A denied disability insurance claim can create serious financial pressure. If your insurer has unfairly denied your claim, a denied long-term disability claims lawyer can help you challenge the decision.
BenGlassLaw has recovered over $100 million in claims and benefits for our clients. If you believe your long-term disability claim was wrongfully denied, an Equitable denied long-term disability claims lawyer can help you strengthen your case and file an appeal.
How an Equitable Denied Long-Term Disability Claims Attorney Can Help
If your disability claim has been denied, there’s no time to waste.
An Equitable denied long-term disability claims attorney can step in and:
- Determine why Equitable denied your claim: An attorney can review the denial letter and identify the reasons Equitable gave for refusing to pay benefits.
- Gather supporting medical evidence: A lawyer can help obtain medical records, physician statements, test results, treatment histories, and other documentation that supports your claim.
- Prepare an appeal: An attorney can help organize the evidence and arguments necessary to challenge the denied claim.
- Communicate with Equitable: A lawyer can handle communications with the insurance company and help ensure that important information is submitted properly.
- Pursue litigation: If an appeal does not resolve the dispute, an attorney can help you pursue a lawsuit.
For a free legal consultation call (703) 591-9829
Why Did Equitable Deny My Long-Term Disability Claim?
Insurance companies may deny long-term disability claims for many different reasons, such as:
- Insufficient medical documentation
- A disagreement with your treating physician’s conclusions
- An allegation that you can perform sedentary or modified work
- Questions about the severity or duration of your condition
- Failure to provide requested information
- Questions about whether your disability began while your coverage was active
- Pre-existing condition provisions
- Policy exclusions or limitations
- Failure to satisfy the policy’s elimination period
- An allegation that you failed to meet the policy’s ongoing requirements
- A determination that you can return to your previous occupation
An Equitable denied disability claims lawyer can review your denial letter and help determine why your claim was rejected.
How Do I Appeal an Equitable Long-Term Disability Claim Denial?
The appeals process gives you an opportunity to challenge Equitable’s long-term disability denial and provide additional information supporting your right to benefits.
While every case is different, you typically must complete these steps:
- Review the denial letter: Identify the specific reasons Equitable gave for denying your claim.
- Review the policy or plan documents: Determine what the long-term disability insurance policy requires you to prove, what documentation you need, and how your appeal must be submitted.
- Gather additional evidence: Collect medical records, physician statements, diagnostic test results, treatment records, job-duty information, and other documentation that supports your disability.
- Prepare a written appeal: Explain why the denial should be reversed and present the evidence supporting your position.
- Submit the appeal on time: Follow the instructions in the denial letter and submit the appeal before the applicable deadline.
- Wait for the appeal decision: Equitable will review the information you submitted with the appeal and determine whether to uphold or reverse its original decision.
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What Types of Damages Can You Recover?
If your appeal is successful, you may be entitled to a variety of damages, such as:
- Past–due disability benefits: You may be entitled to long-term disability benefits that should have been paid during the period covered by your claim.
- Future disability benefits: You may be entitled to continued benefits if you continue satisfying the policy’s requirements.
- Interest: In some cases, interest may be available on unpaid benefits.
- Attorney’s fees: Courts sometimes order the insurer to pay for your legal representation and court fees.
- Bad faith damages: If your policy is an individual private plan governed by state law, you can sue for emotional distress and punitive damages when an insurer acts unreasonably or maliciously.
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How Long Do You Have to Appeal an Equitable Long-Term Disability Claim Denial?
If your long-term disability plan is governed by the Employee Retirement Income Security Act (ERISA), you generally have 180 days after receiving the denial notice to file an appeal. If you have a private policy, the deadline depends on the language in your private contract and state laws. In some cases, it may be shorter.
Failing to submit your appeal on time can jeopardize your ability to challenge the denial, which is why it’s important to get legal help as soon as possible.
What Evidence Can Support a Long-Term Disability Claim?
To support a disability appeal, you will need to gather documentation showing both your diagnosis and its practical effects on your ability to work.
Useful types of evidence may include:
- Medical records: Treatment notes can establish your diagnosis, symptoms, treatment history, and the progression of your condition.
- Physician opinions: Your doctors can provide information about your functional limitations and ability to perform work-related activities.
- Diagnostic testing: Imaging, laboratory testing, neurological testing, and other examinations may provide evidence supporting the severity of your condition.
- Medication records: Prescriptions and treatment changes may help demonstrate the seriousness or progression of your condition.
- Functional assessments: Certain evaluations may provide information about your ability to sit, stand, walk, lift, concentrate, communicate, or perform other activities.
- Job descriptions: Documentation of your actual occupational responsibilities can help establish what your work requires.
- Personal observations: A detailed record of your symptoms and limitations may provide useful context about how your condition affects your daily life.
What Happens If Equitable Upholds the Denial?
If Equitable upholds the denial despite your appeal, and your claim is governed by ERISA, you may be able to file a lawsuit in federal court to seek the disability benefits you may be entitled to. If you do so, a federal judge will review the closed record to determine if Equitable’s denial was arbitrary and capricious or an abuse of discretion.
If you have a private disability insurance policy that is not governed by ERISA, you may be able to sue Equitable for breach of contract in state court. Unlike ERISA, you are typically allowed to introduce new evidence, new medical records, and live testimony from your treating physicians during the trial.
In addition, if you can prove that Equitable intentionally or recklessly ignored valid evidence to save money, you can sue them for insurance bad faith.
Schedule a Free Consultation
Just because your long-term disability claim was denied doesn’t mean you are out of options. The attorneys at BenGlassLaw can review your case, gather evidence that supports your claim, and help you pursue benefits.
Book a free consultation to get help with your appeal.
Call (703) 591-9829 or complete a Free Case Evaluation form
