Have you been denied long-term disability benefits by New York Life? If so, you may not be alone. New York Life routinely denies disability claims. Many denials occur at the application stage when you first apply, and also at the 24-month any occupation stage, when the definition of disability changes in your policy.
Application denials are very common. Even if you were approved for short-term disability benefits by your employer, New York Life can find that you are not disabled and deny your claim. The top reasons for application denials are because New York Life failed to get an opinion or medical records from your doctor, or information from you and your employer regarding your job duties.
Other times, New York Life will simply deny your claim based on its medical review and argue that you are not disabled or do not meet the definition of disability under the terms of its LTD plan. The definition of disability usually requires you to be “unable to perform any or all of the material and substantial duties of his or her Regular Occupation.”
Most other long term disability denials occur at the 24-month any occupation stage. Under most New York Life LTD Plans, you are provided LTD benefits for the first 24 months that you are unable to perform the material and substantial duties of your Regular Occupation. After 24 months, New York Life will only consider you disabled if: “solely due to Injury or Sickness, he or she is unable to perform any or all of the material and substantial duties of Any Occupation for which he or she is, or may reasonably become, qualified based on education, training or experience.”
When denying your claim at this stage, New York Life will typically have its own doctors conduct Peer Reviews of your medical records and issue opinions on what they believe your limitations are and whether you can return to work in a different occupation. New York Life will also have a team of vocational consultants review your work history and restrictions, and then find jobs that you may be able to perform.
If you receive a denial letter from New York Life claiming that you "do not meet the definition of disability" or that you can perform work in your own or any occupation, you should consult with an attorney to have your case reviewed before you file your appeal. Simply asking New York Life that you want to appeal your case is not enough! You must obtain supporting documents and medical evidence for your appeal. This will typically include updated opinions and records from your doctors, independent medical or functional capacity exam testing results, an opinion from a vocational expert, and third-party witness opinions.
Failing to provide this information with your appeal may result in another denial. It is often highly recommended that you seek legal help because attorneys may have their own team of doctors, evaluators, and vocational experts that can be used to support your appeal.
If you have been denied long term disability and need help, you should consult with a New York Life Long Term Disability Appeal Attorney as soon as possible.
Operana Law Office | Nationwide Long Term Disability Appeal Attorneys
855-999-1969 | help@operanalaw.com