- LTD claims are complex and often challenging to win on your own, especially because insurers may look for reasons to deny or reduce benefits.
- You should strongly consider hiring a lawyer if your claim has been denied, since appeals require detailed evidence, deadlines, and strong organization.
- A lawyer is especially helpful when your disability is hard to prove, such as chronic pain, mental health issues, autoimmune disorders, or multiple conditions.
- Policies define “disability” differently, and if your policy uses the stricter “Any Occupation” definition, a lawyer can help build a case that meets that standard.
- Many LTD lawyers work on contingency, meaning you pay only if you win, which makes legal help accessible even if finances are tight.
- Common denial reasons include missing documentation, missed deadlines, policy exclusions, and IMEs, and a lawyer can help prevent or correct these issues through proper evidence and strategy.
Long term disability (LTD) benefits can be a lifeline when an injury or illness prevents you from working. But dealing with LTD claims can also feel like navigating a maze—especially when your health is already stretched thin. For many people, the biggest question isn’t whether they qualify for benefits, but whether they need a lawyer to help them get what they’re entitled to.
In this guide, we’ll break down the most common situations where hiring a lawyer makes sense, what lawyers actually do in LTD cases, and how to know if your claim is worth the time and cost. Whether you’re just starting your claim or you’ve already been denied, this article will help you understand your options and make confident decisions.
What Are Long Term Disability Benefits?
Long term disability benefits are designed to replace a portion of your income if you become disabled and cannot work for an extended period. Unlike short-term disability, which typically covers a few weeks to a few months, LTD is meant for longer-term or permanent disabilities.
Why LTD Claims Are So Tricky
LTD claims can be complicated for a few reasons:
- Insurance companies are businesses and may look for ways to reduce payouts.
- Policies have strict definitions of disability, and those definitions can be confusing.
- Medical evidence matters a lot, and sometimes your condition is difficult to document.
- Deadlines are strict, especially when appealing denials.
For these reasons, many people end up needing professional help to get through the process.
When Should You Consider a Lawyer?
Not every LTD claim needs a lawyer. Many people successfully navigate the process on their own. But there are clear situations where a lawyer can make a major difference.
1. You’ve Been Denied Once or More
If your claim is denied, that’s a major warning sign. Insurance companies deny claims for a variety of reasons, including:
- Missing paperwork
- Lack of medical evidence
- Disputes over whether your condition qualifies
- Concerns that you can work in some capacity
A lawyer can help you understand why your claim was denied and build a stronger appeal.
2. Your Disability Is Complex or Hard to Prove
Some conditions are easier to document than others. If your disability is based on:
- Chronic pain
- Mental health conditions
- Autoimmune disorders
- Neurological conditions
- Multiple health issues combined
…then you may benefit from a lawyer’s help in gathering evidence and presenting your case effectively.
3. Your Employer or Insurance Company Is Fighting You
If you suspect your employer or insurer is being unfair or overly aggressive, a lawyer can protect your rights. Some signs include:
- Repeated requests for unnecessary documentation
- Sudden “re-evaluations” or surveillance
- Claims that you’re “able to work” despite medical evidence
- Pressure to return to work too soon
A lawyer can communicate on your behalf and keep the process fair.
4. You’re Running Out of Time
LTD claims have strict deadlines. If you miss a deadline for filing or appealing, you could lose your benefits permanently. A lawyer can help you track deadlines and ensure everything is filed correctly.
5. You’re Not Getting the Full Amount You Deserve
Some people are approved for benefits but only receive a reduced amount. A lawyer can review your policy and help determine whether you qualify for a higher payout.
What Does a Long Term Disability Lawyer Do?
A lawyer specializing in LTD benefits handles many parts of the process that can be overwhelming for someone who’s sick or injured.
The Key Services a Lawyer Provides
- Reviewing your LTD policy to identify coverage, exclusions, and your rights
- Gathering medical evidence and coordinating with doctors
- Preparing and submitting appeals
- Communicating with the insurance company
- Handling hearings or litigation, if needed
- Ensuring deadlines are met
- Negotiating settlements when appropriate
How Lawyers Help With Evidence
Evidence is the backbone of LTD claims. A lawyer will help you build a strong medical record by:
- Collecting doctor notes, test results, and specialist reports
- Obtaining statements from healthcare providers
- Organizing evidence in a way that supports your claim
- Ensuring your documentation addresses the policy’s definition of disability
What Does “Disability” Mean in LTD Policies?
This is one of the most important points in any LTD claim. Disability isn’t always defined the way most people think.
Two Common Definitions
Most policies use one of these definitions:
- Own Occupation: You’re considered disabled if you can’t perform your own job, even if you can do another type of work.
- Any Occupation: You’re only considered disabled if you can’t perform any job that fits your education, experience, and training.
Why This Matters
If your policy uses the “Any Occupation” definition, your claim may be harder to win. Insurance companies often argue that you can perform some other type of work, even if it’s unrealistic.
A lawyer can help interpret your policy and build a case that matches the definition.
What Happens After a Denial?
If your claim is denied, you generally have a chance to appeal. The appeal process varies by policy, but it usually includes:
- Requesting a review
- Submitting additional medical evidence
- Writing a detailed appeal letter
- Possibly going to a hearing or court
How a Lawyer Strengthens an Appeal
A lawyer can help you by:
- Identifying gaps in your evidence
- Gathering missing documentation
- Preparing a strong, organized appeal
- Ensuring your appeal addresses the insurance company’s reasons for denial
- Representing you in hearings or court
What’s the Cost of Hiring a Lawyer?
One of the biggest concerns people have is cost. The good news is that many LTD lawyers work on a contingency basis, which means:
- You don’t pay upfront
- The lawyer gets paid only if you win
- Fees are usually a percentage of the back benefits you receive
This arrangement makes legal help accessible for people who are already struggling financially due to disability.
How to Choose the Right LTD Lawyer
Choosing a lawyer is a big decision. Here are some key questions to ask:
Questions to Ask Before Hiring a Lawyer
- Do you specialize in long term disability claims?
- How many LTD cases have you handled?
- What is your success rate?
- Do you work on contingency?
- What percentage do you charge?
- Will you handle my case personally or pass it to someone else?
- What is the expected timeline for my case?
- What happens if I lose?
What to Look For
A good LTD lawyer should:
- Understand insurance company tactics
- Be detail-oriented with evidence and deadlines
- Communicate clearly and respectfully
- Have experience with your specific type of disability
- Be willing to go to court if needed
What If You Can Work Part-Time or In a Different Job?
Some people assume that if they can work in any capacity, they don’t qualify for LTD. That’s not always true.
Partial Disability Benefits
Some policies offer partial benefits if you can work part-time but not full-time. These benefits are designed to help bridge the gap between your earnings and your normal income.
When a Lawyer Helps With Partial Disability
A lawyer can help you prove:
- Your limitations prevent full-time work
- Your medical condition impacts your earning capacity
- You’re making a good-faith effort to work within your limitations
What If Your Condition Gets Worse Over Time?
Many disabilities aren’t static. They may worsen over time, which can impact your claim.
Why This Matters
If your claim was denied or approved at a lower level, you may qualify for increased benefits later. A lawyer can help you:
- Request a policy review
- Submit updated medical evidence
- File for increased benefits
What Are Common Reasons LTD Claims Get Denied?
Understanding why claims are denied can help you avoid mistakes.
Common Denial Reasons
- Insufficient medical documentation
- Disputes about the severity of the condition
- Policy exclusions or limitations
- Missed deadlines
- Failure to follow treatment plans
- Incomplete paperwork
- Insurance company “independent medical examinations” (IMEs) that contradict your doctor’s findings
How a Lawyer Can Prevent These Issues
A lawyer can help you avoid denial by ensuring:
- Your medical records clearly support your claim
- Your paperwork is complete and accurate
- You follow policy requirements and deadlines
- You’re prepared for IMEs and other insurance tactics
Should You Hire a Lawyer Before You File a Claim?
Not necessarily. Many people successfully file and receive LTD benefits without a lawyer. But there are some cases where getting legal help early can save time and stress.
When Early Legal Help Makes Sense
- Your disability is complex
- You’re unsure whether you meet the policy definition
- You’ve had previous denials or issues
- You expect pushback from the insurer
- You want to ensure your claim is properly documented from the start
What Happens During a Disability Insurance Appeal?
The appeal process is where a lawyer can truly add value. It often includes:
- Gathering new evidence
- Organizing your medical history
- Writing a persuasive appeal letter
- Responding to the insurer’s arguments
- Preparing for a hearing or court case if necessary
What to Expect in an Appeal
Appeals can take weeks or months, depending on:
- The complexity of your case
- How quickly your doctors provide documentation
- Whether the insurer schedules an IME
- The appeal process under your specific policy
A lawyer can help manage the timeline and keep you informed.
What If You’re Still Working But Fear You’ll Lose Your Job?
If your disability is progressing, you may feel pressure to keep working. But pushing yourself too hard can worsen your condition and harm your claim.
Why You Should Avoid “Pushing Through”
- It can create gaps in your medical evidence
- It may lead to missed appointments or treatment
- Insurance companies may argue you’re able to work
- Your health could worsen
A lawyer can help you understand when it’s time to file a claim and how to document your limitations properly.
How Long Does It Take to Get LTD Benefits?
The timeline varies, but generally:
- Initial approval can take weeks to months
- Denials and appeals can add months or even years
- Court cases can take longer
A lawyer can help expedite the process by:
- Ensuring your paperwork is complete
- Gathering strong medical evidence quickly
- Preventing unnecessary delays
When Should You Definitely Hire a Lawyer?
Here are the strongest signs that you should hire a lawyer:
Clear Signs You Need Legal Help
- Your claim was denied
- Your condition is complex or invisible
- Your insurer is delaying or denying without explanation
- You suspect unfair treatment or bad faith
- You need help navigating appeals and deadlines
- You’re not getting the full benefits you deserve
- Your policy has strict definitions or limitations
Closing Thoughts: Don’t Fight Alone
Long term disability benefits are meant to protect you when you need them most. But insurance companies don’t always make it easy. If you’re facing denials, delays, or disputes, a lawyer can be the difference between getting the benefits you deserve and being stuck without income.
If you’re unsure whether you need a lawyer, consider your situation honestly. If your claim is straightforward, you may be able to handle it alone. But if your claim is complex, denied, or likely to be contested, getting legal help early can save you time, stress, and money.
Your health matters—and so does your financial stability. When your disability prevents you from working, you deserve a fair chance at getting the benefits that can help you move forward.
