Long Term Disability Lawyer San Rafael

A denial letter from your insurance company can feel like a door slamming shut when you need help most. You paid for these benefits, your doctors support your claim, and yet the insurer says no. At Roberts Disability Law, P.C., we help California claimants in San Rafael turn that denial into approval. Our firm focuses on disability appeals, and we know how to build the strong case insurers and courts demand.

You have legal options, and the clock is already ticking. Let us explain what happened and what you can do next.

Why Insurers Deny Long-Term Disability Claims

Insurance companies profit by paying fewer claims. That financial motive drives many denials, even for people with serious, well-documented conditions. Understanding the insurer’s reasoning is the first step toward a winning appeal.

Common reasons insurers deny LTD claims include:

• Lack of “objective” medical evidence: Insurers often claim your records do not prove your limitations, especially for conditions with subjective symptoms like chronic pain, fatigue, or cognitive issues.
• “Own occupation” vs. “any occupation” definitions: Many policies pay benefits when you cannot perform your own job, then later cut you off by arguing you can do “any occupation” in the general economy.
• Paper file reviews: An insurance company doctor who never examines you reads your file and concludes you can work.
• Surveillance: Investigators record short clips of you running an errand, then use that footage to misrepresent your daily abilities.
• Dismissal of subjective symptoms: Insurers downplay pain, fatigue, and “brain fog” because these symptoms do not always show up on a scan or lab test.

The impact reaches far beyond paperwork. A denial can wipe out your primary income, pile on medical bills, and create deep anxiety about your family’s future. We see the person behind every claim, and we are ready to fight for the stability you deserve.

Actionable Steps to Take After a Denial

Receiving a denial is not the end of the road. It is the start of the appeals process, and your next moves matter enormously. Follow these steps right away:

1. Read the denial letter carefully. It should explain the specific reasons for the denial and the deadline to appeal. Those reasons tell you exactly what your appeal must overcome.
2. Note the 180-day ERISA appeal deadline. Most employer-sponsored plans fall under ERISA, which gives you only 180 days from the denial to file your written appeal. Missing this deadline can permanently bar you from benefits.
3. Request your full claim file. You have the right to a free copy of your administrative record, including the medical reviews and internal notes the insurer used to deny you.
4. Do not simply reapply. In most cases, you cannot start a fresh claim for the same disability. You must fix the existing one through the appeals process.
5. Contact an attorney immediately. The sooner you call, the more time we have to gather evidence and prepare a thorough appeal before your deadline arrives.

Acting quickly protects your rights and gives your case the strongest possible foundation.

How Roberts Disability Law Helps San Rafael Clients

We handle the legal heavy lifting so you can focus on your health. Our team brings deep experience in ERISA and disability law to every appeal, and we tailor our strategy to your specific condition and policy.

Here is how we support you:

• ERISA appeals: We analyze the insurer’s denial, identify its errors, and prepare a persuasive appeal that directly answers each reason for the denial.
• Building the administrative record: Under ERISA, the evidence submitted before the insurer’s final decision is often the only evidence a court will later review. We build a complete, compelling record while we still can.
• Gathering medical and vocational evidence: We work with your treating physicians for detailed functional statements, and we secure vocational expert opinions to rebut the insurer’s “any occupation” arguments.
• Federal court litigation: Our goal is to get your claim paid during the appeal. If a lawsuit becomes necessary, we know how to resolve or win your case in federal district court.

Frequently Asked Questions

How Long Do I Have to Appeal a Denied LTD Claim in California?

Under ERISA, you typically have 180 days from the date of your denial letter to file a written appeal. Some plans or recent regulatory changes may allow more time, so confirm your exact deadline right away. Missing it can permanently end your right to benefits, which is why prompt action matters.

What Are the Most Common Mistakes People Make When Appealing?

The biggest pitfalls are missing the appeal deadline, submitting a simple letter of disagreement instead of new evidence, and failing to address the insurer’s specific reasons for denial. Many people also reapply rather than appeal, which can forfeit their claim. A strong appeal answers every denial reason with compelling medical and vocational proof.

Secure the Benefits You Deserve

You do not have to face the insurance company alone. The team at Roberts Disability Law, P.C. combines genuine care with fierce determination, and we are ready to be your trusted legal partner in San Rafael.

Contact us today for a consultation. We will review your denial, explain your options in plain language, and outline a clear strategy to fight for your benefits.