How To Appeal a Denial of Long-Term Disability Insurance?

Why You Shouldn’t Lose Hope After a Denied Disability Claim

When it comes to applying for disability benefits, “No” only stands as a final answer when you accept it as one.

A principle benefit of working with a disability lawyer is that your legal representative will not give up when setbacks occur. And setbacks will occur.

The primary sources of disability benefits available to residents of Ohio and across the United States are:

• Social Security Disability Insurance, which is more commonly referred to by its acronym of SSDI. It covers people who become too injured or ill to work after having paid into the program through payroll deductions. It also covers the permanently disabled children of SSDI-eligible adults.
• Workers’ Compensation, which covers people who get injured, killed, or seriously ill while doing their jobs. Except in the cases of deaths, workers’ comp is designed to be temporary. Requalifying regularly is a standard requirement for receiving benefits, and many beneficiaries receive one-time, lump-sum payments, especially if they lost a body part or became blind or deaf.
• Public employee retirement systems, which cover local and state government workers who do not make contributions to Social Security. The retirement systems for teachers, police, school support personnel, and public college and university staff typically offer a combined pension-401(k) plan and a form of disability insurance.
• Private insurance, which comes in many forms, including the commonly known UNUM and AFLAC, as well as riders to health insurance, life insurance, and long-term care insurance policies.

First-time applicants to any of these are likely to receive denials. All getting turned down means, however, is that it’s time to start appealing.

One of two problems—and occasionally a combination of both—generally leads to an initial denial of a request for disability benefits. The first is misfiled paperwork. Incomplete forms, supplemental materials sent to the wrong office, and misreadings of eligibility rules sink many applicants. Enlisting the assistance of a disability lawyer helps in avoiding these common pitfalls.

The other too-common problem is insufficient medical evidence. When a disability benefits program denies an application, it is required to send the applicant a letter that details why the claim cannot be approved. Sitting down with a disability lawyer to read through the rejection letter will yield insights on how to put together an appeal.

Acting quickly on an appeal is essential. A typical deadline for notifying a program of the intent to contest a denial is 30 days. Additional diagnoses, documentation for treatment and rehabilitation plans, medical bills, and financial records can be submitted on appeal.

Each disability program allows multiple rounds of appeals, and a civil lawsuit always stands as a last resort when a final official appeal fails. A disability lawyer who has worked with his or her client since the start of the application process will be well prepared to convince a judge or jury to approve benefits.

Columbus, Ohio, lawyers with Agee Clymer Mitchell & Portman have helped people navigate the SSDI, workers’ compensation, public retirement system, and private insurance disability application and appeal processes. You can request a no-cost consultation online or by calling (800) 678-3318.