An internal appeal for long-term disability benefits is the insurance company’s process for reconsidering their denial of your claim for long-term disability benefits. These benefits may be from disability insurance from an employer or your own insurance. While it is possible that they may decide to reverse their decision, they may also deny your appeal, which is generally the case.
A disability lawyer may advise you to make an external appeal instead. An external appeal, or lawsuit, puts the right to judge your eligibility for benefits into the hands of the court system. If our disability lawyers believe you qualify, we may be able to help you take action to file an internal appeal or file a lawsuit against the insurance company.
An Internal Appeal of a Long-Term Disability Denial May Be Helpful in Some Cases
An internal appeal may be effective in some cases. When the denial letter has a clear and fixable reason for denying benefits, an internal appeal may reverse the original decision. This denial could include:
- Incomplete information in their file
- Inadequate documentation of your condition
- A missed medical appointment or treatment
- A medical clarification is needed
In short, technicalities that could quickly reverse a denial may make an internal appeal effective.
When it comes to more nuanced challenges, the insurance company may double-down on its initial denial. This stance could occur if you provide new evidence of a condition that the insurance company disputes.
At the end of the day, if you’re asking, what is an internal appeal for long-term disability benefits, it is asking the insurance company to reverse the decision they recently made about your case. If you challenge them with an external appeal, the decision about your claim is no longer in their hands—it is in the hands of the courts.
An Alternative Option to Challenge a Long-Term Disability Denial
A disability lawyer may advise that you skip an internal appeal and go directly to an external appeal, or lawsuit. A lawsuit makes the legal system the interpreter of your long-term disability case, not the insurer.
If you work with one of our lawyers in your long-term disability case, they may be able to:
- Interpret your denial letter and design a path forward
- Recommend an internal appeal if they believe the insurance company may overturn their decision
- Recommend an external appeal to challenge a denial in court
- Gather additional evidence and documentation of your case
- Negotiate with the insurers and handle legal paperwork in court
- Take your case to trial if the insurers are not willing to make a settlement
If you receive a denial of your long-term disability claim, it is only natural to feel frustrated or even angry. Fortunately, you do not need to face this situation alone.
There Are Time Limits for Filing a Lawsuit to Challenge a Long-Term Disability Denial
There are time limits to appeal a denied disability claim in court. You generally have two years from the date of your first denial under the Limitations Act. In some cases, the deadline may be as short as one year. If you miss this deadline, you may lose the right to secure compensation in an external appeal.
Similarly, there are deadlines for internal appeals that are specific to each carrier’s policy. If you’re still unsure and asking what is an internal appeal for long-term disability benefits, personal injury lawyer from Preszler Injury Lawyers may be able to clarify the timeframe you have for action in your case.
Talk to a Lawyer from Preszler Injury Lawyers About Your Long-Term Disability Denial
At Preszler Injury Lawyers, we may be able to help you build a case for an internal appeal or file a lawsuit to try to secure your long-term disability benefits. Our lawyers may be able to help you secure new information in your case, such as documentation from specialists, new medical imaging or test results, testimony from medical experts, or other new additions.
If you’re wondering what is an internal appeal for long-term disability benefits, let us review your case to determine if we believe you may qualify for long-term disability benefits. Call 1-800-JUSTICE today to discuss your case with a member of our disability appeal team.
Initial consultations are complimentary, and our firm operates on a contingency-fee-basis, meaning no up-front payment is required for our representation.
We serve Toronto as well as all areas in Ontario. If your injuries prevent you from traveling to meet with us, we can come to you.