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Appealing a Disability Denial

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Disability Appeals – What Are They?

If your application for short or long term disability has been denied, the first option available to you is an appeal. Appealing a disability denial is an “internal” process, requesting that the insurance company reconsider its decision, and approve your claim for disability benefits. This is usually a quick, and comparatively informal process.

If your initial application for disability is denied, and later your appeal is denied as well, you may have additional levels of appeals that you can try. These may become increasingly unlikely to succeed at each successive level. For this reason, your first disability appeal is likely the best bet, and you may want to seek a lawyer’s advice for guidance in this appeal. The disability lawyers at Kadish law offer free guidance for appealing a long term disability termination as well as short term disability appeals. So call today for help with your disability appeal.

Advantages of Appealing a Disability Denial:​

The 3 main advantages of a disability appeal are its speed, low cost, and the ability to still bring a claim if the appeal is denied.

Disability appeal lawyers will admit that bringing a claim through the court system has a much higher rate of success than an appeal, but the appeal is a much quicker process. Instead of taking months (or even years) a disability appeal might be approved in as little as 30 days.

A second major benefit to appealing a disability claim is cost savings. While a formal lawsuit has associated legal and other costs, the disability appeal process does not. Your doctor may charge a small fee to complete a form, or provide an appeal letter in support of your claim, however, there are typically no other costs associated with appealing a long term disability denial in Canada. The insurance appeal process is rather informal and the disability appeal lawyers at Kadish Law provide free appeal services, walking you through the disability appeal process and assist you in writing your disability denial appeal letter at no cost.

Finally, if your appeal is denied, you can still have a lawyer assist you with your claim by bringing a formal claim on your behalf. Although appeals are quick and low cost, they have a very high denial rate, as compared to disability claims with the assistance of lawyers which may take more time and have a greater expense associated with them, but have an exceptionally high approval rate. You can rest assured that as long as you pay attention and work within the relevant timelines, you can try an appeal to take advantage of its associated benefits, and if unsuccessful, still have a lawyer bring a formal claim on your behalf.

Insurance Company Appeal Process:​

One of the things that people find so confusing about the appeal process is the lack of structure. Unlike the initial application, the insurance appeal process does not necessarily have 3 forms to be filled out by the applicant/appellant, doctor, and the employer. Less guidance is given and the responsibility for what to provide in support of one’s appeal is left to the applicant.

Some – but not all – insurers provide a form to be completed by the appellant which will provide information about the medical reasons for the disability claim, the insurer’s misinterpretation of the evidence submitted.

Whether your insurance company provides you with a form or not, we recommend that you provide both (1) a letter from your doctor in support of your appeal, as well as (2) an appeal letter that you write yourself.

The doctor’s letter can be from your family doctor, your specialist, or any treatment provider that you feel is well informed of your condition and is supportive. We strongly recommend that you ask your doctor/specialist to include details relating to your symptoms/restrictions, rather than just your diagnosis. You should also include an appeal letter that you write yourself (or with the help of a spouse or disability appeal lawyer). Read below to learn more about sample long term disability appeal letters.

How to Write An Appeal Letter for Disability (Disability appeal letter examples)

In addition to your doctor’s letter discussed above, we recommend including a disability appeal letter of your own. You can write it yourself or with the support of a spouse, or disability appeal lawyer.

We suggest that your own letter be focused on your restrictions and symptoms. Your disability insurer is likely well aware of your formal diagnosis, and rarely do they deny that you struggle with any issues. Instead the denial is often on the basis of “insufficient medical evidence” proving a “total disability”. This means that despite any diagnosis provided by your doctor, the disability insurer denies that the information provided to date confirms/proves that you are unable to continue to work. For example, they may claim that although you were diagnosed with Depression or Anxiety, you have not proven total disability, that you cannot continue to work regardless. One of our disability appeal lawyers can review your letters and provide guidance if you are unsure what/how to write your disability appeal letter.

Long Term Disability Appeal Letter Examples & Samples

We do not recommend using a “disability appeal letter sample” from someone else. In addition to focusing on your unique symptoms and restrictions (as discussed above) it can be very helpful to address some of the specific concerns that your insurer may have had with your case/application that may have contributed to their decision to deny your claim. A common example is a workplace issue which the insurer may mistakenly believe is the cause of your sick-leave rather than the medical restrictions arising from your illness.

You can take advantage of a free disability appeal review by reaching out to one of our disability appeal lawyers to review your appeal at no cost. We can assist in guiding you in drafting a unique disability denial letter for your appeal giving you the best chance for an approval.