Long-Term Disability Appeal Evidence Checklist

A long-term disability appeal is easier to review when the policy terms, insurer requests, source documents, user-entered function notes and appeal dates are kept in one case file instead of scattered across portals and folders.

The free Long-Term Disability Claim & Appeal Evidence Tracker is designed for that recordkeeping workflow.

This guide is for organization only. It does not determine whether a policy covers a claim, whether ERISA applies, whether a denial is valid or what must be submitted in an individual appeal.

Start with the policy and notice

Record the terms and dates shown in the documents that apply to the claim:

• elimination period;
• own-occupation definition;
• any transition to an any-occupation definition;
• benefit percentage and maximum;
• offsets or reductions described by the policy;
• proof-of-loss requirements;
• appeal date or deadline stated in the denial notice;
• review levels described by the plan or policy.

Keep the source document. The tracker should help you find the relevant language later, not replace the policy or denial notice.

Build a denial-reason index

Create one row for each reason the insurer states and connect it to the source material you already have or still need to locate.

Denial reason recorded from notice	Policy term or section	Source material already available	Missing or requested material	Follow-up
Functional capacity not supported	occupation definition	physician notes	task-level function information	review source records
Objective evidence requested	proof provision	imaging/labs	recent report	request records
Pre-existing-condition issue	exclusion	treatment timeline	older records	reconstruct chronology

The GentleTools tracker keeps the insurer’s stated reasons beside the records and user-entered notes you associate with them. It does not decide which side is correct.

Separate medical records from your own function notes

A medical record and a personal function journal are different source types. Keeping them separate makes the file easier to review.

A user-entered function log can record things such as:

• sitting, standing, walking or lifting tolerance you observed;
• concentration or pace difficulties you experienced;
• breaks or recovery time you recorded;
• symptom variability;
• post-activity changes;
• medication effects you noticed;
• work attempts or attendance events;
• restrictions or limitations exactly as a provider documented them.

Do not rewrite a provider’s conclusion as your own medical determination. Keep the original medical record and use the tracker as an index and chronology.

Track every insurer request

For each request, record:

1. date received;
2. what was requested;
3. due date shown by the insurer, if any;
4. who is obtaining the material;
5. date sent;
6. delivery confirmation or reference number;
7. whether receipt was acknowledged.

This makes outstanding requests visible without treating the tracker as the authority for what must be submitted.

ERISA appeal timing

Many employer-sponsored disability plans are subject to ERISA claims procedures, but not every LTD arrangement is. U.S. Department of Labor guidance says claimants under covered disability plans must generally be afforded at least 180 days following receipt of an adverse benefit determination to appeal the determination. A plan may provide more time, and the plan documents and denial notice remain important sources for the actual procedure.

The GentleTools tool therefore treats 180 days as an optional minimum cross-check only when the user indicates an ERISA-covered or likely ERISA plan. It does not replace the date in the notice or decide whether ERISA applies.

For current federal guidance, use the U.S. Department of Labor disability-benefit claims procedure guidance.

Keep an index of the appeal file

A useful appeal record can index what was submitted, what is still being requested and where each original document is stored.

Common categories include:

• policy or Summary Plan Description;
• claim forms;
• medical records;
• vocational or occupational material;
• job description;
• insurer correspondence;
• review, surveillance or other material disclosed to you;
• provider statements;
• appeal submission and delivery confirmation.

Whether a particular item is required or how it will be evaluated depends on the plan, notice and applicable rules. The tracker does not make that determination.

FAQ

Does GentleTools decide whether a denial is valid?

No. It organizes user-entered facts, policy references, notice dates and source records so the chronology is easier to review or discuss with a qualified professional.

Is 180 days always my LTD appeal deadline?

No. The federal 180-day rule is a minimum appeal opportunity for covered ERISA disability claims, not a universal deadline for every disability policy. Check the plan type, denial notice, policy or SPD and current official guidance.

Should I use the insurer’s portal as my only record?

Keep your own copy of important submissions and confirmations. A private chronology can help you preserve references even if a portal changes later.

Does the tracker upload medical records to GentleTools?

No. Working data and local attachments are designed to remain in your browser. Keep separate backups of important originals too.

Use the Long-Term Disability Claim & Appeal Evidence Tracker when you need the policy references, requests, appeal dates and source-record index in one place. If a broader disability or insurance chronology also needs symptoms, appointments and evidence references together, compare the options in the Private Recordkeeping Apps & Free Logs hub.