Get Help With Sun Life Long-Term Disability Denials And Appeals

The long-term disability process can be complex and overwhelming, especially when facing the challenges of a denied claim. Sun Life is a prominent provider of long-term disability insurance, and understanding the ins and outs of their denial and appeal process is crucial for policyholders.

When Sun Life denies a claim for long-term disability benefits, it can leave individuals uncertain and financially strained. Knowing how to navigate the appeals process effectively is key to potentially overturning the denial and securing the benefits rightfully deserved.

At the Ortiz Law Firm, we have a long history of successfully handling claims with Sun Life. Over the years, we’ve managed hundreds of cases involving appeals, lawsuits, and settlements, giving us a deep understanding of how Sun Life operates. We know their playbook inside and out—the strategies they use to deny claims, the defenses they rely on, and the methods they use to delay payments. This knowledge allows us to craft the strongest possible case for our clients.

Attorney Nick Ortiz has also built strong professional relationships with the defense attorneys regularly hired by Sun Life. In fact, Nick communicates with many of these lawyers several times a week, allowing him to cut through the red tape and get straight to productive discussions. With their personal contact information on hand, including cell phone numbers, he can connect with these attorneys directly to push negotiations forward. This level of access gives our clients a distinct advantage when it comes to resolving their claims.

If you’ve tried appealing on your own (which we don’t recommend!), we may still be able to file a lawsuit against Sun Life to recover the benefits you deserve. Time is crucial, as deadlines are short. Call us now at (888) 321-8131—our team is here to help guide you through this challenging process and get your benefits back.

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About Sun Life Long-Term Disability Insurance

Sun Life Financial Inc. is a global insurance company known for its life and disability insurance. They offer short- and long-term disability insurance that your employer might offer as a group policy.

Most group disability policies from Sun Life are controlled by ERISA, a federal law that often favors insurance companies. This can lead to aggressive denials of LTD claims by Sun Life.

If Sun Life is your long-term disability insurance company, pay particular attention to the paperwork the insurance company requires you to fill out for LTD claims. The applications are not designed to be easy to fill out. It would not be much of a stretch to say that the sheer length and difficulty of the application is intended to overwhelm claimants from the very beginning of the application process.

FREE RESOURCE: Top Ten Mistakes That Will Destroy Your Long-Term Disability Claim

The bottom line is this: Sun Life does not like to pay long-term disability claims. Sun Life has a track record of delaying or denying claims to avoid paying benefits. They might try to get you to settle for less than your plan promises. So, please don’t agree to any offers from Sun Life before talking to our attorney, who can break down the numbers for you.

If Sun Life turned down your long-term disability claim, our attorney has the experience to handle ERISA and LTD appeals and lawsuits. He’ll check out your denial letter from Sun Life for free and help you fight against a wrongful denial. Our attorney will guide you through the process to claim the benefits you deserve. Call us now at (888) 321-8131.

Understanding Sun Life Long-Term Disability Denials

Facing a denial of your long-term disability claim by Sun Life can be overwhelming and frustrating. Sun Life often writes long denial letters, which can be over 20 pages long.

Our theory is that the long denial letter intimidates the claimant into thinking that the negative evidence is so overwhelming that the unfavorable decision must be right. The insured may be so disheartened or intimidated to believe that an appeal of the denial would be useless. In other words, if the insurance company took twenty pages to deny the claim, Sun Life may be right.

Understanding the reasons behind these denials can shed light on your next steps. Claimants must fight “tooth and nail” to collect LTD benefits under such policies. Here are some common reasons why Sun Life may deny your long-term disability claim:

Sun Life’s Medical Consultant Claimed You Are Not Disabled

Sun Life often relies on the opinion of their medical consultants, who may disagree with your healthcare provider’s assessment of your disability. These consultants may argue that your medical condition does not meet their criteria for disability benefits, creating a discrepancy that leads to denial. It’s essential to understand the specific criteria Sun Life uses to evaluate disabilities to counter such claims effectively.

Sun Life’s medical “peer reviews” are so biased against claimants as to be absurd. Yet, Sun Life relies on the reports from its doctors to deny claims. The disability insurance company remains steadfast in its denials and forces all too many claimants to hire an attorney to file lawsuits to receive payments they should already be receiving.

Surveillance Tactics Employed by Sun Life

Sun Life’s claim investigation is extreme. They may conduct investigations, including video surveillance or social media monitoring, to gather evidence contradicting your disability claim.

The investigation often extends beyond the individual disability applicant. The claimant and their family members are known to have been investigated by private investigators. Sun Life also directly attacks a claimant’s reputation and credibility to support the termination of a claim.

Being vigilant about your activities and ensuring consistency between your reported limitations and actual behavior can help you navigate this challenge.

Your Medical Evidence Wasn’t Enough

Insufficient or inconsistent medical evidence is a frequent reason for denials of long-term disability claims by Sun Life. Submitting thorough and up-to-date medical records, test results, and healthcare provider assessments is essential to support your claim. Ensure that your medical evidence demonstrates the impact of your disability on your daily activities and work capacity, leaving no room for ambiguity in the evaluation process.

Navigating a denial of your long-term disability claim from Sun Life requires a proactive approach and a thorough understanding of the reasons behind the decision. By addressing key factors such as conflicting medical opinions, surveillance tactics, and the sufficiency of your medical evidence, you can better position yourself for a successful appeal and eventual approval of your claim. Stay informed, advocate for yourself, and seek professional guidance to navigate the complexities of appealing a denial from Sun Life.

Navigating the Sun Life Long-Term Disability Appeals Process

Navigating the Sun Life long-term disability appeals process can be challenging, but with the right approach, you can increase your chances of a successful appeal. Here’s a breakdown of the critical steps involved in navigating the Sun Life long-term disability appeals process:

Appeals Procedure Overview

When appealing a Sun Life long-term disability denial, it’s essential to understand the appeals process. Typically, the process involves submitting an appeal within a specific deadline, providing additional documentation and evidence to support your claim, and waiting for a decision from Sun Life.

RELATED POST: LTD Appeal Guide: How to Appeal a Long-Term Disability Denial

Gathering Supporting Medical Evidence

One crucial aspect of the appeals process is gathering and submitting relevant medical evidence. This can include medical records, test results, and statements from healthcare providers detailing the impact of your disability on your ability to work. Strong medical evidence can significantly strengthen your appeal.

Consult a Vocational Expert

Consulting a vocational expert can provide valuable insight into how your disability affects your ability to perform specific job duties. A vocational expert can assess your skills, limitations, and job prospects, helping to build a compelling case for your appeal.

Obtain Witness Statements from Coworkers, Family, and Friends

Witness statements from individuals who can attest to the impact of your disability on your daily life and work performance can be powerful supporting evidence. Statements from coworkers, family members, or friends can provide a personal perspective on how your disability has affected you.

Crafting a Compelling Appeal Letter

Writing a persuasive appeal letter is vital to making a strong case for overturning a Sun Life long-term disability denial. Your appeal letter should address critical points, highlight significant evidence, and clearly articulate why your claim deserves approval. Crafting a compelling appeal letter can significantly improve your chances of a successful appeal.

Stay Ahead of the Appeal Deadlines

Staying ahead of all deadlines is essential to ensure a smooth appeals process. Missing deadlines can result in your appeal being denied, so keeping track of important dates and submitting all required documentation on time is crucial.

Navigating the Sun Life long-term disability appeals process requires careful attention to detail, thorough preparation, and strong advocacy. By following these steps and seeking the necessary support, you can work towards a successful outcome in your appeal.

Can You Appeal a Sun Life Long-Term Disability Claim on Your Own?

If Sun Life denies your long-term disability claim, avoid going at it alone. While appealing a Sun Life disability claim denial on your own is possible, a long-term disability attorney can offer valuable guidance, assistance, and expertise throughout the appeals process, increasing the likelihood of a favorable resolution in your favor.

The world of ERISA law is complex, and you don’t want to lose benefits due to a technicality. Instead, we recommend contacting our skilled long-term disability lawyer for a free review of your denial letter.

When you choose Ortiz Law Firm, our attorney will lead you through each step and handle the preparation and submission of your LTD appeal to Sun Life on your behalf. If the appeal doesn’t succeed, we can file a lawsuit against Sun Life. ERISA disability claims have strict deadlines, so don’t wait too long. Contact us today at (888) 321-8131 and let us assist in securing your benefits.

What Happens After You Submit Your Appeal?

After you submit your appeal to Sun Life regarding your long-term disability denial, the process moves to a detailed review stage. Here’s what you can expect:

Medical File Reviews

Sun Life may have a medical consultant review your claim during the appeal review process. This review involves an independent medical professional assessing your medical records and providing an opinion on your condition and disability claim. The findings of this report can play a significant role in determining the outcome of your appeal. It’s crucial to ensure that all your medical documentation is thorough and accurately reflects your condition to support your case effectively.

Vocational Assessments

Sun Life might request a vocational assessment to evaluate your ability to perform various job-related tasks as part of the appeal review process. A vocational expert will assess your skills, education, work experience, and limitations due to your disability. This assessment aims to determine if suitable job opportunities are available to you, given your current physical or mental restrictions. The vocational assessment results can impact the decision on your long-term disability claim.

Independent Medical Exams

Sun Life may also require you to undergo an independent medical examination (IME) during the appeal process. An IME involves being examined by a healthcare provider chosen by the insurance company. The purpose of the IME is to gather additional information about your medical condition and limitations. Although the IME report is supposed to be impartial, it’s essential to be cautious, as these reports can sometimes be used to challenge your claim. Being prepared and transparent during the IME can help ensure that the report accurately represents your condition and supports your claim for long-term disability benefits.

Navigating the appeal process with Sun Life can be complex, but understanding these essential steps can help you prepare and present a solid case to support your long-term disability claim. In the following sections, we will delve deeper into how to handle each of these aspects effectively to increase your chances of a successful appeal outcome.

What If My Long-Term Disability Appeal Is Denied?

Facing a denial on your long-term disability claim from Sun Life can be frustrating and overwhelming. However, all hope is not lost. You can take steps to challenge the decision and potentially overturn it.

Submitting a Second Appeal

If Sun Life denies your long-term disability claim, you may have the option to submit a second appeal. This is a crucial stage where you can provide additional evidence, documentation, or a more detailed explanation of your medical condition. Consider including new medical records, expert opinions, or testimonies from healthcare providers to strengthen your case.

When preparing your second appeal, ensure that you address the reasons for the initial denial clearly and concisely. Craft a compelling argument highlighting why you believe you are entitled to long-term disability benefits. Be strategic in your approach, focusing on key points that support your claim.

Filing a Lawsuit Against Sun Life

If you are not entitled to a second appeal, or your second appeal is also denied, you may consider taking legal action against Sun Life by filing a lawsuit. This step involves seeking the assistance of an attorney experienced in handling long-term disability cases. An attorney can guide you through the legal process, represent you in court, and advocate for your rights.

When pursuing a lawsuit against Sun Life, your attorney will work to build a strong case on your behalf. They will gather evidence, prepare legal arguments, and negotiate with the insurance company to secure a favorable outcome. Remember that the legal process can be complex and time-consuming, requiring patience and perseverance.

Sun Life Case Summaries

The Ortiz Law Firm did not handle these claims. They are merely summarized here to help claimants understand how Federal Courts handle long-term disability insurance claims. Please see our case results and client testimonials to learn more about some of the Sun Life claims we have handled in the past.

• Wilkinson v. Sun Life – Sun Life Abused Its Discretion By Denying Benefits
• Baker v. Sun Life – Court Rules in Favor of Insurance Company
• Faciane v. Sun Life – Court Rules In Favor of Sun Life In Underpayment Suit
• Christmas v. Sun Life – Court Rules Evidence Plainly Supports Sun Life’s Conclusion
• Holmgren v. Sun Life – Court Rules Plaintiff Has Established That He Was Disabled

In summary, if Sun Life denies your long-term disability appeal, don’t lose hope. Consider submitting a second appeal with additional supporting documentation and, if necessary, seek legal counsel to pursue a lawsuit. Remember, perseverance and determination can make a difference in challenging a denial and obtaining the benefits you deserve.

Get Help from Our Disability Attorney with Your Sun Life LTD Denial

Navigating a long-term disability denial from Sun Life can feel overwhelming, but you don’t have to face it alone. If Sun Life has denied your claim, you should hire an attorney to help you appeal the unfavorable decision. Our disability attorney is here to guide you through the appeals process and fight for the benefits you deserve. Nick A. Ortiz is an experienced long-term disability denial lawyer who can help you determine what steps you should take to get the funds you are entitled to.

Understanding Your Denial: If you’ve received a denial from Sun Life for your long-term disability claim, it’s crucial to understand why. Our attorney will review your denial letter carefully to pinpoint the issues that led to the rejection. We can strategize the best approach for your appeal by identifying these reasons.

Crafting a Strong Appeal: When appealing a Sun Life LTD denial, it’s essential to present a compelling case supported by thorough documentation and strong legal arguments. Our disability attorney will work closely with you to gather medical records, expert opinions, and other evidence to strengthen your appeal. We will craft a well-structured appeal letter that addresses all the reasons for denial and highlights why you are entitled to benefits.

Representing You in Appeals: Facing a denied long-term disability claim can be daunting, especially when dealing with a large insurance company like Sun Life. Our attorney will represent you in all communications with Sun Life, ensuring your rights are protected, and your appeal is given the attention it deserves. We will handle all negotiations and legal aspects of the appeals process, allowing you to focus on your health and well-being.

Advocating for Your Rights: Our firm is dedicated to advocating for the rights of individuals unfairly denied long-term disability benefits. Our attorney will tirelessly challenge Sun Life’s decision and seek a favorable outcome for your claim. We understand the complexities of disability insurance law and will use our expertise to pursue the benefits you are entitled to.

Taking the First Step

If you are facing a denial of your Sun Life long-term disability claim, don’t hesitate to reach out to our experienced attorney for help. We offer compassionate and personalized legal representation to protect your rights throughout the appeals process. Let us help you navigate this challenging time and work towards securing the benefits you need. Florida disability denial attorney Nick A. Ortiz is here to take on that burden for you. Call us today at (888) 321-8131 to learn your rights and get the help you need to appeal your disability denial.

FAQs: Sun Life Long-Term Disability Denials and Appeals