Saturday, February 24, 2024

Long-Term Disability Denial Letters and the Appeals Process

Video Transcript:

Welcome to the Four Minute Long-Term Disability Lawyer. A channel where you get straight forward, common sense disability insurance help in more or less four minutes. 

In this video, I’m going to explain some key issues regarding denial letters, and also, talk about the different steps in the administrative appeals process. If you have received a denial letter from your insurance company, here are some basic things that you need to know before you call a lawyer for a free initial consultation.  

First and foremost, you should know that you have 180 days to file an appeal and, that you should not wait very long to contact a long-term disability lawyer.

Ideally, when you call a lawyer, you should know at what stage in the process your case is at.  This will help you in obtaining a better free initial consultation.  You should also be ready email or fax the denial letter to the lawyer relatively quickly.  

Typically, there are only two types of denial letters in long-term disability cases: the initial denial letter and the final denial letter.  The Initial Denial Letter is the first notification to an insured by insurance company, that benefits are being stopped or, that a claim has been denied.   The Final Denial Letter is a second letter that only comes if, and after, the insured has filed an administrative appeal.  

However, changes in the regulations from 2018 have made the clear distinction that once existed, between initial denial letters and final denial letters, somewhat murky.  From 2018 on, insurance companies have been required to provide the insured with the opportunity to present additional commentaries prior to the issuance of the final denial letter.  This change, in effect, has created somewhat of an intermediary appeal step between the initial denial and the final denial letter.  In this intermediary step an insured is typically given the opportunity to respond to the opinion or opinions of the medical and vocational experts hired by the insurance company.

A lot going back and forth can occur in this intermediary step.  For example, the insurance company can decide to request additional medical records or, the insured can decide to ask his or her doctor for a new medical opinion.  

This situation can make it difficult for some insureds to understand at what exact step of the process their case is at.  I feel that sometimes, this confusion can make it harder for a lawyer to provide a good Free Initial Consultation.  I hope that this commentary helps clarify the different types of denial letters and the different steps in the appeals process. 

And, more importantly, help you receive a better free initial consultation from a Long-Term Disability Lawyer.

If you have received a denial letter from your long-term disability insurance company, you can request a free initial consultation from my office by going into my website LongTermDisabilityAppeals.Com.