Disability Insurance Denial

Understanding a Disability Insurance Denial

Understanding a disability insurance denial involves pinpointing the insurer’s reason for rejecting the claim, such as inadequate medical proof, failure to follow a physician’s orders, policy exclusions, or paperwork errors.

Once you understand why your claim was denied, you can collect additional evidence and submit an appeal to clear up any shortcomings and establish your right to benefits.

Common disability insurance denial reasons include:

• Excluded Conditions: Some policies restrict coverage for mental health conditions, substance-related claims, or pre-existing conditions.
• Failure to Follow Treatment: If a disability insurance company believes you didn’t follow your treating physician’s instructions, it may argue your condition isn’t as serious as claimed.
• Insufficient Medical Evidence: Claims can be denied when records lack detailed physician notes, test results, or other evidence showing how your condition limits your ability to work.
• Paperwork Errors: Missed deadlines or incomplete forms can trigger a denial, as can mistakes made by insurance company employees processing your claim.
• Policy Definition Disputes: Your insurers may say your condition doesn’t meet their definition of disability.
• Surveillance Evidence: Insurance companies may rely on photos or videos taken by private investigators or from your social media accounts to suggest your condition is less serious than your medical records show.

Insurers are notorious for using any tactic they can to deny valid claims and avoid paying the benefits they owe. That’s not fair, but policyholders may still have a path to compensation and justice.

At HerCaseMatters, we work with experienced attorneys who can figure out why you received a disability insurance denial. If your insurer acted unfairly, we can collect evidence to show your entitlement to benefits and then file an appeal on your behalf.

Types of Disability Insurance Claim Denials

Disability insurance claim denials generally fall into several categories depending on the type of policy. Knowing which one applies to your case is critical to understanding a disability insurance denial.

Each type of insurance claim is governed by different policy language, evidence standards, timelines, and limits on benefits. Find out more below.

Short-Term Disability Claims

Short-term disability (STD) insurance provides temporary income replacement when a medical condition prevents you from working for a limited period, typically several weeks to a few months. These claims are often filed after illnesses, surgeries, injuries, or pregnancy-related complications.

Short-term disability claims are frequently denied due to administrative issues, such as missed deadlines, incomplete paperwork, or delays in submitting medical documentation.

Because STD benefits often begin soon after work stops, timely filing is especially important. Coverage terms can vary widely between employer-sponsored plans and private policies, including waiting periods, benefit amounts, and eligibility requirements.

Long-Term Disability Claims

Long-term disability (LTD) claims are subject to intense scrutiny because they can provide benefits for many years, sometimes until a woman retires. As a result, insurance companies may conduct more detailed reviews of these claims.

Long-term disability benefits often hinge on whether the medical evidence supports work limitations or whether the claimant meets the policy’s definition of disability.

Many employer-sponsored LTD plans are governed by ERISA (the Employee Retirement Income Security Act), which imposes strict deadlines and provides a mechanism for policyholders to appeal a disability insurance denial.

Social Security Disability Insurance

Social Security Disability Insurance (SSDI) is a federal benefits program run by the Social Security Administration (SSA) that provides income to people who can no longer work because of a long-term or permanent disability.

To qualify for SSDI benefits, you generally must have:

• A qualifying medical condition that meets the SSA’s strict disability standards
• Work history and credits from jobs covered by Social Security

SSDI claims are often denied because the SSA determines that a condition is not severe enough, is expected to improve, or does not meet its legal definition of disability.

An experienced disability lawyer can help challenge a disability insurance denial by gathering stronger medical support, addressing gaps in medical records, and filing a timely appeal to pursue the benefits you’re entitled to.

Veterans Disability

U.S. veterans may be eligible for VA disability benefits if they have a medical condition connected to their military service, such as cancer, hearing loss, or post-traumatic stress disorder (PTSD).
These benefits are administered by the U.S. Department of Veterans Affairs (VA) and are separate from Social Security and private disability insurance. The VA awards monthly compensation depending on the veteran’s disability rating, which ranges from 10% to 100%.

Filing a VA disability claim can be complex, and initial decisions often take several months. If a claim is denied or requires additional review, the process can extend significantly longer, particularly when service connection or disability ratings are disputed.

Call (877) 640-6101 right now to get help for a disability insurance denial. Our case managers are ready to help you take the next step toward the benefits you deserve.

Appealing a Disability Insurance Denial​

A disability claim denial can feel overwhelming, especially for women who are already balancing health concerns, caregiving responsibilities, and work pressures. An experienced disability lawyer can take on the legal burden, allowing you to focus on your well-being.

Below are the key steps typically involved in appealing a disability insurance denial with the help of our legal partners.

1. Get a Free Case Review

The disability attorneys affiliated with HerCaseMatters offer free consultations, allowing you to understand your options without added financial stress.

There are no upfront costs or hourly fees when you work with our legal partners — you only pay if benefits are recovered.

2. Gather Evidence

Women’s disability claims are often minimized or misunderstood, particularly when they involve chronic pain, autoimmune conditions, mental health concerns, or pregnancy-related complications.

A legal team can help gather and organize evidence that tells the full story of how your condition affects your daily life and ability to work.

Evidence to dispute a disability insurance denial may include:

• Information about your job duties
• Medical records and diagnostic test results
• Statements from health care providers explaining symptoms and limitations
• Your disability insurance policy

This step is critical for addressing any gaps or misinterpretations in your original claim, increasing your chances of a successful outcome.

3. Submit the Appeal

Disability appeals are governed by strict rules and documentation requirements. Missing a filing deadline or submitting incomplete or improperly prepared paperwork can permanently impact your claim.

A lawyer can ensure that all forms, medical records, and supporting documents are filed correctly, completely, and on time. Your attorney can also handle all communications with your insurance company, relieving you of the stress of back-and-forth requests.

If your first appeal is denied, your disability insurance denial may be able to file a second appeal to pursue the benefits you’re owed.

4. Take Legal Action

If the insurance company continues to deny your claim, your attorney may recommend filing a disability insurance denial lawsuit. This may involve negotiating a disability insurance denial settlement or presenting your case in court to seek the benefits you were promised.

Your attorney will handle all the legal work, making the appeals process as easy and stress-free as possible. With a legal team by your side, you’ll have peace of mind knowing that your case is in good hands.

Disability Denial Insurance Companies​

Disability insurance is often denied, even when medical evidence supports a claim. Many insurance carriers have been accused of protecting their own interests by narrowly interpreting policies, demanding excessive documentation, or denying claims during reviews.

Insurers have a legal duty to treat policyholders fairly. When they fail to do so, they may be found to have acted in bad faith.

Insurance companies frequently involved in disability insurance denials include:

• Aetna
• Allstate
• Anthem
• Cigna
• Disability Management Services
• Guardian
• The Hartford
• Liberty Mutual
• Lincoln Financial
• Lloyd’s of London
• MetLife
• Northwestern Mutual
• Prudential
• State Farm
• Sun Life
• The Standard
• UnitedHealthcare
• Unum

This is only a partial list. Many insurers have wrongfully issued disability insurance denials, putting their financial interests ahead of the real impact disabilities have on women’s health and livelihood.

If your disability claim was denied, it’s not necessarily the end of the road. Speaking with a lawyer can help you understand your options after a disability insurance denial. Get a free case review right now.

What to Do After a Disability Insurance Claim Denial​

A disability insurance claim denial can feel defeating, but a denial doesn’t mean you’re out of options. Many women successfully challenge denied claims by taking informed, timely action.

What you do next matters. Disability insurance appeals are governed by strict rules and deadlines, and early missteps can affect your ability to get benefits. Taking the right steps after a denial can help protect your claim and reduce unnecessary stress.

Steps to take after a disability insurance denial include:

1. Read the Denial Letter Carefully: Your denial letter explains why the insurance company rejected your claim and outlines important appeal deadlines. Pay close attention to the reasons given, as they determine what evidence will be needed next.
2. Note Deadlines and Requirements: Disability appeals are time-sensitive. Missing a deadline or failing to follow appeal instructions can permanently affect your claim. Write down all dates, required forms, and ways to submit the appeal.
3. Gather and Organize Supporting Evidence: Collect medical records, test results, and provider statements that clearly show how your condition limits your ability to work.
4. Avoid Informal Communication With the Insurer: Insurance companies may request additional information or statements. Responding without guidance can unintentionally harm your claim. Keeping communications formal and documented helps protect your claim.
5. Consider Speaking With a Lawyer: A disability insurance claim denial lawyer​ can review your case, identify weaknesses in the insurer’s reasoning, and file an appeal on your behalf.

If your appeal is denied, additional options may still be available, including further appeals or legal action. Understanding these options early on can help you make informed decisions moving forward.

Get Help Fighting a Disability Insurance Denial​

At HerCaseMatters, we support women nationwide who have been denied disability insurance benefits while coping with serious health conditions. Whether your claim involves a chronic illness, sudden injury, or another disabling condition, you deserve to be heard and treated fairly.

When you reach out to us, you can expect:

• A compassionate team that listens to you and takes your concerns seriously
• Clear guidance on whether you may have grounds to appeal a disability denial
• No upfront costs — you pay nothing unless benefits are recovered

Challenging a denial can feel intimidating, especially when facing a large insurer, but you don’t have to do it on your own.

Reach out today for a free, no-obligation case review. There’s no pressure and no judgment — just support from a team focused on helping women protect their health and financial stability.