What are common reasons Short-term & Long-term Disability Insurance claims are denied?

Pre-existing condition exclusion Definition of 'disability' not met (own occupation vs any occupation) Missed deadline to file proof of loss Insufficient objective medical evidence

All pathways

United States · education only

Private insurance

Short-term & Long-term Disability Insurance

Employer-sponsored or individually purchased policies that pay a percentage of your salary while you cannot work due to a covered medical condition.

Typical timeline: STD: payments often start after a 7–14 day elimination period. LTD: typically begins after 90–180 days of continuous disability.

This page is a dedicated, search-friendly version of the same checklist on the main disability benefits guide. Progress checkboxes sync via your browser on this device only.

Claim checklist & evidence

Forms

Carrier-specific claim form — Attending physician statement + employee statement

Step-by-step

1. Find the policy and read the definitions
Look for 'elimination period', 'own occupation', 'any occupation', and exclusions.
Next: Identify the deadline to file proof of loss.
2. File the claim with the carrier
Submit the employee statement, employer statement, and attending physician statement together.
Next: Send by tracked delivery and keep copies.
3. If denied, request the claim file in writing
ERISA-governed plans must give you the file. You typically have 180 days to appeal.
Next: Add new medical evidence and a treating-provider letter to the appeal.

Evidence to gather

Check off items as you collect them — progress is saved only on this device (same keys as the main benefits guide).

Copy of your STD/LTD policy and certificate — Defines the elimination period, definition of disability, and exclusions.
Attending Physician Statement — Carrier-required form documenting diagnosis and restrictions.

Common reasons claims get denied

Pre-existing condition exclusion
Definition of 'disability' not met (own occupation vs any occupation)
Missed deadline to file proof of loss
Insufficient objective medical evidence

Sources

U.S. Department of Labor — Disability Plans · accessed 2026-04-22