{"id":7695,"date":"2020-10-01T12:21:00","date_gmt":"2020-10-01T17:21:00","guid":{"rendered":"https:\/\/www.nickortizlaw.com\/?p=7695"},"modified":"2024-04-15T16:08:54","modified_gmt":"2024-04-15T21:08:54","slug":"why-most-long-term-disability-appeals-suck","status":"publish","type":"post","link":"https:\/\/www.nickortizlaw.com\/why-most-long-term-disability-appeals-suck\/","title":{"rendered":"Why Most Long-Term Disability Appeals Suck!"},"content":{"rendered":"\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Long Term Disability Insurance Claims - Why Most Long Term Disability Appeals SUCK!\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/JtsPO0ylChg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p>When most people file a <a href=\"https:\/\/www.nickortizlaw.com\/practice-areas\/long-term-disability-insurance-erisa-lawyer\/appeals\/\" data-type=\"page\" data-id=\"77\">long-term disability appeal<\/a>, it is a really basic, one or two-paragraph appeal letter that says, &#8220;Look, long-term disability insurance company. I really think you got this one wrong. I think there is more than enough evidence to support my long-term disability claim. I want you to go back, take another look at my claim file, and I think you will see that there&#8217;s enough evidence to approve my claim for disability benefits. So, I hereby appeal. Go back and take another look at it.&#8221; <\/p>\n\n\n\n<p><strong>Now, that is wholly insufficient.<\/strong><\/p>\n\n\n\n<p>The insurance company wants to show that they&#8217;re taking a good, hard look at your long-term disability appeal, so they assign your claim file to a different adjuster who wasn&#8217;t involved in the initial long-term disability denial. In essence, it&#8217;s as if they&#8217;re taking your case from Susie&#8217;s desk, putting it on Janet&#8217;s desk along with your disability appeal letter, and they&#8217;re saying, &#8220;Hey Janet, did Susie get it right? Do you agree with her denial letter?&#8221;<\/p>\n\n\n\n<p>Well, what do you think that Janet&#8217;s going to do? Nine times out of ten, she will say, &#8220;Yes, my colleague, Susie, got it right. The appeal letter did not change the previous long-term disability denial.&#8221; This is especially true if you have not provided any new medical evidence that they can use to overturn the previous denial. If your claim was denied, your disability appeal letter has to give the insurance company something new in the way of medical evidence or other opinion evidence to get them to change their mind.<\/p>\n\n\n\n<p>When we prepare a disability appeal, the first thing that we do is request a copy of your insurance policy to determine what your rights and responsibilities are in terms of proving your case. We also request an entire copy of your claim file, then we take it, break it down, and reverse engineer it to determine what medical evidence we need to provide to the insurance company. That way, we can work with you to strategize and get updated medical records and,&nbsp;perhaps,&nbsp;<a href=\"https:\/\/www.nickortizlaw.com\/residual-functional-capacity-form\/\" target=\"_blank\" rel=\"noreferrer noopener\">forms or letters from your doctors<\/a>&nbsp;to address the reasons stated in the denial letter as to why the insurance company denied your claim. If you see&nbsp;<a href=\"https:\/\/www.nickortizlaw.com\/ltd-faq\/i-have-multiple-doctors-treating-me-for-my-disability-is-it-okay-to-send-for-than-one-doctors-letter-to-the-insurance-company\/\">multiple doctors, we&#8217;ll try to obtain a statement from each<\/a>. <\/p>\n\n\n\n<p class=\"blockquote\"><strong>RELATED POST<\/strong>:\u00a0<a href=\"https:\/\/www.nickortizlaw.com\/how-to-appeal-an-ltd-denial\/\" data-type=\"post\" data-id=\"3255\">How to Appeal a Long-Term Disability Denial: Your LTD Appeal Guide<\/a><\/p>\n\n\n\n<p>We also work with you to obtain your statement, typically as an affidavit or a sworn statement. In the statement, we identify your impairments and resulting limitations. The statement is additional evidence that we can submit with your disability appeal to show the insurance company why you can&#8217;t do your job and new evidence that may get the insurance company to change its mind.<\/p>\n\n\n\n<p>Finally, we do a comprehensive legal analysis, taking the reasons why the insurance company denied your claim, which should be outlined in the denial letter. We show why their reasons are insufficient as a matter of law. We may cite legal cases to compare your claim to others where the insurance companies may have made similar mistakes.<\/p>\n\n\n\n<p>To give you an idea,&nbsp;<strong>our long-term disability appeal letters tend to be 16 to 20 pages long<\/strong>. They summarize all your medical records, all the opinion evidence, and all the legal reasons why we think their decision is insufficient and the claim should be approved.&nbsp;<strong>That&#8217;s a lot different than a simple one or two-paragraph appeal<\/strong>. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"get-help-with-your-long-term-disability-appeal\">Get Help with Your Long-Term Disability Appeal<\/h2>\n\n\n\n<p>If the appeals process is overwhelming, you can hire a long-term disability attorney to prepare your appeal. Most <a href=\"https:\/\/www.nickortizlaw.com\/practice-areas\/long-term-disability-insurance-erisa-lawyer\/\" data-type=\"page\" data-id=\"3218\">long-term disability attorneys<\/a>, including those at the <a href=\"https:\/\/www.nickortizlaw.com\/about-us\/\" data-type=\"page\" data-id=\"1095\">Ortiz Law Firm<\/a>, operate on a contingency fee basis, meaning we only get paid if there is a recovery. There are no up-front costs or fees, so you can get the help you need during this time of financial difficulty.<\/p>\n\n\n\n<p>If you&#8217;d like to talk to an experienced attorney who might help walk you through this process, I encourage you to call us at <strong><a href=\"tel:8883218131\" data-type=\"tel\" data-id=\"tel:8883218131\">(888) 321-8131<\/a><\/strong> or <a href=\"https:\/\/www.nickortizlaw.com\/contact\/\" data-type=\"page\" data-id=\"6\">contact us online<\/a>. I&#8217;ve also written a book about long-term disability cases. It&#8217;s called the <a href=\"https:\/\/resources.nickortizlaw.com\/free-ltd-book\">Top 10 Mistakes That Will Destroy Your Long-Term Disability Claim<\/a>, and it is available to download for free.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>When most people file a long-term disability appeal, it is a really basic, one or two-paragraph appeal letter that says, &#8220;Look, long-term disability insurance company. I really think you got this one wrong. I think there is more than enough evidence to support my long-term disability claim. I want you to go back, take another &hellip;<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[207,210],"tags":[],"_links":{"self":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts\/7695"}],"collection":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/comments?post=7695"}],"version-history":[{"count":0,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts\/7695\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/media?parent=7695"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/categories?post=7695"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/tags?post=7695"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}