Long-Term Disability Lawyer in New Jersey — We Fight Denied LTD Claims

You paid into your long-term disability plan. You followed your doctor's orders. You filed your claim. And then the insurance company said no.

A long-term disability denial can be devastating — financially, emotionally, and physically. But a denial is not the final word. At The López Firm, we represent employees throughout New Jersey and New York whose long-term disability benefits have been wrongfully denied, delayed, or terminated. Attorney Omar A. López has the experience and the tenacity to take on insurance companies and fight for the benefits you earned.

What is Long-Term Disability Insurance?

Long-term disability (LTD) insurance replaces a portion of your income — typically 50 to 70 percent — when a serious illness, injury, or medical condition prevents you from working. Most LTD plans are provided through employers and governed by ERISA, the federal law that controls your rights, your appeal process, and your ability to sue if your claim is denied.

LTD benefits typically begin after a short-term disability or elimination period ends, and can continue for several years or until you reach retirement age, depending on your policy. The stakes are enormous — in a serious case, the total value of a long-term disability claim can reach hundreds of thousands of dollars.

Why Do Insurance Companies Deny Long-Term Disability Claims?

Insurance companies deny LTD claims for many reasons, and not all of them are legitimate. Common denial grounds include:

Insufficient medical evidence. The insurer claims your medical records don't support the severity of your condition. Failure to meet the definition of "disabled." Many plans define disability differently for the first 24 months (unable to perform your own occupation) versus the long term (unable to perform any occupation). Surveillance and independent medical examinations. Insurers conduct surveillance and hire their own doctors to dispute your treating physician's findings. Pre-existing condition exclusions. The insurer argues your condition existed before your coverage began. Missed deadlines or incomplete documentation. Administrative grounds are used to deny otherwise valid claims.

An experienced denied disability benefits lawyer in NJ knows how to identify the insurer's true motivation, counter their arguments, and build a record that supports your claim at every level.

The Long-Term Disability Appeal Process Under ERISA

If your LTD claim is governed by ERISA — which is the case for most employer-sponsored plans — you must exhaust the plan's internal appeal process before you can file a lawsuit. This makes the appeal the single most important step in your case.

You typically have 60 to 180 days from the denial to file your appeal. During this window, you can submit additional medical evidence, vocational assessments, functional capacity evaluations, and expert opinions. Once the appeal record is closed, you generally cannot add new evidence in federal court — the judge decides the case based on what was submitted during the appeal.

This is why working with a long-term disability lawyer in NJ from the beginning — before you file your appeal — gives you the best possible chance of winning.

Frequently Asked Questions about Long-Term Disability Insurance

  • Long-term disability (LTD) insurance replaces a portion of your income — typically 50 to 70 percent — when a serious illness, injury, or medical condition prevents you from working. Most LTD plans are provided through employers and governed by ERISA, the federal law that controls your rights, your appeal process, and your ability to sue if your claim is denied.

  • Insurance companies don't just deny new claims — they also terminate ongoing benefits for claimants they have been paying for months or even years. If your LTD benefits have been cut off, you have the same appeal rights as someone whose initial claim was denied. The clock starts running from the date of the termination notice

  • Common reasons insurers terminate ongoing LTD benefits include a change in the plan's definition of disability at the 24-month mark, completion of surveillance that the insurer claims shows you are not disabled, and results from an independent medical examination conducted by a physician hired by the insurer.

  • You can reach us anytime via our contact page or email. We aim to respond quickly—usually within one business day.