Questions & answers · Disability insurance

My employer long-term disability insurer denied my claim. How do I appeal under ERISA?

Disability insuranceAppealChecked Nov 5, 2026

From K.Actuary, founded by Sangmin Kwon, ASA · sources checked 2026-11-05 · Source: eCFR · 29 CFR 2560.503-1 · § 2560.503-1(h)(2)(ii)-(iv) View original ↗

In short

A job-based disability plan must give you at least 180 days to appeal.
Ask for your full claim file for free. Add new records and letters.
The plan usually must decide within 45 days, with one 45-day extension.

What this means

If your disability plan comes through your job, a federal rule (ERISA) sets your appeal rights. The plan must give you at least 180 days after you get the denial to appeal [1][2]. You can send letters, records, and other papers. The review must look at them, even if they were not used the first time [1].

You can ask for free copies of all papers that relate to your claim [1]. Before the plan turns down your appeal, it must give you any new evidence or new reason it used. It must do this for free, and early enough for you to reply [2].

The plan must decide your appeal within 45 days after it gets it. For special reasons, it can take one more 45-day period, but it must tell you in writing [3]. If the plan does not follow these rules (other than small, harmless slips), the plan's appeals count as finished for you. This matters if you want to go to court [4]. The final denial must tell you about your right to sue and any time limit in the plan, with the exact end date [5].

Your next step

Write to the plan asking for your complete claim file, then send your appeal with new medical records and a letter from your treating provider.

Deadline: at least 180 days after you receive the denial — use the exact date in your denial letter.

Check it yourself

Your denial letter and the plan's summary plan description say your exact appeal deadline. If you bought the policy yourself (not through a job), ERISA does not apply and state law does — "Don't know yet" for your state. Whether the plan's mental health limit applies to you depends on the policy wording.

Where this comes from (5)

[1] eCFR · 29 CFR 2560.503-1 · § 2560.503-1(h)(2)(ii)-(iv) · checked 2026-11-05
( ii ) Provide claimants the opportunity to submit written comments, documents, records, and other information relating to the claim for benefits; ( iii ) Provide that a claimant shall be provided, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the claimant's claim for benefits. … ( iv ) Provide for a review that takes into account all c…
[2] eCFR · 29 CFR 2560.503-1 · § 2560.503-1(h)(4) and (h)(3)(i) · checked 2026-11-05
( 4 ) Plans providing disability benefits. The claims procedures of a plan providing disability benefits will not … be deemed to provide a claimant with a reasonable opportunity for a full and fair review … unless, in addition to complying with the requirements of paragraphs (h)(2)(ii) through (iv) and (h)(3)(i) through (v) of this section, the claims procedures— ( i ) Provide that before the plan can issue an advers…
[3] eCFR · 29 CFR 2560.503-1 · § 2560.503-1(i)(3)(i) and (i)(1)(i) · checked 2026-11-05
claims involving disability benefits (whether the plan provides for one or two appeals) shall be governed by paragraph (i)(1)(i) of this section, except that a period of 45 days shall apply instead of 60 days for purposes of that paragraph. … the plan administrator shall notify a claimant … of the plan's benefit determination on review within a reasonable period of time, but not later than 60 days after receipt of th…
[4] eCFR · 29 CFR 2560.503-1 · § 2560.503-1(l)(2)(i)-(ii) · checked 2026-11-05
In the case of a claim for disability benefits, if the plan fails to strictly adhere to all the requirements of this section with respect to a claim, the claimant is deemed to have exhausted the administrative remedies available under the plan … the administrative remedies available under a plan with respect to claims for disability benefits will not be deemed exhausted based on de minimis violations that do not caus…
[5] eCFR · 29 CFR 2560.503-1 · § 2560.503-1(j)(4)(ii) · checked 2026-11-05
In the case of a plan providing disability benefits, in addition to the information described in paragraph (j)(4)(i) of this section, the statement of the claimant's right to bring an action under section 502(a) of the Act shall also describe any applicable contractual limitations period that applies to the claimant's right to bring such an action, including the calendar date on which the contractual limitations peri…

How we found this

We matched your question to 5 official sources, quoted the exact lines, and re-checked each quote against its source on 2026-11-05.

What we don’t know yet

Your own plan or notice may say something different. If your letter cites another rule, send it and we will look again.

Every answer is checked against the official rule it quotes.

Information only — not legal advice. Your plan, insurer or agency decides.

This answer quotes the official sources listed above, with the date we checked them. Your own policy, notice and state rules control. We are not your lawyer or your insurer. We don’t file, argue or negotiate claims for you — you send any letter or form yourself.

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