Long Term Disability Claim Deadlines: What You Need to Know

Every long term disability insurance policy is different, and different state or federal laws apply, depending on where you obtained the insurance. Most policies impose deadlines that a claimant has to meet to seek disability benefits. There are deadlines to file for disability benefits, to appeal a denial of those benefits, and to file a lawsuit once you have gone through the pre-suit claim process (what insurance companies call “exhausting administrative remedies”). Different deadlines apply to employer group (ERISA) disability insurance than those that apply to individual disability income insurance. Below, we discuss key concepts you need to know about long term disability claim deadlines.

Filing the Initial Disability Insurance Claim

When you first stop working because of a disability, you must apply for disability benefits. This is often called providing “notice of claim.” Once that is done, you must provide proof of your disability. This includes but is not limited to:

• Medical records
• Vocational records
• Performance reviews that comment on your inability to do the job
• Witness statements from friends or co-workers

Keep in mind that you must prove you are disabled. The insurance company does not have to prove it for you, and more importantly, they do not have to prove you are not disabled.

The deadline that applies to filing for benefits and providing proof of that disability can usually be found under the heading “Proof of Loss” in your policy or company’s disability benefit plan. Policies and plans will require that you submit your application and proof of disability anywhere from within 30 days to up to a year after the date you stopped working. Each one is different though, and you must look to the policy or plan to find out the deadline that applies to your claim. If you do not notify your insurance company or provide proof of loss within the deadlines, the insurance company could deny your claim.

Filing an Appeal

If your benefits are denied, or paid and then terminated, you may be provided a chance to appeal that decision. Again, different policies and plans have different deadlines, as well as a different number of times you may appeal before filing a lawsuit. Some individual policies do not allow appeals, while most employer benefit plans allow one appeal that must be filed within 180 days after the date of the denial/termination letter. In some states, you may also have a right to start a bad faith claim if your individual disability insurance benefits were denied or terminated, and different deadlines may apply to those claims.

Important Note: If you did not receive your denial letter until much later than the date on the letter, look at the date on the envelope to determine if the letter was sent on the same day that the letter was written. If not, keep the envelope as proof that the insurance company delayed mailing this letter, as this may give you more time to gather the evidence you would like to submit for an appeal.

It is important to understand that your policy or plan may require one or more appeals before you file a lawsuit, so do not think you can skip that process. Missing the appeal deadline may cause you to lose your claim forever. Understanding the appeals process is crucial, and in some cases it may be your last chance to submit evidence in your claim. Consulting with one of our experienced disability attorneys can help you navigate your obligation to appeal.

Litigating Your Disability Insurance Claim

Once you have gone through the pre-suit appeals, you may file a lawsuit. Your state law will determine the statute of limitations to file a lawsuit, but your plan or policy may shorten this deadline substantially. If you miss this deadline, you will lose your right to file a lawsuit to recover your benefits.

Important Note: Read your policy or plan thoroughly to determine what deadlines apply to your particular claim. Failure to meet those deadlines could result in the denial of your claim. If you are not sure what deadlines you must meet, consult with a disability attorney who specializes in disability insurance cases. In some jurisdictions, your plan may shorten the deadline to file a lawsuit to as few as 60 days after the decision letter on your pre-suit appeal.

It is recommended to consult with a disability insurance attorney from the beginning of your claim, but you should certainly contact an attorney if your claim has been denied before you file an appeal.

About Tucker Law Group

Tucker Law Group is a nationally recognized disability law firm that serves disabled Americans and veterans nationwide. The law firm attorneys and supporting staff help clients with ERISA claims, individual disability insurance claims, and VA disability compensation claim denials. Visit the Tucker Law Group website to learn more information about long term disability claim deadlines and how to handle a claim.