Arizona Long Term Disability Insurance Lawyers
Your long term disability claim was denied. You have 180 days. Long term disability denials are won — and lost — on the administrative appeal. Once that record closes, your case is essentially decided. Knowing how to build it correctly is everything.
How Insurance Companies Deny LTD Claims
Long term disability denials follow a predictable pattern. Understanding the tactics insurers use is the first step in fighting back.
"Surveillance" Investigations
Insurers hire private investigators to video you doing yard work, shopping, or attending family events — then claim the footage proves you can work. We know how to challenge surveillance evidence and explain context the insurer ignores.
"Independent" Medical Exams (IMEs)
Insurers send claimants to doctors they pay regularly. These "independent" examiners almost always conclude you can work in some capacity. We document the financial relationships and challenge IME findings with your treating doctor records.
"Any Occupation" Reclassification
Most LTD policies pay benefits if you can't perform your "own occupation" for 24 months — then switch to "any occupation" standard. Insurers use this transition to terminate benefits even when your condition hasn't improved.
Mental Health 24-Month Limit
Most LTD policies cap mental health and substance abuse benefits at 24 months. Insurers force depression, anxiety, and PTSD claims into this limit — even when physical conditions also contribute to disability.
Pre-Existing Condition Exclusions
If you sought treatment for a condition in the months before your coverage started, insurers will use that as grounds for denial. The look-back period and what counts as treatment are highly technical.
Insurance Companies We Appeal Against
Each LTD insurer has its own denial patterns, IME doctors, and tactics. We've appealed claims against every major long term disability insurer.
Unum
Largest U.S. LTD insurer. Aggressive surveillance, frequent IME use.
MetLife
Large group disability insurer. Common in employer-sponsored plans.
The Hartford
Acquired Cigna's group disability business in 2020. Major group insurer.
Reliance Standard
Active in mid-size employer plans. Known for aggressive claim review.
Prudential
Major group and individual LTD insurer. Older policies still in force.
Lincoln Financial
Growing presence in employer-sponsored LTD market.
Standard Insurance Company
Northwest-based insurer with national LTD business.
Sun Life Financial
Major insurer with significant group LTD exposure.
Mutual of Omaha
Common in smaller employer plans.
New York Life
Individual disability insurance specialist.
Aetna
Acquired by CVS. Continues to administer many LTD claims.
Northwestern Mutual
Major individual disability insurance carrier.
If your LTD policy came through work, ERISA governs your case — and the rules favor the insurer.
The Employee Retirement Income Security Act (ERISA) is federal law that pre-empts state law for most employer-sponsored disability plans. It creates a unique procedural landscape that traps unrepresented claimants:
This is why the administrative appeal is everything. By the time your case reaches court, the record is locked. Building that record correctly is the only path to winning.
What Wins LTD Appeals
These are the elements we add to the administrative record during the appeal window — before the file closes and your case is essentially decided.
Detailed Treating Doctor Statements
Vocational Expert Reports
Functional Capacity Evaluation (FCE)
Objection to Surveillance & IME Reports
SSDI Award & Records
LTD Conditions We Help Appeal
Some conditions are denied disproportionately by LTD insurers. If your claim involves any of these, we've seen the playbook before.
Fibromyalgia & Chronic Pain
Subjective pain conditions face heavy LTD scrutiny. We document treatment-resistance and functional impact.
View Details →Back Pain & Spinal Conditions
Insurers question whether you can work a sedentary job. We document the breaks, position changes, and lost productivity.
View Details →Depression, Anxiety & Bipolar
The 24-month mental health limit forces these claims onto a deadline. We document physical co-occurring conditions to extend benefits.
View Details →Migraine & Chronic Headache
Subjective disorders insurers love to deny. We document frequency, severity, and treatment-resistance with neurologist support.
View Details →Lupus & Autoimmune Disease
Episodic conditions are easy targets for insurers claiming you can work between flares. We document the unpredictability that makes work impossible.
View Details →EDS & POTS
Multi-system disorders are difficult to fit into insurer disability templates. We document the cumulative limitations across systems.
View Details →How Desert Disability Wins LTD Appeals
Long term disability cases are decided on the record. We make sure the right record exists before the file closes.
Full Policy Review & Strategy
Every LTD policy is different. We obtain the complete plan document, summary plan description, and denial letter — then build the appeal strategy around your specific policy language.
Administrative Record Building
We make sure every piece of supportive medical, vocational, and functional evidence is in the file before it closes. After the appeal window expires, no new evidence can be added.
IME & Surveillance Challenges
We document the financial relationships between insurers and their preferred IME doctors. We obtain raw surveillance footage and provide context the insurer's edited version omits.
Vocational & FCE Evidence
Independent vocational experts and functional capacity evaluations directly address "own occupation" and "any occupation" standards in your policy.
ERISA Litigation If Necessary
If the administrative appeal fails, we litigate in federal court under ERISA. Our record-building during appeal is designed to support that litigation if it becomes necessary.
Your LTD claim was denied. The clock is running.
If your administrative appeal isn't filed within the deadline (typically 180 days), you lose the right to challenge the denial in court. Get a free case review now.
GET MY FREE CASE REVIEW →What to Do If Your LTD Claim Was Denied
Time is the enemy in LTD cases. The administrative appeal deadline is short, and missing it forfeits your right to sue.
Find Your Denial Letter and Read the Deadline
Most ERISA-governed LTD plans give you 180 days from the denial letter to file your administrative appeal. Individual (non-ERISA) policies vary. Identify the exact deadline immediately.
Request Your Complete Claim File
Under ERISA you have the right to your complete administrative file at no charge. The file contains the IME reports, surveillance footage, vocational analyses, and internal memos the insurer used to deny you.
Don't Submit Your Own Appeal Without Help
Many denied claimants write a letter explaining why they disagree. That letter usually hurts more than it helps — and once filed, the record is locked when the next denial comes.
Get Treatment Continuation Documented
Insurers exploit any gap in treatment as evidence you've recovered. Make sure ongoing treatment with specialists is documented even if you've hit deductibles or are between providers.
Consider Filing for SSDI in Parallel
If you qualify for SSDI based on the same condition, the Social Security approval becomes powerful evidence in your LTD appeal. There are also offset implications to understand.
Talk to a Lawyer Before the Deadline
The administrative appeal is your one shot to build the record. After it closes, your case is essentially decided. We'll review your file at no cost and explain your options.
Arizona LTD Frequently Asked Questions
For most employer-sponsored plans (governed by ERISA), you have 180 days from the denial letter to file your administrative appeal. Some plans give 60 days for short term disability denials. Individual (non-ERISA) policies vary widely. The deadline is in your denial letter — check it immediately and calendar it.
SSDI is the federal Social Security disability program — you qualify based on inability to do any work in the national economy. Long term disability is private insurance, either through your employer (group LTD) or purchased individually. LTD policies typically pay a percentage of your salary and have their own definitions of disability that vary by policy. You can receive both at the same time, though benefits may offset.
Most group LTD policies pay benefits for the first 24 months if you can't perform the duties of your "own occupation" — the job you held when you became disabled. After 24 months, the standard typically shifts to "any occupation" you're reasonably qualified for. This transition is a common point at which insurers terminate benefits.
Yes — and they do. Insurers routinely hire private investigators to video claimants in public. The footage is often edited to show activity without context (the medication taken before, the recovery time needed after, or the limited duration of the activity). We've seen this pattern hundreds of times and know how to challenge it in the administrative record.
Not directly, if your plan is ERISA-governed. You must exhaust the administrative appeals process before filing in federal court. If you sue before exhausting appeals, the court will dismiss. After exhausting, you can file an ERISA lawsuit — but the court usually reviews only the administrative record. New evidence is generally not allowed.
Most group LTD policies cap mental health and substance abuse benefits at 24 months — even if you're still disabled. Insurers force depression, anxiety, PTSD, and bipolar disorder claims into this limit. If you have co-occurring physical conditions, we work to document them so benefits continue past the 24-month cap.
No. Like our SSDI work, we represent LTD claimants on a contingency basis — no fee unless we win. Initial case reviews are always free. We'll review your denial letter and policy at no cost.
Trusted by Arizona Disability Claimants
“Filing for disability was not the option I planned for, I had a work place injury and I tried very hard to get my health back. Brandi Anderson at Desert Disability was very compassionate and understanding. She guided me through the process from start to finish.”
“Outstanding service from the very first time I called Jeff Herman's office. The team was so helpful with explaining everything and basically walking me through the process. I could not be happier with the service I received. Brandi was fantastic!”
“I was treated very well by everyone at Desert Disability. When my claim was denied, they kept pushing and it was eventually approved. Would recommend them to anyone filing for benefits.”
Your Arizona Long Term Disability Lawyers
Desert Disability represents long term disability claimants throughout Arizona — Scottsdale, Phoenix, Tucson, Mesa, Gilbert, Chandler, and surrounding communities. We work on contingency: no fee unless we win your case.