Start your Short-Term Disability Appeal letter by looking at the insurance company’s denial letter. Your appeal letter should look like this:
Your Name and address
[Name of Your Insurance Company] Appeal Department
[Address in your denial letter – often found toward the end of the letter]
[Date – make sure this is on or before the deadline given in your denial letter]
Subject: Re: Short Term Disability Claim Number [use your claim number on your denial letter]
Dear [Insurance Company] Appeal Department,
I have received your denial letter dated [date of your denial letter]. This is my appeal of your decision to deny my claim.
[Most Short-Term Disability Appeals need three sections:]
- Background About My Claim. [Explain the context for your claim (what happened, what your health-related restrictions and limitations are, what your required job duties are, and why you were unable to work. Restrictions & Limitations + Required Job Duties You Can No Longer Perform = Your Disability Claim].
- Evidence That Supports My Claim. [Briefly describe the medical records that show the treatment you’ve been getting, any statements from your doctor(s) about what functional restrictions and limitations you have as a result of your medical condition, relevant test results, etc.]
- The Initial Claim Denial Was Incorrect Because [Explain what the denial letter got wrong (is the disability insurance company missing some of your important medical records? Cherry picking details from your records that are irrelevant? Misstating the requirements of your job? etc.)].
- Attachments Included with This Appeal. [List any additional medical records, doctor letters of support, and any other new evidence you are submitting with your appeal. If you are not sure whether the insurance company already has a copy of something, send it again. Even if they did a terrible job getting your medical records to evaluate your claim, it is ultimately your responsibility to make sure they have all the proof of your claim that you want them to consider].
Please contact me at [list your phone number(s) and email address)] if you have any questions or need any additional information.
Sincerely,
[Sign your letter, gather all your attachments, make copies of everything, and send to the insurance company prior to the deadline]
That’s a very basic example of what your Short-Term Disability Appeal letter should cover. For a longer discussion, see our article, “How to Appeal a Short Term Disability Denial.”
Insurance Appeal Consultants can help you understand your Short-Term Disability denial letter and plan an effective appeal. Visit https://insuranceappealconsultants.com/start-a-strategy-session/ to take the first steps towards reclaiming your benefits.
