Common Reasons Disability Claims Are Denied
Insurance companies deny claims for a wide range of reasons — and not all of them are legitimate. Some denials are the result of incomplete documentation. Others involve policy language that is deliberately vague. And some are simply the result of an insurer applying pressure to avoid paying out a valid claim.
Common reasons disability claims are denied include:
- Insufficient medical evidence to support the claimed condition
- Failure to meet the policy's definition of "disability"
- Missing documentation, forms, or attending physician statements
- Surveillance or independent medical exams used to minimize your condition
- Pre-existing condition exclusions applied incorrectly
- Failure to follow prescribed treatment — even when treatment was inaccessible
- Claim filed outside of the required timeframe
You should not have to fight for benefits you earned — especially while you are already fighting for your health. We are here to carry that weight with you.
The First Steps After a Disability Denial
The period immediately following a denial is critical. Most long-term disability policies — especially those governed by ERISA — require you to exhaust the internal appeals process before you can take your case to court. That means your appeal is not just a second chance. It is the foundation of everything that comes after.
Here is what to do if your claim has been denied:
- Read your denial letter carefully and note the specific reasons cited.
- Identify your appeal deadline — most policies allow 180 days, but some are shorter.
- Do not submit a quick or informal appeal without legal guidance.
- Gather additional medical records, statements, and documentation that address the denial reasons.
- Contact a disability attorney before responding to the insurance company.
The most important thing you can do in this window is not act alone. An appeal submitted without proper preparation is difficult to correct later. At Cowell Law, we review denials and help clients understand exactly what needs to happen next.
What Cowell Law Does After a Denial
We start with a clear-eyed review of your denial. We look at your policy language, the reasons cited, your medical documentation, and the timeline you are working with. From there, we build a strategy — not a form response, but a complete, documented appeal designed to address every issue the insurer raised.
Our approach includes:
- Detailed review of your denial letter and policy
- Medical record review and gap identification
- Coordination with your treating physicians for supporting statements
- Drafting a complete, well-documented appeal submission
- Managing all deadlines and insurer communications
- Continuing with you through litigation if the appeal is not successful
You do not have to navigate this alone. We guide you through every step with honest communication and responsive support — from the first call to final resolution.
Frequently Asked Questions
How long do I have to appeal a denied disability claim?
Most long-term disability policies allow 180 days from the date of the denial letter to submit an appeal, but some policies have shorter windows. ERISA-governed plans have specific requirements that must be followed. It is important to check your policy and act quickly. Missing a deadline can eliminate your right to appeal.
Should I appeal on my own or hire an attorney?
You can technically appeal on your own, but it carries significant risk. Once you have submitted your appeal under ERISA, the administrative record is largely closed — meaning new evidence is very difficult to introduce in court. An attorney helps you build the strongest possible record from the start, which matters both for the appeal itself and any litigation that may follow.
What if my appeal is also denied?
If your appeal is denied, you may still have options — including filing a lawsuit against the insurance company. Cowell Law handles disability litigation as well as appeals, and we will advise you honestly about whether pursuing further action makes sense in your specific situation.
Does Cowell Law take cases on contingency?
Yes. We work on a contingency basis for most disability cases, which means you do not pay attorney fees unless we recover benefits for you. We will explain the fee structure clearly during your initial consultation.