What a Long-Term Disability Lawyer Does
A long-term disability lawyer represents you in disputes with your insurance company over benefits you believe you are owed. Long-term disability (LTD) insurance is typically provided through your employer's group plan, and when the insurer denies your claim or stops paying, a lawyer can file appeals, gather medical evidence, and argue your case in court if necessary.
The lawyer's job is specific: they do not file your initial claim or handle the paperwork with your employer's benefits department. Instead, they step in after a denial or when you need to challenge a decision already made. They review the insurance policy language, the medical records the insurer reviewed, and the reasons given for the denial, then build a case to overturn it.
Long-term disability cases are contract disputes, not government benefits cases. That means the rules are set by your insurance policy and federal law (usually the Employee Retirement Income Security Act, or ERISA), not by a government agency. A lawyer who understands ERISA and group insurance policies is what you need.
Key Takeaways
- Long-term disability lawyers work on cases where an insurance company has denied or stopped your benefits, not on initial claims.
- Many disability lawyers work on contingency, meaning they take a percentage of the money recovered rather than charging an upfront fee.
- You can find lawyers through your state bar association, disability advocacy organizations, or referrals from your doctor or union representative.
- The lawyer will need copies of your insurance policy, the denial letter, all medical records submitted to the insurer, and any correspondence with the insurance company.
- ERISA law limits how much a lawyer can charge in some cases, so ask about fee agreements and what percentage they will take.
When You Need a Long-Term Disability Lawyer
You should consider hiring a lawyer if your claim was denied, if your benefits were stopped without explanation, or if the insurer is asking for information you believe is unreasonable or invasive. You do not need a lawyer to file an initial claim, but you may need one to challenge what happens after.
The most common trigger is a denial letter. The insurer will give a reason—your condition does not meet the policy definition of disability, the medical evidence does not support your claim, or you did not follow the policy's procedures. If you disagree with that reason, a lawyer can review whether the insurer applied the policy correctly and whether they ignored evidence in your favor.
Another common situation is when the insurer stops paying after a period of time. Some policies pay only for a set number of months or until you reach a certain age. If the insurer stops without warning or gives a reason you do not understand, a lawyer can determine whether they had the right to do so under the policy terms.
How to Find a Long-Term Disability Lawyer
Start with your state bar association's lawyer referral service. Most state bars maintain a searchable directory or a phone line where you can ask for lawyers who handle disability insurance disputes. Ask specifically for lawyers who work with ERISA claims or group insurance disputes, not Social Security Disability Insurance (SSDI) lawyers, which is a different field.
Disability advocacy organizations in your state may also keep lists of lawyers who take these cases. Organizations focused on specific conditions—chronic pain, autoimmune disease, mental health—sometimes maintain referral networks. Your doctor, union representative, or employee information program (EAP) may also know lawyers in your area who handle LTD disputes.
When you contact a lawyer, ask whether they take cases on contingency (meaning they take a percentage of money recovered rather than charging you upfront) and what percentage that is. Ask how many ERISA or long-term disability cases they have handled. Ask whether they have experience with your specific insurance company, because some insurers have patterns that an experienced lawyer will recognize.
What Documents to Gather Before Meeting a Lawyer
Collect your insurance policy itself—the actual document, not just the summary. Your employer's benefits department or HR office can provide this. You will also need the denial letter or the letter stating that benefits have stopped, the full text of any reason given for the decision, and any correspondence between you and the insurance company.
Gather all medical records you submitted to the insurer, as well as any medical records created after the denial. Include records from your treating doctors, any specialists you have seen, and any testing or imaging done. If you have been treated by a mental health provider, include those records too, even if your disability is physical—insurers often look at whether depression or anxiety is affecting your ability to work.
Bring documentation of your work history: job descriptions, performance reviews, and any records showing that you stopped working or reduced your hours because of your condition. If you have filed for Social Security Disability Insurance (SSDI) or workers' compensation, bring those case numbers and any decisions made in those cases, because they can support your LTD claim.
Understanding Contingency Fees and Cost
Most long-term disability lawyers work on contingency, which means they do not charge you upfront. Instead, they take a percentage of the money they recover—typically 25 percent to 33 percent, though this varies. If they do not recover money, you do not pay them.
Under ERISA law, a lawyer's fee may be limited by the court in some cases. If your case goes to court, the judge can reduce the fee if it seems unreasonable compared to the amount recovered or the work done. Ask your lawyer upfront what they expect the fee to be and whether a court could reduce it.
Some lawyers charge hourly rates instead of contingency. This is less common in disability cases but does happen. If a lawyer quotes an hourly rate, ask for an estimate of how many hours they expect the case to take and what the total cost might be. Ask whether you pay as you go or whether they bill you at the end.
What Happens After You Hire a Lawyer
Your lawyer will file an appeal with the insurance company, usually within 180 days of the denial (though the exact important date depends on your policy). This appeal is called an administrative appeal or internal appeal. The insurer will review the case again, and your lawyer will submit new medical evidence, legal arguments, or both to show why the denial was wrong.
If the insurer denies the appeal, your lawyer can file a lawsuit in federal court. This is where ERISA cases are heard. The lawsuit can take months or years, and the insurer will likely hire its own lawyer. Your lawyer will exchange documents with the insurer's lawyer, may take depositions (recorded interviews under oath), and will prepare for trial if the case does not settle.
Many cases settle before trial. The insurer may offer to pay back benefits owed plus interest, or to resume monthly payments going forward. Your lawyer will advise you on whether a settlement offer is fair or whether you should continue to trial. You make the final decision on whether to accept.
Questions to Ask a Lawyer Before Hiring
Ask how many long-term disability cases the lawyer has handled and how many went to trial versus settled. Ask what percentage of cases they have won. Ask whether they have handled cases with your specific insurance company and whether they know how that company typically denies claims.
Ask what the timeline looks like—how long the administrative appeal usually takes, how long a lawsuit typically takes, and whether the lawyer expects your case to settle or go to trial. Ask what documents and information you will need to provide and how often you will need to be in contact.
Ask what happens if you cannot afford to pay for medical records or informed witnesses. Some lawyers will advance these costs and deduct them from the recovery; others expect you to pay them. Ask whether the lawyer carries malpractice insurance and whether they are in good standing with the state bar.
Red Flags When Choosing a Lawyer
Do not hire a lawyer who promises a specific outcome or guarantees that you will win. No lawyer can may provide a result. Do not hire a lawyer who pressures you to sign a fee agreement when ready or who will not explain the agreement in writing.
Be cautious of lawyers who do not ask detailed questions about your medical condition, your work history, or the specific language of your insurance policy. A lawyer who treats your case as routine without understanding the details may miss important arguments.
Avoid lawyers who do not return phone calls or who seem disorganized. A disability case requires careful tracking of important date and documents. If a lawyer is hard to reach during the initial consultation, they may be hard to reach during your case.
Frequently Asked Questions
Can I switch lawyers if I am unhappy with the one I hired?
Yes. You can fire your lawyer at any time and hire a different one. The new lawyer will need to file a substitution of counsel with the court or the insurance company. Be aware that if you are in the middle of a case, switching lawyers may cause delays. Ask the new lawyer whether they will take over the case and what they will charge.
What is the difference between a long-term disability lawyer and an SSDI lawyer?
Long-term disability lawyers handle disputes with private insurance companies over group plans provided through employers. SSDI lawyers handle claims with the Social Security Administration, a government agency. The laws, procedures, and evidence are completely different. Make sure you hire a lawyer who handles the type of case you have.
How long does a long-term disability case usually take?
An administrative appeal typically takes three to six months. A lawsuit can take one to three years or longer, depending on how complex the case is and how busy the court is. Some cases settle quickly; others go to trial. Your lawyer should give you a timeline based on the facts of your case and the court's schedule.
What if I cannot afford a lawyer?
Most disability lawyers work on contingency, so you do not pay upfront. If you cannot find a lawyer willing to take your case, contact your state bar association or a legal aid organization to ask about free or low-cost consultations. Some disability advocacy organizations also offer referrals to lawyers who work with low-income clients.
Can I appeal my long-term disability denial on my own without a lawyer?
Yes, you can file an appeal yourself. However, insurance companies have lawyers, and they know how to read insurance policies and ERISA law. Having a lawyer on your side significantly increases your chances of winning. If you cannot afford one upfront, a contingency arrangement means you only pay if you recover money.