What a long-term disability law firm handles

A long-term disability (LTD) law firm represents people in disputes with their insurance company over denied or terminated benefits. These are not Social Security Disability Insurance (SSDI) firms — they handle private insurance policies, usually group plans through an employer. The firm's job is to challenge the insurance company's decision, gather medical evidence, and push back on claim denials or benefit cuts.

Most LTD cases involve one of three situations: the insurance company denied the initial claim, terminated benefits after a period of time, or reduced benefits based on a re-evaluation. The firm reviews the policy language, the insurer's reasoning, and your medical records to find grounds for appeal or lawsuit. If the case goes to court, the firm represents you in federal litigation — these cases fall under a federal law called ERISA (Employee Retirement Income Security Act of 1974).

Long-term disability law is separate from SSDI law. A disability lawyer who handles SSDI appeals works within the Social Security Administration system. An LTD firm works against private insurance companies and their claim denials. Some firms do both, but the processes, timelines, and legal standards are completely different.

Key Takeaways

  • Long-term disability law firms represent people whose private insurance company has denied, terminated, or reduced their LTD benefits.
  • These firms work under ERISA, a federal law that governs private disability insurance, not under Social Security rules.
  • Most firms work on contingency, meaning they take a percentage of any money recovered rather than charging upfront fees.
  • You typically contact an LTD firm after the insurance company has denied your claim or after you have exhausted the company's internal appeal process.
  • The firm's role is to review the policy, challenge the insurer's reasoning, and represent you in appeals or federal court if necessary.

When you should contact an LTD law firm

Contact an LTD firm after your insurance company has made a decision you disagree with — either a denial, termination, or reduction of benefits. Do not wait until you have lost all your money or missed a important date. Insurance policies and ERISA law have strict timelines for appeals and lawsuits, and missing them can bar you from recovery.

The right time to call is usually after the insurance company has issued a formal denial letter or after you have completed the company's internal appeal process without success. Some people call before appealing internally; a firm can review your case and advise whether the internal appeal is worth pursuing or whether litigation is the faster path. Either way, the sooner you call, the sooner the firm can review your policy and identify important date you need to meet.

You do not need to have an SSDI case pending to hire an LTD firm. These are separate systems. However, if you are pursuing both SSDI and LTD benefits, having a lawyer for each process is common — the SSDI lawyer handles the Social Security claim, and the LTD firm handles the insurance company dispute.

How LTD firms charge for their work

Most long-term disability law firms work on contingency, meaning they take a percentage of any money you recover — typically 25 to 33 percent — and charge nothing upfront. You pay only if the firm wins money for you through settlement or court judgment. Some firms also charge for costs like medical record retrieval or informed witness fees, which may be deducted from your recovery or billed separately.

A few firms charge hourly rates instead of contingency. These are less common in LTD work because the cases are often lengthy and expensive to litigate. Before you hire any firm, ask in writing what they charge, whether costs are included in the percentage or billed separately, and what happens if you lose the case.

Contingency arrangements mean the firm has financial incentive to recover money for you, but they also mean the firm will decline cases it thinks are unlikely to win. If a firm turns you down, that is useful information — it may mean your case is weak, or it may mean the firm is too busy. Getting a second opinion from another firm is reasonable.

What happens after you hire an LTD firm

Once you sign a representation agreement, the firm requests your complete file from the insurance company — your policy, all claim documents, medical records they reviewed, and the denial letter or termination notice. This process usually takes two to four weeks. The firm also requests your own medical records directly from your doctors and any other providers who have treated you since you stopped working.

The firm then reviews everything to understand why the insurer denied or terminated your benefits. Common reasons include the insurer claiming you do not meet the policy's definition of disability, that your condition has improved, or that you can perform other work. The firm identifies weaknesses in the insurer's reasoning and gathers additional medical evidence — often by having your doctor write a detailed letter or by obtaining an independent medical evaluation — to counter the insurer's position.

Next comes the appeal. Most ERISA policies require you to exhaust the insurance company's internal appeal before suing in federal court. The firm submits a written appeal with new medical evidence and legal arguments. This appeal process typically takes 30 to 60 days. If the insurer denies the appeal, the firm can then file a lawsuit in federal court on your behalf.

The difference between ERISA appeals and federal court litigation

An ERISA appeal is a written submission to the insurance company asking them to reconsider their decision. You do not go to court; the firm sends documents and arguments to the insurer's appeals department. The insurer must respond within a set timeframe — usually 30 to 60 days — and either reverse the decision or uphold it. Many cases settle during or after this appeal phase because the insurer realizes the firm has found strong evidence the denial was wrong.

If the appeal fails, the firm can file a lawsuit in federal court. This is a real lawsuit with discovery (exchanging documents with the insurer), depositions (recorded questioning of witnesses), and potentially a trial. Federal court litigation is slower and more expensive than the appeal process, but it gives you the right to present evidence in front of a judge. Court cases typically take one to three years from filing to resolution.

Most LTD cases settle before trial. Once a lawsuit is filed, the insurer often becomes more willing to negotiate because the cost and risk of litigation increase. Settlement talks may happen months into the lawsuit, and many cases resolve without a trial.

What documents and information you need to provide

When you contact an LTD firm, have the following ready: your insurance policy (or a copy from your employer's benefits department), the denial or termination letter from the insurer, any internal appeal letters you have sent, and a list of all doctors and providers who have treated you since you became unable to work. You do not need to gather medical records yourself — the firm will request them — but you should be able to name the providers and describe your condition.

You will also need to describe your work history: what your job was, what tasks it required, and when you stopped working. The insurer will argue you can do other work; the firm needs to understand your actual job demands to counter that claim. Bring any documentation of your work duties — job descriptions, performance reviews, or emails describing your responsibilities — if you have them.

Finally, be prepared to discuss your medical history in detail. The firm will ask about your diagnosis, treatments, medications, and how your condition affects your ability to work. The more specific you can be, the stronger the firm's case.

Red flags when choosing an LTD firm

Avoid firms that may provide a win or promise a specific dollar amount. No firm can may provide the outcome of a case, and any firm making such promises is not being honest with you. Similarly, avoid firms that pressure you to sign when ready or that are vague about their fees and costs.

Be cautious of firms that do not ask detailed questions about your case. A good LTD firm will spend time understanding your medical condition, your policy, and the insurer's reasoning before agreeing to represent you. If a firm says yes to your case in a five-minute phone call, that is a warning sign.

Check whether the firm has experience with ERISA litigation specifically. Some disability lawyers focus on SSDI appeals and have little experience with private insurance disputes. ERISA law is different, and you want a firm that knows it well. Ask how many LTD cases the firm has handled and how many have gone to federal court.

Frequently Asked Questions

Can I hire an LTD firm while I am still working through the insurance company's internal appeal?

Yes. Many people hire a firm after receiving a denial letter but before submitting an internal appeal. The firm can advise whether the appeal is worth pursuing or whether litigation is a better use of time and money. There is no rule requiring you to exhaust appeals on your own first.

What if I already settled with the insurance company — can I still hire a lawyer?

If you signed a settlement agreement, you likely gave up the right to sue. A firm can review the settlement to see whether it was final or whether any claims remain open, but in most cases a signed settlement closes the door to further recovery. This is why it is important to have a lawyer review any settlement offer before you sign.

How long does an LTD case usually take from start to finish?

An internal appeal takes 30 to 60 days. If you go to federal court, expect one to three years depending on the court's schedule and whether the case settles. Many cases resolve within the first year once litigation begins, but some take longer.

Do I need a separate lawyer for SSDI if I hire an LTD firm?

You can have both. SSDI and LTD are separate systems with different rules and timelines. Some people hire one firm to handle both, but many hire separate lawyers — one for SSDI and one for the LTD dispute. Ask any firm you contact whether they handle both or only one.

What happens if the LTD firm wins — how much money will I get?

That depends on your policy, how long benefits were denied, and what the insurer owes you. The firm will recover back pay (benefits you should have received), and in some cases future benefits or a lump sum settlement. The firm takes its percentage from the total recovery, and you receive the rest. Ask the firm to estimate your potential recovery based on your policy and the length of the denial.