Sample Appeal Letter for Short Term Disability [Free]

Disability Insurance From Employer?

If the disability insurance is from an employer and that employer is not a church or government agency, it is subject to the Employee Retirement Income Security Act (ERISA). 

According to ERISA, the appeal of a denied disability claim must be made within 180 days of receiving the denial letter. If it is not appealed within this time, the person cannot sue the insurance company to get benefits.

Before drafting the letter, the claimant should read the letter of denial carefully and find out the steps required for appeal. There may be forms to fill out that need to be included with the letter.

They need to ascertain if the original application was faulty in any way. The claimant’s doctor can write a letter to be included in the appeal. 

If there are medical records that relate to tests or treatment given after the claim was made, the claimant should request copies of them. This is more evidence of the disability.

Very Important To Enclose All Documents!

It is very important to enclose all documents and information that pertain to the case in the claims process and the appeal letter. If the appeal is denied, the person may sue the insurance company.

If this happens, any information used to make the case for the appeal must have been already submitted in the claim and subsequent appeal letter. If any information is left out such as hospital records or doctor’s records, it will not be allowed in court.