claimant’s reputation and credibility to support the termination of a claim.
Being vigilant about your activities and ensuring consistency between your reported limitations and actual behavior can help you overcome this challenge.
Your Medical Evidence Wasn’t Enough
Insufficient or inconsistent medical evidence is a common reason Sun Life denies long-term disability claims. Submitting thorough and up-to-date medical records, test results, and provider evaluations is essential to supporting your claim. Make sure your medical evidence demonstrates the impact of your disability on your daily activities and ability to work, and leaves no room for ambiguity in the evaluation process.
Overcoming a Sun Life long-term disability claim denial requires a proactive approach and a thorough understanding of the reasons behind the decision. By addressing key factors such as conflicting medical opinions, surveillance tactics, and the sufficiency of your medical evidence, you can better position yourself for a successful appeal and eventual approval of your claim. Stay informed, advocate for yourself, and seek professional guidance to navigate the complexities of appealing a Sun Life denial.
Navigating the Sun Life Long-Term Disability Appeals Process
Navigating the Sun Life long-term disability appeals process can be challenging, but with the right approach, you can increase your chances of a successful appeal. Here’s a breakdown of the critical steps involved in navigating the Sun Life long-term disability appeals process:
Appeals Process Overview
When appealing a Sun Life long-term disability denial, it’s important to understand the appeals process. Typically, the process involves submitting an appeal within a certain time frame, providing additional documentation and evidence to support your claim, and waiting for a decision from Sun Life.
RELATED POST: LTD Appeal Guide: How to Appeal a Long-Term Disability Denial
Gathering Supporting Medical Evidence
A critical aspect of the appeal process is gathering and submitting relevant medical evidence. This can include medical records, test results, and statements from health care providers detailing the impact of your disability on your ability to work. Strong medical evidence can greatly strengthen your appeal.
Consult a Vocational Expert
Consulting a vocational expert can provide valuable insight into how your disability affects your ability to perform certain job functions. A vocational expert can evaluate your skills, limitations, and job prospects, to help build a compelling case for your appeal.
Obtain Testimony from Coworkers, Family, and Friends
Testimony from people who can attest to the impact of your disability on your daily life and work performance can be powerful supporting evidence. Testimony from coworkers, family members, or friends can provide a personal perspective on how your disability has affected you.
Writing a Compelling Appeal Letter
Writing a compelling appeal letter is essential to making a strong case for overturning a Sun Life long-term disability denial. Your appeal letter should address critical issues, highlight significant evidence, and clearly articulate why your claim deserves to be approved. Writing a strong appeal letter can greatly improve your chances of a successful appeal.
Stay Ahead of Appeal Deadlines
Staying ahead of all deadlines is essential to ensuring a smooth appeal process. Missing deadlines can result in your appeal being denied, so it is important to keep track of important dates and submit all required documentation on time.
Navigating the Sun Life long-term disability appeals process requires careful attention to detail, thorough preparation, and strong advocacy. By following these steps and getting the support you need, you can work towards a successful outcome to your appeal.
Can I Appeal a Sun Life Long-Term Disability Denial on My Own?
If Sun Life denies your long-term disability claim, you should not go it alone. While it is possible to appeal a Sun Life disability claim denial on your own is possible, a long-term disability attorney can provide valuable guidance, assistance, and expertise throughout the appeals process, increasing the likelihood of a favorable resolution in your favor.
The world of ERISA law is complex, and you don’t want to lose benefits on a technicality. Instead, we recommend that you contact our experienced long-term disability attorney for a free case evaluation. ERISA disability claims have strict deadlines, so don’t wait too long. Contact us online or call us today at (888) 321-8131 and let us help you secure your benefits.
What Happens After You File Your Appeal?
After you submit your appeal of your long-term disability denial to Sun Life, the process moves into a detailed review stage. Here’s what to expect.
Medical Reviews
Sun Life may have a medical consultant review your claim during the appeal review process. This review involves an independent medical professional reviewing your medical records and providing an opinion on your condition and disability claim. The findings of this report can play a significant role in determining the outcome of your appeal. It’s important to ensure that all of your medical documentation is thorough and accurately reflects your condition in order to effectively support your case.
Vocational Assessments
Sun Life may request a vocational assessment to evaluate your ability to perform job-related tasks as part of the appeal review process. A vocational expert will evaluate your skills, education, work experience, and limitations due to your disability. The purpose of this evaluation is to determine if there are suitable job opportunities are available to you given your current physical or mental limitations. The results of the vocational evaluation may affect the decision on your long-term disability claim.
Independent Medical Examinations
Sun Life may also require you to undergo an Independent Medical Examination (IME) during the appeal process. An IME is an examination by a medical provider selected by the insurance company. The purpose of the IME is to gather additional information about your medical condition and limitations.
Although the IME report is supposed to be impartial, it’s important to be careful, because these reports can sometimes be used to challenge your claim. Being prepared and transparent during the IME can help ensure that the report accurately reflects your condition and supports your claim for long-term disability benefits.
Navigating the Sun Life appeals process can be complex, but understanding these essential steps can help you prepare and present a solid case to support your long-term disability claim. In the following sections, we will discuss how to effectively address each of these issues to increase your chances of a successful appeal.
What If My Long-Term Disability Appeal Is Denied?
Facing a denial of your Sun Life long-term disability claim can be frustrating and overwhelming. However, all hope is not lost. There are steps you can take to appeal and possibly overturn the decision.
File a Second Appeal
If Sun Life denies your long-term disability appeal, don’t lose hope. You may have the option of filing a second appeal. This is a crucial stage where you can provide additional evidence, documentation, or a more detailed explanation of your medical condition. Consider including new medical records, expert opinions, or testimony from medical providers to strengthen your case.
When preparing your second appeal, be sure to clearly and concisely address the reasons for the initial denial clearly and concisely. Create a compelling argument that highlights why you believe you are entitled to long-term disability benefits. Be strategic and focus on key points that support your claim. Remember, persistence and determination can make all the difference in overturning a denial and obtaining the benefits you deserve.
Filing a Lawsuit Against Sun Life
If you do not qualify for a second appeal, or if your second appeal is also denied, you may consider taking legal action against Sun Life by filing a lawsuit. This step involves hiring an attorney experienced in handling long-term disability cases. An attorney can guide you through the legal process, represent you in court, and advocate for your rights.
Your lawyer will work to build a strong case on your behalf. They will gather evidence, prepare legal arguments, and negotiate with the insurance company to achieve a favorable outcome. Keep in mind that the legal process can be complex and time-consuming, requiring patience and perseverance.
Sun Life Case Summaries
The Ortiz Law Firm has not handle these claims, but they are summarized here to help claimants understand how federal courts handle long-term disability insurance claims. Please review our case results and client testimonials to learn more about some of the Sun Life claims we have handled in the past.
- Wilkinson v. Sun Life – Sun Life Abused Its Discretion in Denying Benefits
- Baker v. Sun Life – Court Rules in Favor of Insurance Company
- Faciane v. Sun Life – Court Rules in Favor of Sun Life in Underpayment Claim
- Christmas v. Sun Life – Court Rules That Evidence Clearly Supports Sun Life’s Conclusion
- Holmgren v. Sun Life – Court Rules Plaintiff Has Established That He Was Disabled
Get Help with Your Sun Life LTD Denial
If Sun Life has denied your claim, you should hire an attorney to help you appeal the unfavorable decision. Our disability lawyer is here to guide you through the appeals process and fight for the benefits you deserve. Nick A. Ortiz is an experienced long-term disability denial lawyer who can help you determine what steps you should take to get the funds you are entitled to.
Understanding Your Denial: If you’ve received a denial of your long-term disability claim from Sun Life, it’s important to understand why. Our attorney will carefully review your denial letter determine the issues that led to the denial. By identifying these reasons, we can strategize the best approach for your appeal.
Prepare a Strong Appeal: When appealing a Sun Life LTD denial, it’s important to present a compelling case supported by thorough documentation and strong legal arguments. Our disability lawyer will work closely with you to gather medical records, expert testimony, and other evidence to strengthen your appeal. We will draft a well-structured appeal letter that addresses all the reasons for the denial and highlights why you are entitled to benefits.
Represent You On Appeals: Facing a denied long-term disability claim can be daunting, especially when dealing with a large insurance company like Sun Life. Our attorney will represent you in all communications with Sun Life, ensuring that your rights are protected, and your appeal receives the attention it deserves. We will handle all aspects of the appeal process, allowing you to focus on your health and well-being.
Advocating for Your Rights: Our firm is dedicated to advocating for the rights of individuals who have been unfairly denied long-term disability benefits. Our attorney will tirelessly challenge Sun Life’s decision and seek a favorable outcome for your claim. We understand the complexities of disability insurance law and will use our expertise to pursue the benefits you deserve.
Take the First Step
If you are facing a denial of your Sun Life long-term disability claim, don’t hesitate to contact our experienced attorney for help. We provide compassionate and personalized legal representation to protect your rights throughout the appeals process. Let us help you navigate this difficult time and work toward securing the benefits you need. Florida disability denial attorney Nick A. Ortiz is here to take on this burden for you. Call us today at (888) 321-8131 to learn your rights and get the help you need to appeal your disability denial.
Frequently Asked Questions
Why did Sun Life deny my long-term disability claim?
Sun Life may deny your claim due to insufficient medical evidence, missed deadlines, or failure to meet policy requirements.
How can I appeal a denial of my LTD claim with Sun Life?
To appeal a denial, gather additional medical evidence, review your policy for appeal guidelines, and submit a detailed response to Sun Life.
Should I seek legal assistance for my long-term disability appeal with Sun Life?
Seeking legal assistance can be beneficial, especially if you encounter challenges navigating the appeals process or require additional support in presenting your case.
What is the typical timeframe for Sun Life to review an appeal?
Sun Life typically takes 45-60 days to review long-term disability appeals, but this timeframe can vary based on the case’s complexity.
What happens if Sun Life upholds the denial of my long-term disability claim after the appeal?
If Sun Life upholds the denial after the appeal, you may have the option to file an additional appeal or pursue further legal action in state or federal court.
