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When filing a long-term disability (LTD) appeal, many people ask: “How long will it take?” Unfortunately, the answer is “it depends.”
There are two main phases to the appeal timeline:
- Preparing and filing the appeal
- The insurance company’s review period
We’ll break down what happens in each phase—and why the entire process can take several months or more.
Phase 1: Preparing the Appeal
Under ERISA, you have 180 days after receiving a denial to file your appeal. You don’t need to use all 180 days. But we find that the preparation of a good, effective appeal typically takes 75 to 90 days. This process takes time because we’re not simply updating medical records and arguing the original claim again; we’re making the “proof of loss” in the claim stronger.
Our office uses much of this time to:
- Obtain and review your complete claim file;
- Identify any weaknesses or negative information used against you, and counter that evidence;
- Gather new evidence to support your claim, including an affidavit from you as well as opinion evidence from your medical providers regarding your “residual functional capacity”; and
- Write a detailed appeal letter, typically making six to ten legal arguments and citing published case law.
This is critical because, in most cases, if your appeal is denied and you go to federal court, you will not be able to add any new evidence. The judge will only review what was in your appeal file. You must submit everything during the appeal phase.
RELATED VIDEO: How Long Does a Long-Term Disability Appeal Take?
Phase 2: The Insurance Company’s Review
Once the appeal is filed, the focus shifts to the insurance company. So how long do you have to wait—and what happens behind the scenes during that time?
The Short Answer: It Depends
Under federal law (ERISA), once your appeal is filed, your insurance company has a maximum of 90 days (45 days plus an additional 45 days) to make a decision—although in some cases this period can be extended slightly.
The typical timeline is:
- 45 days for the initial review; plus
- An optional 45-day extension if they need more time and notify you properly
This means that you should typically receive a decision within 45 to 90 days of submitting your appeal.
But that’s just the general rule. In reality, there are a few things that can extend the timeline—and it’s important to be prepared for those possibilities.
RELATED POST: What Are My Chances of Winning a Long-Term Disability Appeal?
What Can Cause Delays in the Insurance Company’s Review?
Even though insurers are required to follow specific timelines, the process isn’t always straightforward. Here are some common reasons the review may take longer than expected:
- They Ask for More Information (“Tolling”): If the insurance company says it needs more information to decide your appeal—for example, medical records, test results, or a statement from your doctor—they can “stop the clock” while they wait for it. This is called “tolling,” and it stops the 45- or 90-day countdown until they receive the documents.
- They Order a Third-Party Review of Your Claim: It’s common for insurance companies to send your records to an independent medical reviewer or vocational expert. These reviews take time—especially if the expert finds something the insurer wants to investigate further.
- You Need to Respond to New Evidence: When the insurer receives a report from a third-party reviewer that could affect your claim, the insurer must give you a chance to respond before making a decision. That’s your right under ERISA—and an important one. However, writing a response (or getting one from your doctor) can take time, especially if you need to dispute inaccurate findings or schedule additional evaluations.
- Your Doctor Takes Time to Respond: Doctors are busy and don’t always understand the importance of disability documentation. When the insurance company—or you—ask your doctor for a letter or a form, it can take several weeks or more to complete.
Why the Appeal Review Stage Is Important
The appeal review stage is likely your last chance to submit evidence. If the insurer denies your appeal and you have to sue the insurance company in federal court, the judge will decide based solely on what’s in the administrative record—what’s already been submitted during the appeal.
So, when the insurer extends the timeline to review a new medical opinion or vocational opinion, we often use that time to develop a thorough, fact-based rebuttal to strengthen your case even more.
RELATED POST: Why Is It So Hard To Win a Long-Term Disability Lawsuit?
A Realistic Timeline
Here’s how the timeline typically plays out after an appeal is filed:
| Stage | Estimated Time |
|---|---|
| Initial insurer review | 45 days |
| Optional extension | + 45 days |
| Tolling / outside delays (e.g., waiting for a doctor or review report) | Variable (may stop the clock) |
In some cases, the full process can take 3 to 5 months or more, depending on the complexity of the case and how quickly outside parties respond.
What If You’re Handling the Appeal Yourself?
If you’re handling your own LTD appeal, it’s important to:
- Keep track of when you filed your appeal;
- Save all written communication from the insurer, especially any notices about delays;
- Respond quickly to any requests for additional documents or statements;
- Ask your doctors to prioritize your paperwork, explaining that a delay could affect your income.
Many people manage their own appeals successfully—but it can be overwhelming, especially when juggling health challenges and financial stress.
FREE GUIDE: How To Appeal a Long-Term Disability Denial
When to Consider Getting Legal Help
You don’t have to hire an attorney to file your appeal—but working with an attorney can help ensure that:
- Your appeal includes the right evidence and strategy
- You don’t miss critical deadlines or opportunities to respond
- You’re prepared for what happens if the appeal is denied and the next step is litigation
We understand the emotional and financial stress of waiting. But building a strong appeal gives you the best possible chance of getting your benefits reinstated. If you’re not sure if your appeal is on the right track, or if you’re worried about what comes next, we’re here to help.
Contact our office for a free case evaluation. We’ll review your situation and let you know where things stand—and how we may be able to help. Call (888) 321-8131 to schedule your free case evaluation today.
