When the Insurer Says No

Long-term disability (LTD) benefits are supposed to replace part of your income when illness or injury prevents you from working. But insurers deny and terminate valid claims routinely — because doing so protects their bottom line. A denial is not the final word. It is the beginning of a process in which experienced counsel can make the difference.

Why Claims Get Denied

  • "You don't meet the definition of disability." The insurer asserts you can still work.
  • The shift from "own occupation" to "any occupation." Many policies pay if you cannot do your own job for an initial period (often about two years), then continue only if you cannot do any job suited to your education, training, and experience. Insurers frequently cut benefits at this "change of definition."
  • Surveillance and insurer medical exams used to suggest you are more capable than you are.
  • Alleged gaps in treatment or insufficient "objective" evidence — a common but often unfair basis for denying pain and mental-health claims.
  • Pre-existing condition or policy-exclusion arguments.

Mental-health conditions — depression, anxiety, PTSD, chronic pain — are valid bases for LTD benefits. Insurers often demand "objective" proof that such conditions cannot provide; we know how to build the medical record that meets the policy's actual requirements.

Don't Get Trapped by Limitation Periods

LTD claims are contractual, and the time limit to sue can be short — and the way it is triggered (for example, by a denial letter) can be a trap for the unwary. Some policies and statutes impose strict limitation periods, and an internal "appeal" with the insurer does not necessarily pause the clock to sue. Get legal advice as soon as you are denied, so you do not lose the right to litigate.

Lump Sum or Reinstatement

Depending on your situation, the goal may be to have your monthly benefits reinstated and continued, or to negotiate a lump-sum settlement that buys out the future value of the claim. We advise on which approach serves you best and pursue it.

What To Do If You Are Denied

  • Keep the denial letter and note any deadlines it states.
  • Do not rely solely on the insurer's internal appeal — it may not protect your right to sue.
  • Continue treatment and keep your medical records current.
  • Request a complete copy of your policy and claim file.
  • Call Azimi Law promptly — limitation periods may be running.

Frequently Asked Questions

My LTD claim was denied. Is it worth fighting?
Often, yes. Insurers deny many valid claims, and a denial is not the final word — it is the start of a process. With the right medical evidence and legal pressure, denied and terminated claims are frequently overturned or settled. We assess your policy and the denial for free.
What does the 'change of definition' mean?
Many policies pay benefits if you cannot perform your own occupation for an initial period — commonly around two years — and then continue only if you cannot perform any occupation suited to your background. Insurers often terminate benefits at this transition, and that decision can frequently be challenged.
Are mental-health and chronic-pain claims covered?
Yes. Depression, anxiety, PTSD, and chronic pain are legitimate bases for LTD benefits. Insurers often demand 'objective' proof these conditions cannot produce; we build the medical record that satisfies the policy's actual requirements.
Should I just use the insurer's internal appeal?
Be cautious. An internal appeal does not necessarily pause the limitation period to sue, and relying on it alone can cause you to lose the right to litigate. Get legal advice promptly after a denial so your deadlines are protected.
What does it cost to hire you?
Nothing up front. We handle LTD claims on a contingency-fee basis — you pay no fee unless we recover your benefits or a settlement.