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WHEN TO GET A LAWYER – BEFORE OR AFTER I APPEAL MY DISABILITY CLAIM DENIAL?

You’ve received the dreaded disability insurance denial letter. The insurance company says it is denying your disability claim or stopping your benefit payments. Now you are coping with your disability or serious injury and facing the prospect of major financial problems. The stress and anxiety of that can aggravate your medical condition. You know that a lawyer who specializes in long-term disability denial cases can help. But should you hire a lawyer before or after you appeal your disability insurance denial?


 Close up of a man man signing legal documents

When to get a lawyer if claim for disability denied


Lawyers who regularly handle long-term disability (“LTD”) claims and denials understand how the system works. We understand that it is never a fair fight for an insurance claimant to go it alone against the insurance company. We know how to get the insurance company to look at the evidence again. For those reasons, you should hire a long-term disability lawyer as soon as possible, and in any case, before you appeal your disability claim denial.


Why should I get a lawyer as soon as my disability claim is denied?


Ideally, you should contact a lawyer immediately after the insurance company tells you it has denied your claim. The main reason that you should act quickly once your disability claim has been denied is to avoid further delay. The longer you wait, the longer it will take to get your disability benefits reinstated or your claim settled.

The next key reason to act fast is your own well-being. From the moment you hire a disability claims lawyer to help with your appeal, you can focus on your health and let the lawyer deal with the stress, deadlines, and paperwork that come with a long-term disability denial.

Another great reason to hire an LTD lawyer: most disability claim lawyers (including Ludwar Law) offer a free, no-obligation initial consultation to discuss your claim. You have nothing to lose and will not be out-of-pocket to get their opinion on your appeal.


How will a lawyer help with my disability claim denial?


First, your lawyer will nail down the reason your claim was denied. It may be that your claim has been denied because the insurance company says you didn’t follow your doctor’s instructions because they say you are fit to work, or due to their incorrect interpretation of the insurance policy. In some cases, the denial is as simple as missing unreasonable deadlines for claim forms.


Often, the problem is not that you aren't disabled; it's that your evidence isn't considered good enough to “prove” your disability”. The nature of your disability may itself be the reason for the denial. Long-term disability claims for conditions such as depression, fibromyalgia, anxiety, chronic fatigue syndrome, memory and concentration problems, headaches, and/or post-traumatic stress disorder (“PTSD”) are difficult to substantiate and tend to not be taken seriously by insurance companies.


An insurance company is required to provide you with the reason that your claim was denied, but sometimes they do not. In other cases, the reason the insurance company gives for the denial is unclear or unfair. It is important that you always obtain a written denial letter confirming why the insurance company is denying your claim.


Taking action to appeal your disability insurance denial


Once the reason for the denial is known, your lawyer will take action. Your lawyer will discuss the options with you and advise you on the best strategy for appeal. Your lawyer will also inform you about the deadlines for appeal or review of the decision. Your LTD lawyer will ensure appeal deadlines are met and protect the limitation period for starting a lawsuit, in case court proceedings become necessary.


The next steps your lawyer takes on your behalf to appeal the denial will depend on the reason(s) your claim was rejected. The steps your lawyer takes to appeal your disability insurance denial may include:

  • Obtaining the documents necessary to prove your disability from work (e.g., updated clinical records) and providing them to the insurance company.

  • Arranging for you to be examined by the best specialists and experts to support the fact that you are totally disabled as per your policy definition.

  • Carefully drafting a Statement of Claim should your claim need to handled through the court system. Your lawyer will ensure that your Statement of Claim addresses each reason for the denial in a clear and persuasive manner. Your lawyer will obtain any new documents, medical reports, or other evidence to support your claim for LTD disability benefits.

Facing a long-term disability denial? Ludwar Law is here to help you


If you have questions about a long-term disability denial or are having problems obtaining benefits from your insurance provider, reach out to Ludwar Law today to discuss your situation. James Ludwar has a proven 27-year commitment to clients involved in disability claims in Alberta and Saskatchewan. James provides trusted advice and clear solutions to people who have had their disability claims turned down by insurance companies. To schedule your free initial consultation, call us today at 403-670-0055 (or toll-free 1-877-682-3476) or contact us using our eForm.



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