Winning An Administrative Appeal Directly in LTD Claim

Hi, I’m Nick Ortiz. I’m a board certified disability insurance attorney. People often ask me, “What are my chances of winning an administrative appeal directly with an insurance company in a longterm disability claim.”

Just to be clear, for the purposes of this video, we’re only going to be focused on the administrative review process that is appeals directly with the insurance company. We’re not talking about lawsuits against a long term disability insurance company.

We’re in September 2017 and I just returned for a disability conference with a lot of disability attorneys. One of the featured speakers does a lot of long term disability claims. He said that in his office, they typically win about 30% of their administrative review claims. He said that he’s spoken to numerous other attorneys and they win about anywhere in that same ballpark of about 30% of their appeals as well. But let me tell you our firm’s own experience.

Again, we’re in September 2017 and so far this year we’ve won about 50% of our administrative appeals, and what that means is the client came in with their claim being denied and we were able to have their claims overturned 50% of the time. Now obviously that doesn’t guarantee any future success, but it does show that about one out of two of our cases are overturned. As for those cases that are not overturned, we take those cases to court and litigation and that’s going to be the topic of our next video, what are my chances of winning an appeal in court.

If you’d like additional information about the long term disability insurance process then I encourage you to download a free copy of a book that I wrote called The Top 10 Mistakes That Will Destroy Your Long-Term Disability Claim. You can download a free copy at If you’d like to talk to an experienced long term disability attorney then I encourage you to give our office a call at 850-898-9904. Thanks for watching. We look forward to hearing from you.