Applying for Long-Term Disability Benefits After a Short-Term Disability Denial

If your short-term disability (STD) claim was denied, you’re probably feeling discouraged—and maybe wondering whether it even makes sense to try for long-term disability (LTD) benefits. The truth is: you often can still pursue LTD, and in many cases you should. Denying an STD claim does not automatically bar a valid LTD claim.

Why Short-Term Disability Claims Get Denied

We see STD denials happen for a number of reasons, such as:

• The insurer argues your condition doesn’t meet the policy’s standard of disability.
• Medical records are missing, inconsistent, or not detailed enough.
• The policy excludes your condition due to a pre-existing condition clause.
• The insurer disputes how long or how severely your symptoms affect your ability to work.

These issues don’t necessarily mean you’ll lose an LTD claim. In fact, LTD claims are often evaluated under different terms and definitions.

Key Differences Between STD and LTD Claims

Many people assume that if a short-term disability claim was denied, their long-term claim will automatically fail too. That isn’t the case. While the two types of coverage are related, they operate under different rules:

• Duration of Coverage: STD is designed for weeks or months of recovery; LTD is meant to support you when a condition lasts many months or years.
• Definition of Disability: STD denials often focus on whether you can’t work for a short period. LTD policies may use broader or different definitions, such as being unable to perform your own occupation or any occupation.
• Evidence Required: Because LTD is focused on longer-lasting impairments, insurers will expect more comprehensive records, such as specialist evaluations, long-term treatment notes, and functional assessments.

Understanding these differences is critical to building a stronger LTD claim after an STD denial. We’ve seen many clients succeed in securing LTD benefits even after their STD claim was denied.

RELATED POST: Own Occupation vs. Any Occupation In LTD Claims

Why You Should Still Consider Filing for LTD After STD Denial

Even if STD benefits were denied, you may still qualify for LTD if:

• Your condition has worsened or become clearly disabling.
• You now have stronger medical evidence to support your claim.
• The LTD policy uses a different standard of disability that fits your situation better.
• A different insurer is handling the LTD claim and will do a fresh review.

We’ve seen this play out many times. For example, we helped a client who was denied STD benefits by Sedgwick after only seven weeks because they claimed there were no “objective findings.” We filed an LTD claim with Lincoln at the same time using the same medical evidence, and Lincoln approved LTD benefits. Later, we also won the STD appeal.

In another case, a client with multiple chronic conditions was denied STD by Lincoln Financial. We filed an LTD claim alongside the STD appeal. The LTD claim was approved, which helped us overturn the STD denial and recover nearly tens of thousands of dollars in past-due STD benefits. Over the long term, the client received hundreds of thousands of dollars in LTD benefits.

How to Strengthen Your LTD Claim After STD Denial

Here are the steps we recommend:

1. Review your Denial Letter Carefully: Note why the insurer denied your claim and directly address those issues.
2. Collect Thorough Medical Records: Include test results, imaging, notes from specialists, and therapy records.
3. Ask Your Doctors for Detailed Support: Strong physician statements that clearly explain your restrictions and limitations are crucial.
4. Use Tools Like Residual Functional Capacity (RFC) Forms: RFC forms show how your condition limits your ability to work.
5. File Promptly: Timing is key—especially under ERISA plans with strict deadlines.
6. Get Help If You Need It: Disability insurance law is complex, and having an experienced attorney can make a big difference.

Moving Forward After a Denial

A denial doesn’t have to be the end of the road. While it’s discouraging to have your STD claim rejected, many claimants go on to receive LTD benefits. The key is to approach the long-term disability application with a stronger strategy, better documentation, and a clear understanding of the policy’s requirements.

If you’re facing uncertainty about your next steps, remember that you do not have to navigate the process alone. The Ortiz Law Firm helps individuals nationwide pursue the LTD benefits they deserve. Call (888) 321-8131 today to discuss your situation and learn how we can help.