🛡️ Free disability-claim evidence tool

Long-Term Disability Claim & Appeal Evidence Tracker

Keep the policy terms, claim requests, medical/function evidence, payments, offsets, denial reasons and appeal record in one claimant-owned file instead of across portals, emails and paper folders.

Important: LTD policies differ. Employer plans may be governed by ERISA; individual, government and church plans can follow different rules. This tool uses dates and policy terms you enter and never substitutes for the policy, denial letter or legal advice.

1. Policy & claim setup

Claim nicknameInsurer / administratorClaim/reference IDPlan typeLast day workedDisability / claim startElimination period (days)Monthly benefit ($)Own-occupation period (months)Denial/termination receivedAppeal date / deadline shown in letterERISA 180-day minimum cross-check?

2. Claim dashboard

3. Insurer request & entered due-date tracker

Request dateRequested itemDue dateStatusConfirmation / ref

Notes

4. Functional evidence journal

DateDay ratingActivity tolerance (minutes)Recovery after activity (hours)

Work-function affectedProvider discussed?Evidence reference

What happened and what could/couldn’t be done

5. Benefit, offset & payment ledger

MonthGross expected ($)Offsets / reductions ($)Actually received ($)Note

Month	Expected	Offsets	Net expected	Received	Difference	Action

6. Denial / termination issue matrix

IssueInsurer positionYour evidence / responseStatus

7. Local evidence vault

Drop policy pages, denial letters, medical records, job descriptions, FCE/IME reports and correspondence

Files stay in this browser with SHA-256 fingerprints. Keep originals in a separate backup location too.

8. Appeal packet snapshot

9. Export, backup & delete

Why this is more than a symptom diary

An LTD file can involve policy definitions, occupational information, insurer requests, source medical records and the claimant’s own function notes. This tool keeps those record types beside each other without deciding whether the policy covers the claim or how any evidence should be weighed.

ERISA 180-day minimum cross-check

For disability plans covered by ERISA, U.S. Department of Labor guidance says claimants must generally be afforded at least 180 days following receipt of an adverse benefit determination to appeal. A plan may provide more time, and not every LTD policy is governed by ERISA. Use the plan documents and denial notice for the actual procedure; this optional marker is only a minimum cross-check from the receipt date you enter. Check current U.S. Department of Labor guidance →