When a Long-Term Disability Claim Gets Denied, a Lawyer Can Review Your Case
A long-term disability (LTD) lawyer is an attorney who specializes in appealing denied disability insurance claims. After your insurer denies your LTD claim, you have the right to request an internal appeal — and a lawyer can file that appeal, gather medical evidence, and argue your case to the insurance company. They can also file a lawsuit in federal court if the internal appeal fails.
Most LTD lawyers work on contingency, meaning they take payment only if you win money back. Their fee is usually a percentage of what you recover, typically 25 to 40 percent. You pay nothing upfront. This arrangement exists because LTD cases are expensive to litigate, and the lawyer absorbs the risk.
The decision to hire a lawyer depends on the size of your claim, how strong your medical evidence is, and how much time you can spend on the appeal yourself. Some people win internal appeals without a lawyer. Others need one to navigate the legal standards insurers use to deny claims.
Key Takeaways
- LTD lawyers work on contingency, so you pay nothing unless you win money back, and their fee comes from your recovery.
- A lawyer's main job after denial is to file an internal appeal with new or stronger medical evidence and legal arguments about why the denial was wrong.
- You have a time limit to request an internal appeal — usually 180 days from the denial letter, though this varies by plan — and a lawyer can help you meet that important date.
- If the internal appeal fails, a lawyer can file a federal court lawsuit, but this is expensive and takes years, so most cases settle during the appeal stage.
- Finding the right lawyer means looking for someone with LTD experience, checking their track record on cases like yours, and understanding their fee structure before you hire them.
What an LTD Lawyer Does After Your Claim Is Denied
After you receive a denial letter, your insurer is required to give you the reason for the denial and tell you how to appeal. The appeal process is called an internal appeal because it stays within the insurance company — you are asking them to reconsider their own decision.
A lawyer's role in the internal appeal is to gather stronger medical evidence, write a detailed legal brief explaining why the denial was wrong, and submit both to the insurer's appeals department. They will also review the original denial letter to identify what the insurer got wrong — whether they misread your medical records, ignored a doctor's statement, or applied the wrong legal standard to your case.
The insurer has 45 days (or sometimes 60 days, depending on your plan) to respond to the internal appeal. During that time, a lawyer can request your complete claim file from the insurer, which includes all the documents they reviewed when they denied you. This file often contains surprises — notes from the insurer's own doctor, or evidence they claim to have reviewed but did not actually read.
How to Find an LTD Lawyer in Your Area
Start by asking your primary care doctor or the specialist treating your condition whether they know disability lawyers. Many doctors work with the same lawyers repeatedly and can give you a referral.
Next, contact your state bar association's lawyer referral service. Every state bar maintains a list of attorneys by practice area. Search for "disability insurance" or "long-term disability" in your state. The bar will give you names and phone numbers of lawyers who handle these cases.
You can also search online for "long-term disability lawyer" plus your state name. Look for law firms that list LTD cases as a main practice area, not a side service. Read their case results or settlements if they publish them — this tells you whether they win cases and how much money they typically recover.
When you have a list of three to five lawyers, call each one for a free initial consultation. Most disability lawyers offer this at no charge. During the call, ask them how many LTD cases they have handled, what percentage they win on internal appeals, and whether they have handled cases with a diagnosis similar to yours.
What to Expect When You Hire an LTD Lawyer
Before you sign anything, the lawyer will send you a contingency fee agreement. This document states the percentage they will take if you win, what costs they will charge you for (court filing fees, medical record requests, informed reports), and what happens if you lose. Read this carefully. Some lawyers charge you for costs even if you lose; others absorb those costs themselves.
Once you sign, the lawyer will request your complete claim file from the insurer. They will also ask you to sign medical release forms so they can contact your doctors directly and ask for detailed statements about your condition and why you cannot work. This takes two to four weeks.
While the lawyer gathers evidence, they will also research the legal standard your insurer uses to deny claims. Long-term disability policies contain language about what "disability" means — some require that you cannot do any job, others require only that you cannot do your own job. The lawyer will find this language in your policy and use it to argue that the insurer applied the wrong standard or ignored evidence that meets the standard.
The lawyer will then write an appeal brief — a detailed legal document that walks through your medical evidence, your policy language, and the law, and explains why the denial was wrong. This brief is submitted to the insurer along with new medical evidence or a doctor's statement supporting your claim.
The Internal Appeal Timeline and What Happens Next
You have a important date to request an internal appeal. Your denial letter will state this important date — it is usually 180 days from the date of the denial, though some plans allow up to one year. A lawyer can file the appeal on your behalf and make sure you meet this important date.
After the appeal is filed, the insurer has 45 days (or 60 days for some plans) to respond. During this time, they will review the new evidence and the lawyer's brief. Some insurers respond quickly; others wait until the last day.
If the insurer denies the appeal, you then have the option to file a lawsuit in federal court. This is a major step. Federal court cases take one to three years, cost $10,000 to $50,000 in legal fees and informed costs, and go to trial only if you and the insurer cannot settle. Most cases settle before trial, but settlement talks can take months.
If you win the internal appeal, the insurer will restart your benefits and may owe you back pay from the date of the denial. The lawyer's contingency fee comes from this back pay.
When You Might Not Need a Lawyer
You do not need a lawyer if your denial was clearly a mistake and you have strong medical evidence to prove it. For example, if the insurer denied you because they said you did not submit medical records, and you have proof that you did, you can write a straightforward appeal letter yourself with copies of those records.
You also may not need a lawyer if your claim is small — for example, if you were only denied for a few months of benefits and you have already returned to work. The lawyer's contingency fee might be larger than the amount you would recover.
However, if your denial involves complex medical issues, if the insurer's reason for denial is vague or seems wrong, or if your monthly benefit is high enough that back pay would be substantial, a lawyer is worth the cost. Many lawyers will tell you honestly whether they think your case is strong enough to pursue.
Red Flags When Choosing a Lawyer
Avoid lawyers who may provide a win or promise a specific amount of money. No lawyer can may provide the outcome of an appeal or lawsuit. If a lawyer says they can, they are not being honest.
Be cautious of lawyers who pressure you to sign when ready or who do not explain their fee structure clearly. A good lawyer will take time to answer your questions and will put everything in writing.
Do not hire a lawyer who has never handled an LTD case before. Disability insurance law is specialized. A general practice attorney or a personal injury lawyer may not know the legal standards insurers use or how to argue an appeal effectively.
Check whether the lawyer is licensed to practice in your state and whether they have any disciplinary history. You can verify this through your state bar association's website.
Frequently Asked Questions
How much does an LTD lawyer cost?
Most work on contingency, taking 25 to 40 percent of money you recover. You pay nothing upfront. Some lawyers also charge you for costs like medical records requests or court filing fees, while others absorb these costs. Ask about this before you hire them.
Can I appeal my denial without a lawyer?
Yes. You can file an internal appeal yourself by writing a letter to the insurer, including new medical evidence or a doctor's statement, and explaining why you believe the denial was wrong. Many people do this successfully. A lawyer is most useful if the denial is complex or if you are unsure how to argue it.
What if I already filed an internal appeal and lost?
You can still hire a lawyer to file a federal court lawsuit. However, this is more expensive and takes longer than an internal appeal. The lawyer will review whether you have grounds to sue and whether the potential recovery is worth the cost and time.
How long does it take to win an LTD case with a lawyer?
An internal appeal usually takes two to four months. If you win, you get your benefits restarted and back pay. If you lose and file a lawsuit, the case typically takes one to three years to settle or go to trial.
What should I bring to my first meeting with an LTD lawyer?
Bring your denial letter, your LTD policy, all medical records related to your condition, any correspondence with the insurer, and a list of doctors who have treated you. The lawyer will use these to assess whether your case is worth pursuing.