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If your Long-Term Disability is Denied you can file an Appeal

If your long term disability claim is denied, or if you have received a letter terminating your existing disability benefits, in many cases you can file a successful appeal. Not only does the appeal give you a chance to overturn the decision, but it is also a required step in order to preserve your right to file a lawsuit at a later date.


The long term disability appeal must be filed in accordance with the procedures and deadlines specified in your disability benefits plan.

If you don’t have your policy documents by now, you must obtain them quickly from the plan administrator. The most important thing to keep in mind is your deadline, because you are usually limited to a two- or three-month time period. You have to use this time very effectively.


The appeal stage is your last opportunity to make the administrative record as complete as possible.

This record is the legal term for all the evidence submitted to the insurance company. Once the appeal process is complete, the record is “set in stone.” Should you later file a lawsuit against your plan, the judge will only look at the existing administrative record. If you have not submitted enough supporting evidence, or the right type of evidence, you could lose your case regardless of how sick or disabled you may be.


The ERISA Long Term Disability Claim and Appeals Process

1. File a claim with your company-provided long term disability insurance.

  •   The disability insurance provider will investigate your claim.
  •   If your claim is denied, the provider must issue you a notification with explanation of the basis of their denial.


2. Appeal Adverse Decision

  •   If your claim is denied, you must file an Administrative Appeal. You should strongly consider contacting an experienced ERISA attorney to assist you in the appeal process.
  •   Submit a claim appeal in writing. This must be done within a specific time-frame or you risk permanently losing the chance to appeal!
  •   The appeal process is your final opportunity to add pertinent information to the claim record. This is significant in the event that the appeal is denied and you need to file a lawsuit. Your attorney can provide much needed guidance to you as to additional medical information that might strengthen the appeal, and future suit, should a lawsuit become necessary. You do not want to risk entering a lawsuit with an incomplete or weak claim record, which would severely decrease your chances of being awarded the disability compensation you deserve.


3. File a Lawsuit in Federal Court

  •   You can only take this step once you have gone through the entire appeals process.
  •   A Federal Judge will typically determine whether the ERISA plan’s decision was arbitrary and capricious.


4. A District Court decision can be appealed to the United States Circuit Court.

Once the court rules, the losing party can elect to appeal in select circumstances.


The LTD Appeal Process

Qualifying Incident
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File a claim with disability insurance provider
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Claim Awarded
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Claim Denied
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Find a qualified and experienced ERISA Attorney
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File a claim appeal with disability insurance provider
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Claim Appeal Awarded
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Claim Appeal Denied
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File a law suit in Federal District Court
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Suit Won
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Claim Awarded
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Unfavorable finding in Federal District Court
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File an appeal with the United State Court of Appeals

Bemis, Roach & Reed has successfully handled cases against the following insurance companies:

  • Aetna
  • Cigna
  • Connecticut General Life
  • Hartford
  • Life Insurance Co. of North America
  • Lincoln Financial
  • Northwestern Mutual
  • Provident
  • Reliance
  • Unum Life

  • Assurant
  • CNA
  • Fortis
  • Liberty Mutual
  • Life Insurance Co. of New York
  • Metlife
  • Paul Revere
  • Prudential
  • Standard
  • Unum Provident

For answers to other questions regarding ERISA please see our page ERISA Frequently Asked Questions or call toll free (866) 433-4979 for a free personal consultation.

Bemis, Roach & Reed has successfully represented long term disability clients throughout the state of Texas and can easily fight for claims across the state by working the cases remotely, via phone, fax and e-mail.

5 star disability lawyers

"Words can not truly express the gratitude that I feel toward Mr. Lonnie Roach and his professional team. I give them an A+++. Very compassionate and prompt. Their priorities are first and foremost helping you succeed at your case. When you feel helpless, feeling like someone is on your side can mean the world to you. Thank you for working for the people."
-Amy K.


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Can I file a new claim for disability if I was already denied?

Can I file a new claim for disability if I was already denied?

If your claim for disability benefits was denied but your medical condition or financial situation has changed, you may now be eligible for benefits.

Bemis, Roach & Reed has helped clients who are disabled from a wide variety of medical conditions. If you are unable to work due to any of the following conditions and have been denied disability benefits, contact us. We would like to help.

Long Term Disability Lawyers

Bemis, Roach & Reed
We have the Knowledge, We have the Experience, We have the Answers.
We can help you with your Disability Case.

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At Bemis, Roach and Reed, if we can't help you, we will try to find the right attorneys for you.

We offer each of our prospective clients a free no obligation one hour phone or office consultation to see if we can help you and if you are comfortable with us. We know how difficult a time like this can be and how hard the decisions are. If we can be of assistance to you and help you find a solution to your issue we will even if that means referring you to another attorney.

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