The Standard Long-Term Disability Denials And Appeals

What to Do If The Standard Denied or Terminated Your LTD Claim

If The Standard Insurance Company has denied or terminated your long-term disability (LTD) benefits, you are not alone. The Standard is known for its detailed claim reviews and strict interpretation of policy language—often leaving disabled claimants confused, frustrated, and without income.

A denial does not mean your claim is over. But what you do next matters. Understanding why The Standard denied your claim—and how the appeals process works—can significantly affect your ability to recover benefits.

The Ortiz Law Firm represents long-term disability claimants nationwide and Nick Ortiz has handled claims involving The Standard since 2005.

Why The Standard Denies Long-Term Disability Claims

Most denials issued by The Standard fall into predictable categories. Identifying the stated reason for denial is the foundation of a successful appeal.

Common reasons The Standard denies LTD claims include:

• Alleged insufficient medical evidence
• Failure to meet the policy’s definition of disability
• Pre-existing condition exclusions
• Mental health or substance abuse limitations
• Reliance on peer review physicians or vocational experts
• Surveillance or social media activity
• Inconsistencies in medical records
• Policy exclusions or limited benefit periods

While these reasons may sound reasonable on paper, many denials are based on aggressive policy interpretations rather than a fair assessment of your ability to work.

Understanding Your Disability Policy with The Standard

The Definition of Disability

Most Standard disability policies use a two-stage definition of disability.

During the initial own-occupation period, you must show that your condition prevents you from performing the material duties of your specific job. After that period ends, often after 24 or 36 months, the policy shifts to an any-occupation standard.

Many terminations occur at this transition point, even when a claimant’s medical condition has not improved. The Standard often relies on vocational assessments or paper-only medical reviews to justify these decisions.

Pre-Existing Condition Exclusions

Pre-existing condition exclusions are a frequent basis for denial. These provisions typically apply if treatment, consultation, or medication occurred within a defined look-back period before coverage began.

The Standard may apply these exclusions broadly, sometimes tying current disability to unrelated or minor prior treatment. These determinations can often be challenged, but only with careful analysis of medical timelines and policy language.

Mental Health and Substance Abuse Limitations

Many Standard policies limit benefits for disabilities caused or contributed to by mental disorders or substance abuse—often capping benefits at 24 months.

Insurers sometimes apply these limits even when physical conditions play a substantial role. Courts have generally upheld such limitations, which makes it critical to document all disabling physical conditions clearly and consistently.

Why Claims Are Denied Even When You Are Clearly Disabled

Claimants are often shocked to receive a denial when their doctors support their inability to work. This disconnect usually stems from how insurers evaluate claims.

The Standard may rely heavily on:

• Internal medical consultants who never examine you
• Vocational experts who focus on hypothetical jobs
• Selective reading of medical records

If your medical documentation does not clearly explain how your condition prevents sustained full-time work, insurers may deny benefits—even when disability is obvious in daily life.

Medical Evidence Pitfalls That Can Hurt Your Claim

Even strong claims can fail due to documentation issues. Common problems include:

• Treating physicians using vague or conditional language
• Doctors misunderstanding insurer questions
• Incomplete descriptions of functional limitations
• Failure to connect symptoms to job duties

Insurers sometimes contact doctors directly and ask leading questions. Proactive communication with your healthcare providers is essential to prevent misunderstandings that can later be used against you.

Surveillance, Social Media, and Credibility Attacks

The Standard may conduct video surveillance or review social media activity. Isolated activities, such as attending a family event or running errands, are often cited as evidence that a claimant can work.

These snapshots rarely reflect pain, fatigue, symptom variability, or recovery time. Successfully countering surveillance requires strong medical documentation and functional evidence.

What to Do After a Denial from The Standard

A denial letter is not the end of your claim. You have the right to file an administrative appeal—but deadlines are strict.

After receiving a denial, you should:

• Carefully review the denial letter
• Request the complete claim file
• Obtain a copy of the policy
• Calendar all appeal deadlines
• Begin gathering updated medical evidence

Missing an appeal deadline may permanently bar your claim.

How The Standard Long-Term Disability Appeal Process Works

Most employer-provided Standard disability policies are governed by ERISA. Under ERISA:

• You usually have 180 days to appeal
• All evidence must be submitted during the appeal
• Courts typically review only the administrative record

This makes the appeal—not the lawsuit—the most important stage of the case.

What Happens If Your Appeal Is Delayed

Delays are common. Some claimants experience months of silence or repeated promises of review “next week.”

If your appeal is delayed:

• Follow up regularly
• Request written status updates
• Keep detailed communication records
• Escalate when delays become unreasonable

Persistent delays may justify legal intervention.

Filing a Lawsuit Against The Standard

If administrative appeals are exhausted, you may be able to file a lawsuit in federal court (ERISA claims) or under state law (individual policies).

Courts generally cannot consider new evidence, which is why building a strong appeal record is critical.

Federal Court Cases Involving The Standard

Courts across the country have addressed disputes involving The Standard, including:

• Claims denied at the any-occupation stage
• Mental health limitation disputes
• Disagreements over disability onset dates

These cases highlight the importance of detailed documentation and strict compliance with policy requirements.

Lump-Sum Settlements and Buyouts

In some cases, claims may be resolved through a lump-sum settlement instead of ongoing monthly benefits. These buyouts require careful evaluation to ensure the offer reflects the true value of future benefits.

Settlement decisions should never be made without fully understanding the financial and legal implications.

FREE RESOURCE: Use Our LTD Lump-Sum Buyout Calculator

How the Ortiz Law Firm Helps Standard Claimants

We help claimants by:

• Reviewing denial letters and policies
• Identifying weaknesses in The Standard’s reasoning
• Building comprehensive appeal records
• Managing communications with insurers
• Filing lawsuits when necessary

We operate under a No Recovery, Zero Fee Guarantee.

Get Help with Your Standard Disability Denial

If The Standard denied or terminated your long-term disability claim, you do not have to face the appeals process alone.

Call (888) 321-8131 for a free case evaluation.

Frequently Asked Questions