It is extremely frustrating and stress-inducing to receive a letter in the mail terminating or denying long-term disability benefits. People with long-term disability insurance, either through an employer-provided policy or a privately purchased policy, rely on funds being available if they are hurt and cannot work. The important thing to know is that insurance companies do sometimes change their minds on appeal if the appeal is convincing. In providing information for the appeal, it is important to provide information that specifically addresses the reason for denial. For example, if an insurer provides a list of jobs it is possible for an insured to perform, an appeal should address why the insured cannot in fact perform those jobs. Usually, the letter denying benefits states the deadline for appeal, and it is important to meet that deadline.

It is important to know that if the case does ultimately end up in court, it can be challenging to introduce new information that wasn’t provided to the insurance company during the appeal process. In the case of policies governed by ERISA, which is most employer-provided coverage, courts are hesitant to let any new information in. The reasoning behind this policy is that courts want insureds to put forth their best case on appeal so that the parties are more likely to resolve any disputes before bringing the case to court.

Some people file long-term disability appeals themselves and some hire attorneys. Hiring an attorney can be beneficial because an experienced long-term disability attorney can recognize the issues that matter most to the insurance company and will matter most to a court. Also, considering that courts often will not consider new information and arguments not included in the appeal, making a case in court can be challenging for an attorney if he or she did not play a role in the appeal process.