File a disability insurance claim and appeal a denial
A disability claim filed on a complete evidentiary record, or a denial appealed inside the ERISA window—the policy’s definition of disability and elimination period established, an attending physician statement and objective diagnostics assembled to match that definition, the claim or appeal submitted, and the administrative record preserved for any further review.
Not on sale yet
Included with every copy
- Your own copy — keep it forever
- Gets better over time — free updates included
- Run it on web and mobile
- Invite a partner to go through it with you — you share the same progress
- 1 knowledge checks to test what you've learned
- The playbook's community — ask questions, get additions, and see how other buyers improve it, right on the step
Who it's for
U.S. workers covered by an employer-sponsored short-term or long-term disability plan governed by ERISA who need to file a claim or appeal a denial. Also relevant for independent contractors who purchased an individual disability policy with ERISA-like procedures, though state-law appeal rules differ. Does not apply to claimants whose only coverage is a state disability program or SSDI.
About this playbook
A disability claim is approved or denied based on how well your medical evidence matches the policy’s specific definition of disability—not on how severe your condition feels. This guide walks you through locating your policy’s key terms, gathering objective medical evidence keyed to its definition of disability, filing the initial claim, and appealing a denial within the strict ERISA deadlines. It covers employer-sponsored short-term and long-term disability plans governed by ERISA, including navigating the elimination period, the own-occupation versus any-occupation standard, and the attending physician statement. It does not cover state disability programs (CA SDI, NY PFL, NJ TDI, RI TDI), Social Security Disability Insurance, or private non-ERISA policies, though the evidence you assemble here supports those separate applications. The claim file you build determines your outcome at every stage, because ERISA closes the administrative record at the end of the internal appeal—making the appeal the decisive step before any lawsuit.
What you'll do, step by step
Free preview — these steps are open to read in full before you buy.
Phase 1: Understand Your Policy Terms and Deadlines
0/4Before you gather any evidence, you must know exactly what your policy covers, how it defines disability, and what deadlines apply. The policy language determines every subsequent decision, from which medical records matter to how you frame your appeal.
- 45 min
- 20 min
- 15 min
- 15 min
Phase 2: Assemble Objective Medical Evidence That Matches the Policy Definition
4 stepsPhase 3: File the Initial Claim
4 stepsPhase 4: Navigate the Claims-Review Process
3 stepsPhase 5: Appeal a Denial Within the ERISA Window
5 stepsPhase 6: Preserve the Administrative Record for Further Review
2 stepsDetails
What you need first
A physical or mental condition that has prevented you from working (or is expected to) longer than your policy’s elimination period. Access to the plan documents—Summary Plan Description and insurance certificate—from your employer, HR, or the insurer’s portal. Willingness to request medical records and communicate with your treating providers. If appealing, a written denial letter received within the last 180 days (or your policy’s specified appeal window).
Tags
What people who used it say
Only buyers who got through at least half the steps can leave a review.
No reviews yet. The first ones appear once buyers get through at least half the steps.
Common questions
About the creator
I cover paperwork, applications and dealing with public institutions. My playbooks say plainly what to do first and where the time goes.
Similar playbooks
