Posted on Tuesday, December 16th, 2025 at 8:39 pm
When you file a long-term disability claim, you expect the insurance company to process it fairly and approve your benefits. Unfortunately, many long term disability claim mistakes occur during the application process, resulting in denials. Understanding the most common long-term disability claim mistakes—documentation errors, missed deadlines, and inconsistent medical records- can help you avoid these pitfalls and protect your claim from the start.
Documentation Errors That Trigger Immediate Denials
Insurance companies scrutinize every detail of your claim. Small mistakes in your paperwork give them a reason to deny your application. One of the most common documentation errors involves incomplete or vague Attending Physician Statements (APS). Your doctor’s APS is the foundation of your claim. If your doctor describes your symptoms vaguely or fails to explain how your condition limits your ability to work, the insurance company will use that as grounds for denial. Even minor errors, like writing “right leg” instead of “right arm,” become red flags that insurers use to question the accuracy of your entire claim.
Another critical documentation error is failing to include all your disabling conditions. Many claimants focus on their primary diagnosis and overlook secondary conditions that also affect their ability to work. Insurance companies use incomplete condition lists as justification for denials. You must document every medical condition that impacts your job performance, not just the most obvious one.
Missing medical records and test results also weaken your claim significantly. Insurance companies expect comprehensive documentation, including imaging studies, lab work, and specialist reports. If key records are absent, the insurer may conclude that your condition is not as serious as you claim. Before filing your claim, gather all medical records from every healthcare provider who has treated you for your disabling condition.
Missed Deadlines That Cost You Benefits
Disability insurance policies contain strict deadlines that you must follow. Missing even one deadline can result in automatic denial of your claim or termination of benefits you’ve already received. Many claimants don’t realize how time-sensitive the application process is until it’s too late.
The most critical deadline is the initial filing window. Disability insurance policies typically require you to notify your employer and file your claim within a specific timeframe set by your plan—commonly 30 to 90 days from when your disability begins, though some plans allow up to 180 days. You must review your plan’s Summary Plan Description to confirm your exact deadline, as missing it can result in automatic denial. This is why it’s essential to file as soon as you realize you cannot work.
Beyond the initial filing deadline, insurance companies set additional deadlines for submitting supporting documents. When your insurer requests medical records, physician statements, or other information, they typically give you up to 45 days to respond under ERISA regulations, though some plans may specify shorter timeframes of 14-21 days. Always check your plan documents for the specific deadline. Ignoring these requests or submitting information late provides the insurance company with another reason to deny or terminate your claim. You must track every deadline and respond promptly with complete information.
Inconsistent Medical Records That Undermine Your Claim
Insurance companies look for consistency in your medical documentation. If your medical records show gaps in treatment or inconsistent symptom reporting, the insurer will use those gaps to argue that your condition is not truly disabling.
Gaps between doctor visits are particularly problematic. If you go months without seeing your treating physician, the insurance company may argue that your condition has improved or that you’re not taking your disability seriously. Regular, consistent treatment demonstrates that your condition is ongoing and requires continuous medical management. You should maintain a treatment schedule that aligns with your doctor’s recommendations and attend every appointment.
Inconsistent symptom reporting also undermines your claim. If you report severe pain and functional limitations at one visit but describe yourself as “doing okay” at the next visit, the insurance company will seize on those inconsistencies. This doesn’t mean you can’t have good days and bad days—it means you need to accurately describe your overall condition at each visit. Be honest with your doctor about your symptoms, limitations, and how your condition affects your daily activities.
Conflicting medical opinions from different providers can also damage your claim. If one doctor says you’re disabled while another suggests you could work, the insurance company will use that conflict as justification for denial. Ensure all your treating providers understand your full medical picture and communicate with each other about your condition and limitations.
How to Strengthen Your LTD Claim From the Start
The best way to avoid claim denials is to file a complete, accurate application from the beginning. Start by filing your claim as soon as you become disabled—don’t wait. Gather all your medical records, test results, and documentation before submitting your application. Work closely with your treating physician to ensure your APS is detailed, accurate, and consistent with your medical records.
Keep detailed records of all communications with your insurance company. Document every phone call, email, and document you submit. If you mail information, use certified mail with a return receipt requested. If you email documents, request acknowledgment of receipt. This creates a paper trail that protects you if the insurance company later claims they never received your information.
Consider hiring an experienced disability attorney early in the process. An attorney can review your policy, identify potential issues, and help you submit a comprehensive application that maximizes your chances of approval. Many claimants wait until after a denial to hire an attorney, but by then, critical deadlines may have passed, and opportunities to submit evidence may be lost.
Frequently Asked Questions About LTD Claim Mistakes
What happens if I miss the deadline to file my LTD claim?
Most disability policies have strict filing windows, typically 30 to 90 days from the date your disability begins (though some plans allow up to 180 days). Missing this deadline usually results in automatic denial of your claim. Some policies may allow exceptions in limited circumstances, but you cannot count on this. If you’ve missed a deadline, contact an attorney immediately to explore your options.
Can I fix documentation errors after submitting my claim?
Yes, you can resubmit corrected forms or additional documentation. However, it’s far better to get your application right the first time. Resubmitting corrected information may delay your claim and give the insurance company additional reasons to scrutinize your application. An experienced attorney can help you navigate the correction process and ensure your resubmission strengthens rather than weakens your claim.
How often should I see my doctor to support my LTD claim?
Regular, consistent treatment is essential to support your disability claim. Insurance companies view gaps in care as evidence that your condition may not be as disabling as you claim. Follow your doctor’s recommended treatment schedule and attend every appointment. If your doctor recommends monthly visits, don’t skip appointments just because you’re having a good week.
What should I do if my claim is denied?
You have the right to appeal a denied claim. The appeal process is your opportunity to submit additional evidence and address the insurance company’s specific reasons for denying your claim. Under ERISA regulations, you have up to 180 days to file an appeal. This may be your only chance to introduce new medical records, specialist opinions, or other documentation. Hiring an attorney before filing your appeal significantly improves your chances of success.
Get Help Protecting Your LTD Claim
Capitan Law focuses on long-term disability claims. We understand the mistakes that lead to denials, and we know how to help you avoid them. Whether you’re preparing to file your initial claim or appealing a denial, our experienced team can guide you through the process and work toward recovering the benefits outlined in your policy
We offer a free consultation to review your situation and explain your options. We work on a contingency basis, which means there are no upfront costs, and we only get paid if you win. Call (267) 419-7888 today to schedule your free consultation and take the first step toward protecting your disability benefits.
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