One situation I see a lot of is people who come into my office, or who I meet with virtually, and they’ve already done an appeal letter, or they’re thinking about doing an appeal letter. I had one lady who even said, “Can you review my draft appeal letter and let me know what you think?” And I said, “Of course, I’d be happy to. Send it to me.”
What I usually see are appeal letters that are 1-2 pages long. I’ve even seen some as short as a simple paragraph, or an email that says I would like to formally appeal my long-term disability denial.
What’s the problem with short appeal letters?
The problem with that is at the beginning stage of an appeal, you have to send all of the information that would convince the insurance company to change their minds. If you don’t send all of that information with your appeal, then the insurance company is going to make the same decision. They stand by their decision that they made the first time. They’re not going to say that they are wrong, unless you give them some reason to see that they’re wrong. If you just send in a one to two page appeal letter, or even a one paragraph appeal, and I’ve even seen some insurance companies, some claims specialists who will go out there and say, “Oh, just send me an email back saying I appeal and then we’ll review it. We’ll fix this for you.” And that’s just all bogus. You have to do this long form.
The best way to appeal
There is a better way to appeal. For example, I just finished an appeal and filed it. It was 33 pages long, single-spaced. These appeals are very complicated. My goal when I file these appeals is to make sure that the insurance company absolutely knows that I will go to the mat on this case because I am 100% convinced that my client is entitled to long-term disability benefits under this policy. The best way to do that is to show every single instance where the insurance company messed up, and to provide additional materials and additional information and documentation that proves that my client is disabled and unable to work according to the terms of the policy. So, when you ask the question, how long does my appeal letter have to be, or how long should it be? It’s not as simple an answer as to say, “Oh, one page, two page, 10 pages, 20 pages, 25, 30, 35.”
No magic number, but quality is imperative
There’s no real magic number, but it has to be long enough to make the point that they were wrong, and you’re right. You’re entitled to your long-term disability benefits. If they don’t give it to you, a federal judge is going to reverse their decision and award attorney’s fees. That is the goal in filing a long-term disability appeal. If you don’t do that, then the insurance company is going to look at it, and they’re going to check the box and they’re going to say, “No go, so sorry, too sad, too bad.” They’re going to send you on your way. They’re going to deny you again. Then your only option is to file a lawsuit in federal district court, which you will most likely lose, because the federal district court judge is going to review everything that you submitted to the insurance company.
So, if you don’t submit the right things to the insurance company, if you don’t argue your position in your appeal letter, then the federal district court judge is never going to see that information. The first time you argue it can’t be in court. You have to argue it to the insurance company, give them the opportunity to do the right thing, and then you can make that argument in federal district court.
I hope this video has been helpful. If you have questions about writing an appeal letter, whether you should be the one to write the appeal letter at all, or whether you need to hire an attorney to write the appeal letter, I’m happy to answer those questions based on your particular situation. Just give us a call or send us an email and we’ll be in touch. Hope you have a good day.