Sample "Appeal Letter for Long Term Disability Denial"

A Long-Term Disability Appeal Letter sample is a formal statement filed to dispute an unsatisfactory ruling of the insurance company regarding a long-term disability - typically, if the claim to receive income protection after a serious illness or injury that keeps the claimant medically unfit for work was denied. Whether you have filed your claim late, could not provide required documentation to the insurer, or did not submit sufficient evidence to prove you are actually disabled, you have a right to contest the denial letter you have received from the insurance company and make sure your financial standing is secure.

You can find a sample Letter of Appeal for Long-Term Disability through the link below. To compose an effective letter, you need to refer to the refusal you have received, attach new evidence the recipient has not seen before, include your physician's opinion about your disability and limitations, share more medical records with the insurance company, and add a personal touch telling the insurer about negative effects of their refusal - for instance, the lack of disability compensation will force you to seek employment and worsen your health.


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Sample Appeal Letter
for Long Term Disability Denial
From: Sarah Allen
2349 Winding Way
Ocala, Florida 59839
+1 991-294-2330
[Date]
To: Steven Kelly
850 Snyder Avenue
Ocala, Florida 9489
Dear Mr. Kelly,
My name is Sarah Allen and I am writing to appeal my denial for disability benefits dated
June 28, 2016. I applied because I have been unable to maintain a job since my surgery to
remove a brain tumor almost 1 year ago. I have tried extremely hard to work, but my
vision is blurred and glasses do not help, my hand-eye coordination is very poor which
prevents me from driving a vehicle and I have tremendous difficulty concentrating on
tasks that are assigned to me. As a last resort, I applied for disability because I have 2
children and my husband does not make enough money as a courier to support all of us.
We have had to borrow money from our family for some months to pay our rent and
utilities.
I have attached my medical records showing the damage done to my brain from the
malignant tumor and the strong treatments. Also attached are the results of tests showing
my abnormal brain functions which have affected my hand-eye coordination, vision, and
ability to concentrate. There is also a letter from my physician explaining that in his
opinion I am unable to work. I have included my husband’s W-2 Form as well showing
his income last year and the number of hours he worked.
©
TEMPLATEROLLER.COM
Sample Appeal Letter
for Long Term Disability Denial
From: Sarah Allen
2349 Winding Way
Ocala, Florida 59839
+1 991-294-2330
[Date]
To: Steven Kelly
850 Snyder Avenue
Ocala, Florida 9489
Dear Mr. Kelly,
My name is Sarah Allen and I am writing to appeal my denial for disability benefits dated
June 28, 2016. I applied because I have been unable to maintain a job since my surgery to
remove a brain tumor almost 1 year ago. I have tried extremely hard to work, but my
vision is blurred and glasses do not help, my hand-eye coordination is very poor which
prevents me from driving a vehicle and I have tremendous difficulty concentrating on
tasks that are assigned to me. As a last resort, I applied for disability because I have 2
children and my husband does not make enough money as a courier to support all of us.
We have had to borrow money from our family for some months to pay our rent and
utilities.
I have attached my medical records showing the damage done to my brain from the
malignant tumor and the strong treatments. Also attached are the results of tests showing
my abnormal brain functions which have affected my hand-eye coordination, vision, and
ability to concentrate. There is also a letter from my physician explaining that in his
opinion I am unable to work. I have included my husband’s W-2 Form as well showing
his income last year and the number of hours he worked.
©
TEMPLATEROLLER.COM
Please reconsider my disability claim that you denied on June 28, 2016, using this
additional information. I would like nothing better than to work, but my efforts for the
last 2 years have been unsuccessful. Thank you for your time and consideration.
Sincerely,
Sarah Allen
[Signature]
©
TEMPLATEROLLER.COM
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