Filing for long-term disability (LTD) can be a stressful and emotionally draining experience. When your ability to earn a living is suddenly compromised due to illness or injury, the last thing you need is to navigate a complex legal and insurance system without a clear understanding of your rights. Unfortunately, many claimants are unaware of the protections they’re entitled to under the law—protections that can make a crucial difference in whether your claim is approved or denied.
In this article, we’ll guide you through your legal rights when filing a long-term disability claim and how a long-term disability claims lawyer can help you advocate for yourself if you face obstacles during the process.
You Have the Right to Understand Your Policy
One of the most basic rights you have is the right to receive and review a copy of your LTD policy. Whether your policy is employer-sponsored or privately purchased, the insurance provider must provide you with documentation that outlines:
- What conditions are covered
- The definition of disability used in the policy
- Any waiting or elimination periods
- The duration of benefits
- Exclusions and limitations
- The appeals process
Understanding your policy is the foundation of your legal protections. If you are covered under a group plan through your employer, the policy may fall under a federal law known as ERISA (Employee Retirement Income Security Act), which provides specific procedural safeguards during the claims process.
You Have the Right to File a Claim Without Retaliation
If you’re filing through an employer-sponsored plan, you are protected from retaliation under both ERISA and other employment laws. Your employer cannot legally fire, demote, or discipline you simply because you filed for long-term disability. If this happens, you may have grounds for a wrongful termination or retaliation lawsuit.
If you suspect any form of discrimination or pushback due to your claim, keep detailed records of all correspondence and seek legal advice promptly.
You Have the Right to a Fair Review
When you submit a claim for LTD benefits, the insurance company is legally required to evaluate your application fairly. Under ERISA, this includes the obligation to:
- Acknowledge your claim within a reasonable time
- Request any additional documentation needed
- Provide a written explanation if your claim is denied
- Allow you to appeal the denial
This process must be transparent, and any decisions made by the insurer must be based on medical evidence and the language of the policy—not arbitrary judgment.
In some cases, insurers hire their own doctors to review your medical records. You have the right to know who reviewed your claim and request a copy of the report. You also have the right to challenge their findings with counter-evidence from your own physician.
You Have the Right to Appeal a Denial
If your LTD claim is denied, you are not at a dead end—you have the right to file an appeal. Under ERISA, you typically have 180 days from the date of the denial letter to submit your appeal. During this period, you should gather all relevant medical records, obtain detailed physician statements, and consider consulting an attorney who specializes in disability law.
Be aware that your appeal is often your only chance to submit new evidence. If your case ends up in court later, judges usually review only what’s included in the claim file from the appeal stage. This is why it’s crucial to make your appeal as thorough and compelling as possible.
You Have the Right to Legal Representation
At any point during the claims process—whether you’re filing an initial claim, appealing a denial, or preparing for litigation—you have the right to hire a lawyer. Disability lawyers typically work on a contingency basis, which means they only get paid if you win your case. This makes legal help more accessible to claimants who are already dealing with financial hardship.
A lawyer can:
- Help you interpret your policy
- Communicate with the insurer on your behalf
- Gather medical and vocational evidence
- Prepare your appeal
- Represent you in court, if necessary
Hiring a legal expert doesn’t mean you’re anticipating conflict—it means you’re prepared to protect your rights.
You Have the Right to Privacy
Your medical and personal information is protected by federal privacy laws like HIPAA. Insurance companies have the right to request documentation relevant to your disability, but they cannot access your full medical history without permission. You can limit what information is shared and revoke authorizations at any time.
If you suspect your privacy has been violated or your information was used inappropriately, you may have grounds for legal action.
Final Thoughts
Filing for long-term disability isn’t just a paperwork exercise—it’s a legal process where your rights matter. Knowing those rights gives you the power to advocate for yourself, push back when something feels wrong, and make informed decisions throughout your claim.
If you’re unsure about your policy, your claim status, or what to do after a denial, don’t wait. Seek professional help and stand up for the benefits you’ve earned. Your health and livelihood are worth fighting for.
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