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After submitting a long term disability (“LTD”) appeal through a group policy, a claimant may unexpectedly receive new reports or assessments from their insurer. These can include peer reviews, vocational evaluations, or other updated findings.

When this occurs, it’s often possible—and important—to respond. Below, we’ll explain when insurers issue new reports, what rights may apply under ERISA (the federal law that governs most group LTD policies), and how to approach this phase of the process effectively.

Note: This article is for general informational purposes only and does not constitute legal advice. The rights described typically apply to ERISA-governed policies, which usually come through an employer. Individual policies are typically not subject to the same rules. 

If ERISA applies to your long term disability claim, you have the right to request and review your claim file in the event of a denial.  This is a critical right to exercise before filing your ERISA long term disability appeal.  Having the claim file will give you valuable insight as to why your insurer denied your claim.