Denied Long-Term Disability in Maryland? How to Appeal

If your long-term disability claim was denied in Maryland, you generally have a limited window to appeal, and how you use that time can make or break your case. Whether your policy falls under ERISA or is a private policy affects your deadline, your appeal process, and even your options if the appeal doesn't succeed, which makes identifying your policy type the very first step.

Lebau & Neuworth’s dedicated long term disability lawyers help Maryland claimants understand exactly what kind of policy they have and how to build the strongest possible appeal before time runs out. If your long-term disability claim was denied, call (410) 296-3030 to talk with our team.

Why Long-Term Disability Claims Get Denied

Long-term disability claims get denied for a range of reasons, including insufficient medical documentation, a determination that the medical evidence doesn't support the claimed level of impairment, surveillance or social media activity that the insurer argues contradicts the claimed limitations, a missed deadline or incomplete paperwork, or a policy provision the insurer argues excludes or limits the specific condition at issue. 

First, Find Out What Kind of Policy You Have

If your long-term disability coverage came through an employer-sponsored plan, it's generally governed by the federal Employee Retirement Income Security Act, or ERISA, which imposes its own specific claims and appeals procedures. 

If you purchased an individual long-term disability policy directly rather than through an employer, ERISA generally doesn't apply, and your appeal rights are instead governed by the terms of your specific policy and Maryland insurance law. 

The 180-Day ERISA Appeal Window You Cannot Miss

If your policy is governed by ERISA, you generally have 180 days from the date of your denial letter to file a formal appeal. This deadline is strict, and missing it can permanently forfeit your right to challenge the denial through the plan's internal appeal process, which is often a required step before you can pursue further legal action. Private policies not governed by ERISA may have different deadlines specified in the policy itself, making it just as important to identify the applicable deadline for your specific situation right away.

How to Build a Strong Appeal

A strong long-term disability appeal generally requires more than simply restating that you're unable to work. It requires directly addressing the insurer's stated reasons for denial with specific evidence, including updated medical records, statements from treating physicians addressing your specific functional limitations, and, where appropriate, vocational or functional capacity evaluations that speak directly to your ability to perform your job duties.

Completing the Administrative Record

Everything submitted during your appeal becomes part of what's known as the administrative record. If your appeal is ultimately denied and your case proceeds to litigation, particularly in an ERISA case, a court will typically only review the evidence that was already part of this administrative record. This means your appeal isn't just a request for reconsideration; it's often your last opportunity to submit new evidence that a court could later consider.

Why the Administrative Appeal Is So Important

Unlike some other legal processes where new evidence can be introduced later, an incomplete appeal can permanently limit what a court is able to consider if your case proceeds further. This is why building the strongest possible appeal the first time, rather than treating it as a quick formality, matters so much.

What Happens If Your Appeal Is Denied

If your administrative appeal is denied, your next steps depend on your policy type. 

For ERISA-governed plans, this generally means the option to file a lawsuit in federal court, based largely on the administrative record already established during your appeal. 

For private policies not governed by ERISA, your options may include filing a lawsuit in state court, potentially with the ability to introduce additional evidence beyond what was submitted during your appeal, depending on the specific policy and circumstances involved.

How a Disability Attorney Strengthens Your Appeal

An experienced disability attorney can help identify exactly what the insurer's denial letter is really disputing, gather the specific type of medical and vocational evidence needed to address those disputes, and make sure your administrative record is as complete as possible before it becomes the foundation for any further legal action. 

Given how much weight the administrative record carries, particularly in ERISA cases, having experienced guidance during the appeal stage itself, rather than only after a lawsuit becomes necessary, can make a meaningful difference in the outcome of your case.

Talk to a Maryland Long-Term Disability Attorney

A long-term disability denial can feel like the end of the road, but a well-built appeal can change the outcome, especially when it's filed within the strict deadlines that apply to your specific policy. Given how much the administrative record matters, particularly for ERISA-governed claims, the appeal stage isn't the time to cut corners.

Lebau & Neuworth focuses exclusively on representing individuals in employment law and employee and disability benefits disputes; not companies, unions, or insurance companies. Our team brings decades of combined experience to every long-term disability case we handle, and that focus has earned us a national reputation for successfully representing clients in court, mediations, negotiations, and arbitrations. We work with the full range of the workforce, from executives and doctors to teachers, retail workers, and everyone in between, and every one of them gets the same aggressive protection of their individual rights.

Our Maryland long-term disability team can help you understand your policy type, meet your appeal deadline, and build a complete administrative record addressing the specific reasons for your denial. If you're also navigating Social Security disability benefits or need guidance on workplace accommodations while your appeal is pending, our team is ready to help with that as well. 

Contact a disability benefits lawyer at Lebau & Neuworth at (410) 296-3030 today.

Frequently Asked Questions

How long do I have to appeal an LTD denial?

If your policy is governed by ERISA, you generally have 180 days from the date of your denial letter to file an appeal. If your policy is a private policy not governed by ERISA, the deadline may be different and is generally specified in your policy documents, so it's important to confirm your specific timeline right away.

What's the difference between an ERISA and a private policy?

An ERISA plan is generally an employer-sponsored benefit governed by federal law, with its own specific claims and appeals procedures and deadlines. A private policy, purchased individually rather than through an employer, is instead governed by the terms of the policy itself and applicable state insurance law, which can mean different deadlines and different options if your appeal is denied.

Why is the administrative appeal so important?

The administrative appeal is often your last opportunity to submit new evidence, since everything you provide becomes part of the administrative record. Particularly in ERISA cases, if your appeal is denied and you pursue litigation, a court will typically only review the evidence already contained in that record, making a thorough appeal essential.

Can I just file a lawsuit instead of appealing?

Generally, no, especially for ERISA-governed plans, which typically require you to exhaust the plan's internal appeal process before you're permitted to file a lawsuit. Skipping this step can result in your case being dismissed for failing to exhaust the required administrative remedies first.

What Your HR Won’t Share: Getting Reasonable Work Accommodations

Everyone deserves the chance to do their best to the workplace, without barriers standing in the way of fairness or dignity. If you need adjustments to do your job, those rights are protected by the Americans with Disabilities Act (ADA). But too often, HR departments don’t give you the whole story, letting confusion and outdated assumptions get in the way of your success. You deserve straight answers, honest support, and the confidence to stand up for what’s fair. Knowledge is power, and knowing your rights means you can shape your work environment to fit your needs.

At Lebau & Neuworth, we believe in justice for hardworking people. Our mission is to be your advocate, standing firmly behind employees and individuals who are simply seeking a fair opportunity to do their jobs. We’re honored to be partners in your pursuit of equality, ready to empower you with clear guidance and strong advocacy. If you’re ready to claim the respect and support you deserve in your workplace, reach out to Lebau & Neuworth. Let’s work together to make dignity and fairness a reality for everyone.

What Are Reasonable Work Accommodations Under the Law?

Reasonable work accommodations are changes or adjustments in the workplace that enable employees with disabilities to perform their jobs to the best of their abilities. These accommodations are not special treatment, but they are a legal right designed to level the playing field and allow everyone to contribute and succeed. The purpose is simple: to remove unnecessary barriers, so talent and effort, not circumstance, determine your success.

Examples of reasonable accommodations include:

Asking for workplace accommodations can sometimes feel intimidating or uncomfortable, especially if you’re worried about being treated differently. It’s not always clear how to start the conversation or what you’re entitled to. Having a compassionate legal team in your corner can make a big difference, helping you navigate the process, advocate for your needs, and ensure your rights are respected every step of the way.

Why HR Might Not Fully Explain Your Rights

HR departments are supposed to support employees, but sometimes they fall short when it comes to explaining all your rights surrounding accommodations. Companies may have competing priorities, or HR staff might rely on myths and outdated policies rather than empowering you with real options. 

Some reasons you might not get the full story include:

When these practices persist, they often serve to benefit larger organizations at the expense of employees’ rights and personal well-being. Partnering with legal counsel is your way to ensure your voice is heard and your rights are upheld in the workplace.

Reasonable Accommodations for Mental Health or ADHD

You have the right to seek reasonable accommodations for mental health conditions, including ADHD, under the ADA. These adjustments are designed to give you an equal opportunity to thrive, whether you’re dealing with anxiety, depression, ADHD, or similar conditions. Accommodations address the unique barriers you may face, helping you focus, stay organized, and manage stress so you can do your best work.

Examples of accommodations for mental health or ADHD include:

Remote Work and ADA: What You Should Know

If you work remotely, your rights don’t disappear. Accommodations are just as important in a home office as they are in a traditional one. You can request changes tailored to your needs, such as flexibility in hours, specialized software, or modifications in how meetings and communications occur. Regardless of your workplace, you are entitled to the necessary adjustments to help you reach your full potential and contribute effectively to your team.

How to Request Reasonable Accommodations the Right Way

Getting started with a request for reasonable accommodations can set the tone for a productive and respectful process. Start by considering your specific needs and how certain adjustments could support your job performance. Next, submit your request in writing, either via email or a formal letter, to your supervisor or the HR department. Clearly explain your condition (you do not need to share your full medical history), the limitations you’re experiencing, and suggest specific accommodations that would help. 

Stay open to dialogue: employers may offer alternative solutions, and a collaborative approach often leads to the best outcome. Always keep a copy of all communications, and know that you have the right to ask for support in the process. If you feel your request isn’t taken seriously or are facing roadblocks, a legal advocate can make sure your rights are protected.

What If Your Employer Denies Your Request?

Sometimes, despite following all the right steps, employees are met with resistance from HR or management when requesting reasonable accommodations. Pushback can take many forms, from outright denial to vague explanations or unnecessary delays. If your employer refuses your request or doesn’t engage in a meaningful conversation about your needs, this is the moment when you may need to involve an attorney who understands your rights and can advocate on your behalf.

What to Include in Your Accommodation Request

If your accommodation request is denied, here’s what you should do:

Retaliation, such as being demoted, reassigned, or treated unfairly after asking for accommodations, is unlawful, but unfortunately, it happens. Always keep detailed records of communications and any changes to your employment situation. Documentation is your best defense if your rights are violated, and seeking legal support can help protect you and uphold workplace fairness.

How Lebau & Neuworth Helps Workers Get the Support They Deserve

Supporting employees with reasonable accommodations enables people to thrive in their roles, contribute fully, and showcase their talents without unnecessary barriers. When organizations prioritize accessibility and fairness, everyone benefits: morale rises, performance improves, and workplaces become more inclusive for all. Ensuring your colleagues have the support they need sends a powerful message about respect and shared success.

Lebau & Neuworth stands beside employees and individuals seeking justice in their workplaces. With a reputation for compassionate advocacy and deep legal skill, our Baltimore-based attorneys relentlessly pursue fairness for workers facing discrimination, harassment, wrongful termination, and wage disputes. Whether you’re fighting for accommodations or defending against workplace injustices, Lebau & Neuworth provides the experience and unwavering dedication you need to stand up for your rights and secure the support you deserve. Contact us today so we can fight for your right to work.

Lebau & Neuworth Wins Disability Benefits For Persons With Migraines

The law firm of Lebau & Neuworth recently obtained long-term disability benefits on behalf of two clients who suffered from migraines. Both clients, one who worked for Maryland hospital for many years and the other at a D.C. tech company for just a few years, initially had their claims denied before seeking our representation.

Representing these clients and many others in employment and disability-benefit law matters, Lebau & Neuworth knows how difficult it is for a migraine sufferer and his/her family to cope with this disorder. 

The two primary sources of disability benefits that may be available to them are from Social Security and from disability benefit insurance policies (through an employer or a privately owned policy).

Social Security Disability Benefits 

(From the National Headache Foundation)

If you experience chronic migraine that makes it difficult or impossible for you to work, you can file a claim for Social Security disability (SSD) benefits. You will need to provide medical documentation of your illness in order for your claim to be approved. This medical documentation will help support that you are unable to work for at least 12 months, which is a requirement for applying for disability.

A migraine attack can incapacitate someone for days. The light and sound sensitivity, as well as the physical toll that migraine disease takes on the body, can mean that the person needs days of recovery time. But in order to be approved for disability benefits due to migraine disease, there needs to be an underlying medical condition or a person needs to ask for a Medical Vocational Allowance.

All of the conditions that qualify for Social Security disability benefits are listed in the Social Security Administration’s Blue Book, and there is no official listing for migraine disease. However, migraine can be symptoms of other health problems that are listed in the Blue Book. If you experience migraine due to any of these conditions you can be approved for disability benefits based on Blue Book listing for these conditions:

You will need to provide medical documentation such as a diagnosis, treatment plans, test results, medical bills and other documents to prove that you cannot work because of your medical condition. 

Disability Insurance Benefits

Short-term disability is offered by many employers, and the coverage length and amount of benefits are set by the terms of the plan.

Long-term disability benefit insurance is also offered by many employers and covers a percentage of your salary. Again, the plan terms set forth the applicable amount of the benefits, length of the benefits and limitations, if any.

Several insures also offer private disability insurance that you can use to supplement an employer-provided disability policy or to be your sole source of disability benefits.

There are no precise guidelines you must meet to qualify for disability due to migraines. Generally, you will need to prove to the insurance company that your disability and related symptoms prevent you from perform your job. You will have to show that migranes cause significant restrictions such as the inability to concentrate, communicate and interact with others, and additional limitation could be sensitivity to noise and light. Further, side effects from medication can also be considered as causing significant work restrictions.

Our Advice: Get A Good Lawyer

Lebau & Neuworth has seen too many people not get the employment benefits they deserve due to not getting a good lawyer soon enough. There are many pitfalls in trying to deal with an insurance company and the SSD bureaucracy if you do not use a lawyer – and a lawyer who is an expert in disability benefits.

If we take your case, we will work closely with you to develop and prove the best possible case. We will work with you to develop the record and history of your condition, complete all necessary forms, and coordinate communications with your treaters.

Even if you have been denied benefits in the past, we still may be able to help since you may have the right to file an appeal. Getting expert help is often the difference between being denied and being approved for benefits, so contact Lebau & Neuworth at (410) 296-3030 or lebauneuworth.com/contact-us.

Job Coach, Other Workplace Requests Are Reasonable Accommodations

An employer recently failed to get a court to rule that a job coach can never be a reasonable accommodation under the Americans with Disabilities Act.

The ADA mandates that disabled workers be provided reasonable accommodations to perform the essential job functions of their job. There are just a few exceptions to this rule, such as the undue hardship or direct threat defenses.

Employers have long argued that providing a disabled worker with a job cannot be a reasonable accommodation, citing costs and liability issues.

In EEOC v. Walmart,  the Seventh Circuit Court of Appeals ruled that there must be a case-by-case approach to determine if a requested accommodation is reasonable. The Court stated, “To be sure, employers need not pay twice for the same work” if another employee is performing the essential functions of the job for the disabled employee. But the Court added that did not apply in that case since Medicaid, and not Walmart, was paying for the cost of the accommodation.

This is good news for disabled workers and drives home the point that an employer has a significant obligation in providing reasonable accommodations.

If you are being denied a reasonable accommodation at your workplace, Lebau & Neuworth may be able to help. Contact us at (410) 296-3030 or lebauneuworth.com/contact-us.

Amazon’s Broken Leave System Misdelivers for Employees

Lebau & Neuworth lawyers have represented numerous employees of Amazon – which has huge warehouses and delivery centers in Maryland – in various disputes, including claims for overtime wages, wrongful termination, discrimination, harassment and disability benefits.

A recent New York Times article detailed the ongoing mess that is Amazon’s employee leave system. The world’s largest retailer can deliver packages to customer’s in under 24 hours, but when employees need leave from work, they are forced to go through a complex web of apps, software, and phone trees to request the leave. If the leave request is approved, employees then face numerous other difficulties, including the software marking employees on leave as no-shows, losing doctor’s notes, and issues reaching case managers.

Amazon’s leave system is not only a huge inconvenience for its employees, but it could potentially be violating laws such as the Family Medical Leave Act (FMLA) and the Americans With Disabilities Act (ADA). Amazon’s broken leave system could expose it to liability for violations of the FMLA or ADA. For example, if leave is denied because an employee’s doctor note is lost, that may be a violation of the employee’s rights under the FMLA and/or ADA; or if an employee who is on approved FMLA or ADA leave is terminated because Amazon’s leave system marked him or her as “no-show,” that could be a violation of the employee’s rights under the FMLA and/or ADA.

The FMLA is a federal law that entitles eligible employees to 12 workweeks of unpaid leave in a 12-month period. FMLA leave can be given for:

The FMLA covers employers, such as Amazon, who have 50 or more employees in 20 or more workweeks in a year. Employees may be eligible for FMLA if they work for a covered employer for at least 12 months; have worked at least 1,250 hours during the 12 months before the leave; and work where the employer has at least 50 employees within 75 miles.

Amazon’s point system that we have come across in Maryland, when not properly administered, can violate the FMLA.

The FMLA prohibits Amazon from disciplining any employee who has an FMLA-protected absence. This means that an employee should not receive an unfavorable evaluation or points when out on FMLA leave. Also, Amazon is required to return the employee to a substantially equivalent position (same pay and benefits) when returning from FMLA leave.

The ADA is the federal law that makes it illegal for employers with 15 or more employees, like Amazon, from discriminating against qualified individuals with disabilities in job application procedures, hiring, firing, advancement, compensation, job training, and other terms, conditions, and privileges of employment. The ADA also requires employers to give reasonable accommodations to employees with disabilities, which can include leave work for limited periods of time even when the employee has no more leave left or is not yet eligible for FMLA leave.

Importantly, in Montgomery County, Maryland, Amazon has to comply with the county’s paid sick leave law. This is in addition to complying with the FMLA and ADA.

If you have questions about FMLA leave or ADA accommodations, Lebau & Neuworth may be able to help. For more information, contact us at (410) 296-3030 or lebauneuworth.com/contact-us.

CORONAVIRUS PANDEMIC: COVID 19 Created Additional Ways to Prove Disability in Various Benefits Cases

On July 19, 2021, Lebau & Neuworth partner attorney Richard Neuworth made a presentation on the issues of COVID 19 and Social Security Disability, Workers Compensation and Long-Term Disability to the viewers of Lawline. The program was designed to show that COVID 19 produced a new paradigm that created additional ways to prove disability in Social Security Disability, Workers Compensation and Long-Term disability benefits cases.

Through the program, Richard provided particular emphasis concerning long-haul syndrome and how that increases the ways that claimants can obtain both a source of income and medical coverage for COVID or fears of COVID that prevent individuals from returning to work or their past relevant program.

Richard also offered other information concerning sources that examined what long-haul syndrome is and how it affects individuals depending on age and amount of infection; and other information concerning how to prove disability.

To view all of the information presented by Richard, click here.

The attorneys at Lebau & Neuworth are highly experienced in Worker Disability issues. If you need any advice, assistance and representation for COVID-related disability benefits, contact us at (410) 296-3030 or lebauneuworth.com/contact-us.