Long-term disability (LTD) insurance offers a safety net when health problems keep you from working. But getting those benefits isn’t as simple as filling out a few forms. Many people stumble through the process and end up with denied claims.
One big reason is avoidable errors. The 5 mistakes to avoid when filing a long-term disability claim usually involve documentation gaps, missed deadlines, poor communication, underreporting of limitations, and going it alone without legal help. Each of these can sink your claim before it ever gets off the ground.
Read on to learn about the five common missteps so you can avoid them. Whether you’re preparing your initial claim or dealing with a denial, having someone who understands the process—like an LTD attorney—can make a real difference. Contact a long-term disability lawyer near you today for a free consultation and assistance obtaining the benefits you deserve.
What Documentation Errors Can Derail Your Disability Claim?
According to industry data, insurance companies reject up to 60% of initial LTD applications. That figure should make anyone pause and ask—what’s going wrong?
Insurance companies rely heavily on documentation. They want proof—and plenty of it—that your condition truly limits your ability to work. Weak or missing paperwork gives them a reason to deny your claim.
Incomplete Medical Records: The Silent Claim Killer
A stack of paperwork might seem like enough, but quantity doesn’t beat quality. Claims often get rejected because key records are missing. If your file doesn’t clearly explain your diagnosis, symptoms, and how those symptoms affect your daily tasks, it’s easy for an adjuster to stamp it “denied.”
For example, if you’re claiming disability for chronic back pain but haven’t submitted detailed imaging reports, treatment history, or progress notes from your specialist, the insurance company might argue that your condition isn’t disabling. One missing report can make the whole puzzle fall apart.
How to Ensure Your Medical Evidence Strongly Supports Your Condition
Ask your doctor to be specific. Vague phrases like “patient complains of fatigue” don’t carry much weight. Insurers want to see measurable findings, not just symptoms. A doctor’s note that says, “Patient is unable to sit or stand for more than 20 minutes due to lumbar disc herniation as confirmed by MRI,” carries far more force.
Also, consistency across medical visits matters. If one report says you’re in severe pain and another suggests you’re fine, insurance adjusters will question your credibility. Make sure every treating provider stays on the same page.
The Importance of Specialty Care Documentation
Seeing a general practitioner is fine, but claims with strong backing from specialists—like a neurologist for a seizure disorder or a rheumatologist for lupus—carry more weight. Specialists can offer deeper insight and detailed tests that general doctors may not provide.
If you haven’t seen a specialist yet, do so before submitting your claim. Their notes and evaluations can tip the scales in your favor.
Missing Critical Deadlines
Insurance companies don’t need a big reason to deny your long-term disability claim—sometimes, a missed date is all it takes. Filing deadlines, appeal windows, and follow-up requests all come with strict time limits. Missing even one can give the insurer exactly what they need to shut your case down. These deadlines aren’t always suggestions—they’re often firm cutoffs that can end your chance at benefits before your claim is even fully reviewed.
If you miss a deadline, don’t give up hope. There may be arguments to reopen your claim or submit additional evidence.
Understanding the Timeline: From Initial Application to Appeals
Every policy sets its own timeline, but most follow a general pattern. You usually have a limited period—often just 90 to 180 days—from the time your disability begins to file your initial claim. If that claim is denied, the appeal window is usually only 180 days. After that, the door could close.
That time goes by quickly, especially when you’re juggling doctor visits, paperwork, and the day-to-day struggle of living with a serious condition. If you miss a deadline, even by a day, the insurance company can use it to deny your appeal or close your file.
Common Deadline Traps Set by Insurance Companies
Insurers often bury key dates in dense letters filled with legal language. They may tell you they’ll “review additional documents” within 30 days—making it sound like you’ve only got a month to respond. In reality, you might have 180 days to appeal. But if you think the 30 days is all you have, you may rush your appeal or submit it incomplete.
They also set short deadlines for things like independent medical exams (IMEs), supplemental forms, or vocational interviews. One missed appointment or forgotten form can be enough for the company to mark your claim as “non-compliant” and shut it down.
Another trick? Delaying their own responses until the last minute, then demanding a quick reply from you. Don’t fall into that trap.
Creating a Calendar System to Track Important Dates
Relying on memory or waiting for reminders from the insurer doesn’t work. Setting up a calendar—whether digital with alerts or a simple paper version—can keep your claim on track. Mark every deadline as soon as you receive it. Set earlier reminder dates to gather materials or follow up with your doctor in time.
Use this calendar to track everything: when forms are due, when medical records need to be submitted, when your appeal window closes, and even when follow-up phone calls should happen. If you’re working with an attorney, they’ll often keep track of these for you, but even then, it helps to stay informed.
Why Does Your Communication with Insurance Companies Matter?
Everything you say or write to your insurer becomes part of your claim file. That includes offhand comments, recorded interviews, and even your social media posts.
Recorded Statements: What You Say Can Be Used Against You
Insurance reps often ask for recorded statements. They sound casual—”just a few questions to verify your claim”—but their real goal is to find inconsistencies.
Saying something like “I had a good day yesterday” might seem harmless. But if your claim says you can’t sit or walk for long periods, that comment may come back to haunt you.
If you’re asked to give a recorded statement, consult with an attorney first. You don’t have to go into it alone.
Social Media Monitoring: How Insurers Use Your Online Presence
Insurers comb through social media. That happy vacation photo from two years ago? It might be taken out of context to argue you’re more active than you claim. We also have a tendency to only post our best moments on social media, and insurance companies take these posts out of context as a basis to deny claims.
Even posts that have nothing to do with your health—like checking in at a restaurant—can be twisted. Keep your accounts private and think twice before posting.
The Importance of Documented Communication
Always put key communication in writing and memorialize phone calls. If a claims adjuster tells you something over the phone, follow up with an email summarizing the conversation. This creates a paper trail and protects you if the company later denies making that statement.
Save every letter, email, and form. Organize them by date in a secure folder. You may need them later. Don’t leave it up to the insurance company to properly document communications.
Underestimating Your Condition’s Impact on Work Capacity
Insurers don’t just want to know what diagnosis you have—they want to know how it limits your ability to work.
The “Own Occupation” vs. “Any Occupation” Definition Trap
Some policies only pay benefits if you can’t do your own job. Others require that you be unable to perform any job. That’s a big difference.
For example, if you’re a surgeon who can’t stand for long periods, you may be disabled under the “own occupation” standard. But the insurance company might try to switch to the stricter “any occupation” definition later and say you can still work a desk job.
Make sure you understand what standard applies and submit evidence tailored to it if this applies to your claim.
Functional Capacity Evaluations: What They Measure and Why They Matter
A Functional Capacity Evaluation (FCE) tests how long you can sit, stand, walk, lift, and perform other work tasks. Insurers love using them—but the results can be misinterpreted.
If the test lasts only two hours, the insurer might say you’re fine, even though your condition flares up after longer activity. Be honest during the test but explain if your symptoms worsen later.
Daily Activity Logs: Documenting Your Limitations Effectively
Keeping a daily log helps connect your symptoms to your real life. Jot down what you tried to do and how your body responded. For example: “Tried folding laundry for 15 minutes—had to stop due to back pain.”
These logs can support your claim and add personal context that medical records alone don’t show.
How Can Attempting to Handle Your Claim Alone Hurt Your Case?
Many people think they can handle the paperwork themselves. But insurance law isn’t easy to deal with, especially when you’re already dealing with a health condition.
The Complex Legal Framework of ERISA and Insurance Law
Most group LTD policies fall under the federal ERISA law. ERISA puts strict rules in place and limits your options if your claim is denied. Unlike other areas of law, you may not get a jury trial, and the court often only looks at the existing record.
That means you’ve got one chance to get your file right. If you wait until later to bring in legal help, it might be too late to fix the gaps.
Statistics on Represented vs. Unrepresented Claim Success Rates
Studies show that people with legal representation during their LTD claim process tend to get better outcomes. That’s not just about having someone to argue your case—it’s about building a strong file from the beginning.
Lawyers know what insurers look for and how to submit the right evidence in the right way.
When to Involve a Legal Professional in Your Claim Process
The sooner, the better. Waiting until you’re denied adds stress and limits your options. Legal professionals can help from day one by reviewing your policy, gathering proper documents, and dealing with the insurance company on your behalf.
How an Experienced Disability Attorney Can Help
Working with a disability attorney means you’re not guessing your way through the process. You get someone who knows the rules, the loopholes insurers use, and how to present your case the right way.
An attorney can:
- Take over communication with your insurance company so you don’t get tripped up by their tactics.
- Collect and organize your medical records in a way that clearly supports your claim.
- Track every deadline and make sure nothing slips through the cracks.
- Build a strategy that fits your condition and your job history.
- Represent you during appeals or court action, if necessary.
That’s not just helpful—it’s a smart move if you want to give your claim a better shot.
Contact Our Skilled LTD Lawyers Now
Filing for long-term disability benefits—or dealing with a denial—requires more than just paperwork. The decisions you make early on can shape the outcome. That’s why having legal support matters.
At Sandstone Law Group, we help clients protect their rights and secure the benefits they’ve earned. Our team has handled LTD claims under employer-sponsored plans and private policies. We know how insurers work, and we’re ready to stand up for you.
We offer free case evaluations, and you won’t pay any fees unless your claim results in benefits. That means no upfront costs and no pressure—just help when you need it most.
Don’t wait. Every day counts. The sooner you take action, the stronger your case will be. Reach out today to set up your consultation and take the first step toward getting the support you deserve.