MassMutual Disability Claim Denied

Most of us don’t plan to get injured or develop a chronic illness. Unfortunately, disability can and does happen to anyone. According to one study, 1 in 4 of today’s 20-year-olds can expect to be out of work for at least a year due to a disabling condition.

If you have a long-term disability (LTD) insurance policy, you may be able to receive cash benefits while you are unable to work. Unfortunately, many insurance companies – like Massachusetts Mutual Life Insurance Company (or Mass Mutual) –  may unfairly deny your disability claim. A skilled LTD lawyer can help you appeal the denial, including filing a lawsuit in federal court if necessary.

Bross & Frankel advocates for people with disabilities in New Jersey and Pennsylvania. We have helped thousands of people get the short-term, long-term, and Social Security disability benefits that they are entitled to under the law. If you are having trouble getting approved for LTD benefits, reach out to our law office to schedule a free claim review.

Why MassMutual May Deny Your LTD Claim

When you apply for long-term disability benefits, you typically must prove two things: (1) that you are disabled under the policy’s definition of disability; and (2) that your disability prevents you from working. If Mass Mutual does not believe that you are disabled or that you are so disabled that you are unable to work, then it will deny your claim.

Of course, a disability insurance company like MassMutual may deny your disability claim for other reasons, such as a paperwork error or simply because their doctors don’t believe that you submitted sufficient medical evidence to prove that you are disabled. They may even hire investigators to follow you, check your social media, and use other tactics to prove that you aren’t actually disabled.

If your MassMutual policy is through your employer, then it will be governed by the Employee Retirement Income Security Act (ERISA). This federal law sets out specific standards that insurance companies must follow when processing disability claims. One of ERISA’s requirements is that insurers provide you with the specific reason that they denied your claim, including the standards that they used to reach a decision.

Common reasons for a denial from MassMutual include:

• Your claim lacks evidence, which usually means that your medical records are not enough to prove that you are disabled and unable to work as a result.
• Its doctors determined that you are not disabled based on a paper review, an independent medical examination (IME), and/or a functional capacity evaluation (FCE).
• Your “own occupation” coverage switched to an “any occupation” after a set period of time (usually 24 to 48 months), which means that you must prove that you cannot work in any occupation – not just your own.

Whatever the underlying reason for the denial may be, it is important to thoroughly examine the paperwork and comply with any deadlines for filing an appeal. An experienced New Jersey disability benefits lawyer can help you analyze these documents and file a timely appeal to protect your interests.

How to Appeal a MassMutual Denial

The LTD appeals process usually starts with filing an administrative appeal within 180 days of the denial. If that initial appeal is denied, then you may be required to file a second appeal before you can pursue further action. Once Mass Mutual issues a final denial, you may be able to file a lawsuit against the company in federal court (for ERISA claims) or in state court (if you purchased your own long-term disability insurance policy).

The appeals process can be complicated and requires an understanding of the laws that will be applied to your case if it goes to court. Importantly, in a lawsuit, you are typically limited to the medical evidence and supporting documentation that you filed with your initial application and any subsequent appeals. For this reason, it is important to build a strong record, which mainly includes:

• Obtaining and submitting additional medical evidence
• Consulting with a vocational expert to assess your ability to perform the duties of your occupation or any occupation
• Submitting a report from your treating physician(s) about how the symptoms of your disability affect your life and your ability to work
• Getting statements from family, friends, and coworkers who can discuss how your medical or mental health condition affects your ability to work

You should also be sure to meet any deadlines set out in your denial letter. If you miss a deadline, then your appeal could be denied outright – and you probably won’t be able to file a lawsuit. A disability lawyer can work with you to make sure that you submit sufficient evidence and meet all applicable deadlines.

How a Disability Benefits Lawyer Can Help

You are not required to hire a disability attorney to handle an administrative appeal with Mass Mutual. However, having legal representation is often the best way to achieve a favorable outcome for your disability claim.

Insurance providers like MassMutual have teams of lawyers and doctors working for them. They make money by denying or terminating legitimate disability claims. If you want to even the playing field – and increase the likelihood of a successful appeal – then you should hire a New Jersey disability benefits lawyer.

Your attorney will start by carefully reviewing your initial application and evidence, the denial notice, and your insurance policy. From there, they will begin to put together the necessary evidence to support your claim. They will consult experts who can provide you with additional evidence that may be sufficient to overturn a denial.

Dealing with an insurance company can be difficult at any time – but it is especially hard when you are struggling with a mental health or medical condition. Our law firm will take on the big insurance companies for you, and will fight to get you the benefits that you deserve.

Need Help with a Disability Appeal? Call Our Law Firm.

When you apply for long-term disability benefits, you expect that your claim will be approved. Unfortunately, LTD applications are often denied – sometimes based on technicalities or unfair reasons. Bross & Frankel can help you fight back.

Our law firm is committed to advocating for people with disabilities, whether they are seeking short-term disability, long-term disability, Social Security disability, and/or veterans’ disability benefits. We have helped thousands of people get disability benefits. Reach out today to schedule a free claim review with an experienced New Jersey disability benefits lawyer.

How Much Time Do I Have to Appeal a Denial of LTD Benefits from Mass Mutual?

Under ERISA, you have 180 days to file an appeal for a denial of long-term disability insurance benefits. If you have a private LTD policy, then this time frame may be shorter. You should always check the denial letter for the appeal deadline, and then make sure that you file an appeal by that date.

Keeping track of these deadlines can be difficult, especially if you are struggling to manage your medical condition. Bross & Frankel can take on the insurance company for you. Call our law office for a free consultation with an NJ disability lawyer.

If Social Security Approved My Claim for Benefits, How Can Mass Mutual Deny My LTD Claim?

Even if the Social Security Administration (SSA) approved you for disability benefits, that doesn’t mean that you automatically qualify for benefits through Massachusetts Mutual Life Insurance Company. The SSA has a different definition of disability, a different standard for evaluating claims, and different eligibility rules. As such, it is entirely possible to be approved for SSDI and/or SSI and still be denied LTD benefits.

If your MassMutual claim has been denied, you can appeal this determination. Contact Bross & Frankel to talk to an NJ disability attorney about an appeal. Initial consultations are free of charge.