What Steps Should I Take to Prepare for an Appeal After a New York Life Denial?

If New York Life denied your long-term disability (LTD) claim, this isn’t the end of the process. Your administrative appeal is your opportunity to correct the record, add strong evidence of your limitations, and build a complete file that can support you later in court if necessary.

This guide outlines the steps to take now so your appeal is as strong and litigation-ready as possible.

Protect Your Deadline and Build a Paper Trail

The denial letter will state your appeal deadline—most ERISA-governed plans give you 180 days to submit your appeal. Mark the last possible date on your calendar and set a personal goal to file your appeal two to three weeks earlier.

Next, request the following in writing:

• Your complete claim file
• A copy of the policy and any plan documents
• Internal guidelines or “rules” used by New York Life to evaluate the claim

If you haven’t already, this is a good time to start keeping track of your communications with the insurance company. Keep a detailed log of what you sent, the date you sent it, who you sent it to, and if you received any confirmation upon receipt.

IdentifyWhy New York Life Denied Your Claim

Read the denial letter and list the reasons for denial in plain language. That short list becomes your action plan. For every reason, decide what you need to submit in response to it. You will need to gather updated treatment notes, targeted testing, a treating doctor’s functional assessment, or a vocational opinion tied to the actual demands of your past work.

Denial Reason (Example)	What to Gather
“No objective findings”	Updated imaging, EMG/nerve studies, lab results , or a provider letter connecting results to functional limits.
“You can perform other work”	Detailed job demands; vocational opinion addressing reliability, pace, and attendance.
Peer reviewer disagrees with your doctor	Treating provider RFC, clarified notes, and a point‑by‑point response to the peer review.

RELATED POST: Why New York Life Denies Disability Claims (and How to Fight Back)

Strengthen Medical and Vocational Proof

A diagnosis alone does not equal disability—you must show how your condition prevents you from working reliably and consistently. The most common mistake I see claimants make is assuming that a written explanation or argument will fix a denial. ERISA appeals are won with evidence — not with a letter disagreeing with the insurance company.

Ask your providers to document:

• How long you can sit or stand before changing positions
• Whether you can sustain full-time attendance
• How pain, fatigue, or cognitive issues affect pace and concentration
• How often flare-ups or symptoms require unscheduled breaks or absences

When appropriate, discuss targeted testing such as:

• Imaging (MRI/CT) for spinal or joint disorders
• EMG/nerve conduction studies for numbness/weakness
• Neuropsychological testing for cognitive concerns
• CPET testing for post-exertional malaise or fatigue disorders

The most persuasive appeal packets combine clinical evidence with functional evidence.

RELATED POST: What Evidence Can Help Overturn a Denied New York Life Disability Claim?

Collect Day-to-Day Evidence That Shows Real-World Limitations

Small, consistent details carry weight. A short symptom journal, statements from people who see you often, and medication logs that show side effects link the medical file to daily function. If you have a Social Security disability decision, include it for context. (New York Life is not required to agree with it, but insurers take notice when another agency has found you unable to work.)

Surveillance and Social Media

New York Life may use surveillance or social media to question your limitations.

If they present clips or screenshots:

• Provide context (e.g., you rested afterward or pushed through pain for a brief event).
• Tie the explanation back to reliability, frequency, and duration, not “can you do it once.”

Short activity does not equal full-time work.

Package the Appeal Clearly

Submit one complete packet. Open with a concise letter that identifies each issue and points to the proof that answers it. Place provider letters and functional assessments up front, followed by recent medical records and any vocational materials. Number the exhibits and confirm receipt in writing. Before you file, check that every denial point is supported by evidence in the packet.

RELATED POST: What Steps Should I Take to Appeal a New York Life Denial?

What Happens After You File

Under ERISA, New York Life generally has 45 days to issue a decision, with one possible 45-day extension if they notify you in writing.

If New York Life obtains a new medical or vocational report, they should send you a copy for review. If not, request a copy immediately. You are entitled to respond to it before the final decision.

Can You Appeal a New York Life Denial on Your Own?

Yes. ERISA does not require you to have an attorney.

If you are organized, understand your policy, and have strong medical documentation, you may be able to prepare a solid appeal by:

• Requesting the claim file
• Matching each denial reason with supporting evidence
• Submitting a complete, indexed packet on time

But be aware: once the final appeal decision is issued, no new evidence can be added to the record, meaning the strength of your appeal can determine the outcome of a lawsuit.

Why Appealing Without a Lawyer Can Be Risky

In most ERISA cases, the court later reviews the administrative record as it existed at the end of the administrative appeal process. If important evidence is missing or issues aren’t addressed, it’s hard to fix later. Procedural rules, plan deadlines, and technical vocational points can also create traps.

What If Your Appeal Is Denied?

If New York Life upholds the denial, you can usually file a lawsuit in federal court. Check your policy for any contractual time limit to sue. Because courts decide ERISA cases based on the administrative record, the evidence you submit in support of your appeal is critical. If New York Life denies your appeal, the administrative record closes — meaning you may not be able to submit new evidence later.

Note: Some disability insurance policies may allow for a second, optional appeal, but most only give you one chance to get it right.

Why Choose Ortiz Law Firm for a New York Life Appeal

We focus on long-term disability appeals and lawsuits. We know how New York Life handles claims and what evidence moves the needle.

We will:

• Obtain and analyze the complete claim file
• Work with your providers to translate medical findings into functional limitations
• Recommend targeted testing when needed
• Prepare vocational evidence to rebut New York Life’s reviewers
• Build a record that positions your claim for court if necessary

We represent clients nationwide—and if your claim is governed by ERISA, you are not limited to working with an attorney in your state.

What to Do Next

1. Request your complete claim file and policy in writing.
2. Mark your appeal deadline and set a personal target a few weeks before it.
3. Match each denial reason with evidence that disproves it.
4. Submit one complete, indexed appeal packet and confirm receipt.

If you want help building a comprehensive, litigation-ready appeal, call (888) 321-8131 for a free case review.