Last updated 2026-07-09
TL;DR
Standard Insurance (The Standard) is one of the largest group LTD carriers in the US. When they deny your claim, you get one administrative appeal under ERISA before you lose your right to sue. An LTD appeal lawyer who knows ERISA builds the record that decides your case, usually for a contingency fee of 25% to 40% of back pay owed.
Why does The Standard deny so many long term disability claims?
The Standard (Standard Insurance Company) is a Portland, Oregon insurer that runs group long term disability plans for employers nationwide. Like every large ERISA carrier, it both pays claims and decides whether claims are valid. That structural conflict of interest is legal under federal law. The Supreme Court held in Metropolitan Life Insurance Co. v. Glenn (2008) that courts must weigh the conflict when they review a denial [1].
The conflict shows up in patterns you can predict. The Standard's in-house physicians review your records without ever laying eyes on you. They send you to independent medical examiners (IMEs) whose income depends on insurer referrals. They order surveillance. They require Functional Capacity Evaluations, then dispute the results. They argue you can perform "any occupation" once the initial own-occupation period ends, usually at 24 months.
None of this means your appeal is hopeless. It means you need to know what The Standard is doing before you answer a denial letter.
What does ERISA have to do with a Standard LTD appeal?
If your long term disability coverage comes through an employer group plan, the Employee Retirement Income Security Act of 1974 (ERISA) governs it [2]. ERISA is federal law. It preempts the state insurance rules that would otherwise protect you.
Here is the fact that changes everything about your appeal. You get one administrative appeal, sometimes two depending on the plan, before you can sue. Every piece of medical evidence, vocational evidence, and legal argument you want a federal judge to see has to be in the administrative record before that appeal closes. Courts almost never accept new evidence once the administrative process ends.
That single rule is why an ERISA lawyer matters for your Standard appeal. They understand that the appeal is the trial. Most claimants who go it alone write a letter that says "I really am disabled" and resend the same records the insurer already rejected. A skilled lawyer builds a new record from scratch: updated treating physician statements, functional capacity evidence, vocational expert opinions, sometimes neuropsychological testing.
The Department of Labor's claims procedure regulation (29 C.F.R. § 2560.503-1) requires plans to notify you of your appeal rights and give you the appeal window in the denial [3]. Read your denial letter closely. Missing the appeal deadline usually means losing your benefits for good.
What is the ERISA appeal deadline for Standard Insurance denials?
For disability denials, ERISA plans have to give you at least 180 days to file your administrative appeal [3]. The Standard's plans usually give exactly 180 days. That sounds generous. It is not.
Gathering updated medical records, getting treating physicians to write detailed functional limitation letters, pulling vocational evidence, and reviewing the full claim file all take weeks each. Experienced ERISA lawyers often start work 90 days out and still feel the deadline breathing on them.
The claims procedure rule was amended in 2018. Under the current version (effective April 2018), a plan that offers a voluntary second-level appeal has to make clear you are not required to use it and that you have already satisfied the exhaustion requirement after the mandatory first appeal [3]. If The Standard offers you a second internal review, get legal advice before you accept. A voluntary second review extends the clock, does not always help, and can delay your right to sue.
One practical move: request your complete claim file the moment the denial arrives. Under ERISA, The Standard has to hand it over free of charge [2]. The file holds the in-house physician reports, the surveillance video if any exists, the vocational analysis, and internal emails. Your lawyer cannot build the appeal without it.
How does a Standard LTD appeal lawyer get paid?
Almost every ERISA disability appeal lawyer works on contingency for the administrative appeal and any litigation that follows. You pay nothing upfront. The fee comes out of back benefits recovered, usually 25% to 40% depending on the lawyer, the complexity, and whether the case reaches federal court.
ERISA has its own fee-shifting provision under 29 U.S.C. § 1132(g), which lets courts award attorney fees to a prevailing plaintiff [2]. In practice, many ERISA cases settle, and fee awards at trial are not guaranteed. Contingency arrangements shield you from paying fees if you lose.
Some lawyers charge separately for the administrative appeal and the federal litigation phase. Understand the fee structure before you sign a retainer. A flat fee or hourly arrangement for the administrative appeal alone is rare but not unheard of in simple cases.
Say your monthly LTD benefit is $4,000 and The Standard has denied 18 months of it. Your back pay claim is $72,000. A 33% contingency fee on that recovery is $23,760. That math is why lawyers take these cases, and why, frankly, you should not try to handle a strong one yourself.
What evidence should go into a Standard LTD appeal?
The administrative appeal record is everything. When courts review ERISA denials under a deferential "abuse of discretion" standard (which applies when the plan grants the administrator discretionary authority, and most Standard plans do), they look only at the record the administrator had. Build it right.
Treating physician statements are the foundation. A letter that says "my patient is disabled" is close to worthless. What you need is a Residual Functional Capacity (RFC) form or a detailed narrative that spells out how long the person can sit, stand, and walk, how much they can lift, how often they need to lie down or rest, and how their condition hits concentration, attendance, and pace. The more granular, the better.
For mental health claims, which The Standard often caps at 24 months under plan terms, you need neuropsychological testing, psychiatrist records, and if possible a narrative from a treating mental health professional that documents objective clinical findings beyond the patient's self-reported symptoms.
Vocational evidence carries huge weight at the "any occupation" stage. The Standard often uses its own vocational consultants who cite the Dictionary of Occupational Titles (DOT) to name sedentary jobs they claim you can do. A vocational rehabilitation expert hired by your lawyer can pick that analysis apart and explain why those jobs are not realistic given your functional limits, education, age, and work history.
Do not ignore Social Security. An SSDI award is not binding on The Standard under ERISA, but courts have noted it carries weight, and the SSA publishes the medical listing criteria that shape those decisions [5]. If you have not applied for SSDI yet, many ERISA lawyers recommend doing so in parallel, because a denial does not hurt your appeal and an approval helps it. For more on the SSDI appeal process, see how to appeal an SSDI denial.
What are the most common reasons The Standard denies LTD claims?
The Standard's denial letters usually cite one or more of these grounds:
Lack of objective medical evidence. The Standard argues that subjective symptoms (pain, fatigue, cognitive impairment) without corroborating imaging, lab results, or clinical findings are not enough. This hits hardest in fibromyalgia, chronic fatigue syndrome, and chronic pain cases.
Surveillance or social media evidence. They may have video of you walking to your car, or a Facebook photo from a family dinner, and argue it contradicts your claimed limitations.
Own-occupation vs. any-occupation transition. Many group plans pay benefits for two years if you cannot do your own job, then switch to a harder standard: you have to be unable to do any gainful occupation you are reasonably qualified for. The Standard denies a large share of claims right at this transition.
Pre-existing condition exclusion. If you were treated for the disabling condition within a set lookback period before coverage started, The Standard may exclude the claim entirely.
Mental health or substance abuse limitation. Most group plans cap mental health and substance abuse benefits at 24 months [10]. The Standard applies this limit aggressively, sometimes trying to recharacterize a primarily physical condition as a "mental health" claim.
Failure to comply with treatment. If you have stopped seeing a physician, turned down surgery, or refused recommended medication, The Standard may argue you are not under "appropriate care" as the plan requires.
Knowing which argument The Standard is making tells your lawyer exactly what evidence to build.
What happens after the appeal if The Standard still denies the claim?
If The Standard upholds the denial after your mandatory administrative appeal, you can sue in federal district court under ERISA 29 U.S.C. § 1132(a)(1)(B) [2]. The lawsuit asks the court to review the claim file and reverse the denial.
The standard of review matters a lot here. If the plan gives the administrator discretionary authority (it almost certainly does), the court reviews under the "arbitrary and capricious" or "abuse of discretion" standard. That means the insurer wins if there was any reasonable basis for the denial, even if the judge would have decided differently. Under Glenn, courts have to factor in the structural conflict of interest, but deference still tilts toward the insurer more often than claimants would like [1].
A few states have passed laws that strip plan administrators of discretionary authority for insured plans, so courts there apply a de novo standard and decide the case fresh. California, Illinois, and New York are examples. If your plan runs under state law instead (government employer plans and church plans are sometimes exempt from ERISA), the analysis changes completely [6].
Litigation timelines vary. A federal ERISA bench trial (no jury, just a judge reading the administrative record) can resolve in 12 to 24 months. Many cases settle first. The threat of attorney fee awards and ongoing monthly benefit obligations gives insurers real reason to settle strong cases.
For a closer look at how long the full appeal process takes with a lawyer, see how long does a disability appeal take with a lawyer.
How do you find the right lawyer for a Standard LTD appeal?
ERISA disability law is a specialty. Not every disability lawyer handles ERISA group plan cases. Many focus on Social Security disability, which is a separate system with different rules, different evidence standards, and different courts. Hiring an SSDI lawyer to run your ERISA appeal is a real mismatch.
When you interview attorneys, ask directly: What percentage of your practice is ERISA long term disability? Have you handled cases against Standard Insurance? Do you carry the matter through federal litigation if the appeal fails, or refer it out?
The National Organization of Social Security Claimants' Representatives (NOSSCR) includes ERISA practitioners. The American Association for Justice (AAJ) has an ERISA subgroup. State bar referral services sometimes maintain disability law sections. Word of mouth from other lawyers, especially plaintiff-side employment attorneys, is often the best source.
If you are in California and want local counsel, see our resource on san francisco disability appeals lawyers.
Be skeptical of any lawyer who guarantees a result or quotes a very low contingency fee without reviewing your file. Strong cases get taken on contingency. A lawyer who has read your denial letter, reviewed your claim file, and spoken with you for 30 minutes knows whether the case has merit. If a lawyer asks for a large upfront retainer just to "evaluate" the file, treat that as a red flag.
DisabilityFiled's guided intake tool lets you organize your denial letter, claim documents, and medical history into a structured summary you can hand a prospective attorney at the first consultation. It saves time and often helps the lawyer size up the case faster.
How does a Standard LTD appeal compare to a Hartford, Unum, or Lincoln appeal?
The mechanics of an ERISA appeal stay the same no matter the carrier: one mandatory appeal, a closed record, federal court review. The carrier-specific differences live in their claim-handling patterns, which your lawyer needs to know.
The Standard has historically been somewhat less aggressive than Unum (which entered a 2004 regulatory settlement over its claim-handling practices) but more aggressive than some smaller carriers. Hartford Financial Services is a major competitor with similar denial patterns, especially around mental health limitations and functional capacity disputes. If your plan runs through Hartford, see hartford disability benefit denial for carrier-specific detail.
The table below compares key features across the four largest group LTD carriers.
| Carrier | 2004 Multi-State Regulatory Action | Mental Health Limit (typical) | Own-Occ Period (typical) | Notes |
|---|---|---|---|---|
| Unum | Yes | 24 months | 24 months | Entered settlement; claim practices improved but disputes remain |
| The Standard | No | 24 months | 24 months | Structural conflict cases frequently litigated post-Glenn |
| Hartford | No | 24 months | 24 months | Aggressive FCE and surveillance use |
| Lincoln Financial | No | 24 months | 24 months | Vocational denial common at any-occ transition |
The 2004 action against Unum, Provident, and Paul Revere is documented by the California Department of Insurance and came out of a multi-state market conduct exam [4]. The terms forced those companies to reassess thousands of claims. No equivalent action has hit The Standard, which does not make The Standard easier to deal with.
What should you do the day you receive a Standard denial letter?
Read the denial letter all the way through, twice. It has to explain the specific reason for the denial, cite the plan provisions it is applying, and describe the appeal process and deadline under 29 C.F.R. § 2560.503-1 [3]. If it does not, that procedural failure is itself a ground for challenge.
Write your appeal deadline on your calendar the day the letter arrives. 180 days sounds long. It goes fast.
Request the complete claim file in writing right away. You are entitled to it under ERISA, and The Standard has to produce it without charge [8]. Send the request by certified mail or email with a read receipt so you have a record of the date.
Do not call The Standard and talk about your case without representation. Anything you say can land in the file. "I had a good week last week" becomes ammunition.
Schedule consultations with ERISA disability lawyers within the first two weeks. Most offer free consultations. Bring the denial letter, your plan summary (the Summary Plan Description, or SPD), and any recent medical records you have. The lawyer will tell you quickly whether the case is worth pursuing and on what theory.
For a general overview of denial next steps across all disability claim types, see disability denial lawyer.
Can you handle a Standard LTD appeal without a lawyer?
You can. ERISA does not require legal representation. For a small subset of cases, a well-organized, clearly documented appeal by a self-represented claimant does succeed.
But the odds are not with you. The Standard's appeal unit is staffed by people who do this all day. The record-building requirements are technical. Leaving a piece of evidence out during the administrative appeal usually means it cannot be considered later in federal court.
Here is the biggest risk of going without a lawyer: you do not know what you do not know. Claimants who lose their administrative appeals often find out afterward that they could have submitted a vocational expert report, that their treating physician's letter was too vague, or that the plan had a procedural defect that would have been a strong argument.
If the denied benefit is small, say under $12,000 in total back pay, the math on hiring a lawyer gets harder. Some lawyers will still take the case. Others will decline and point you to a legal aid organization or a law school clinic.
For cases with substantial back pay and ongoing monthly benefits, trying to handle the appeal yourself is almost always a mistake. The contingency fee you pay on success is almost certainly less than the benefits you leave on the table by losing an appeal you could have won.
What questions should you ask a Standard LTD appeal lawyer at the consultation?
Walk into any consultation with a list. These are the questions that actually matter:
How many ERISA long term disability appeals have you handled in the last three years? How many went to federal court? What was your win rate?
Have you handled claims against The Standard specifically? What were the outcomes?
Will you personally handle my case, or does it get passed to a junior associate or a legal assistant?
What is your fee structure for the administrative appeal versus federal litigation? Are they separate agreements?
What do you see as the strongest and weakest parts of my claim based on what you have seen today?
What additional evidence do we need to build, and how do we get it?
What is a realistic timeline, and a realistic range of outcomes?
A good lawyer answers these directly. Hedging on win rates is fine, because nobody has a 100% record. But vague non-answers about the theory of your case or the fee structure are warning signs.
For context on the full spectrum of denial types and when to bring in legal help, see disability denial claims lawyer.
Frequently asked questions
How long do I have to appeal a Standard Insurance LTD denial?
ERISA regulations require disability plans to give you at least 180 days to file an administrative appeal after a denial. The Standard's plans typically use exactly that 180-day window. Missing the deadline almost always means losing your right to benefits permanently, so mark the date immediately and contact a lawyer within the first few weeks, not the last few.
Does hiring a lawyer guarantee I win my Standard LTD appeal?
No. Nothing in ERISA litigation is guaranteed, and any lawyer who says otherwise is not being honest with you. What a good ERISA lawyer does is improve the quality of the administrative record, catch procedural errors by The Standard, and position the case for federal court if the appeal fails. That improves your odds. It does not eliminate the risk of losing.
What is the contingency fee for an ERISA disability appeal lawyer?
Most ERISA LTD lawyers charge a contingency fee of 25% to 40% of back benefits recovered. You pay nothing upfront. If you lose, you owe no fee for the lawyer's time, though you may owe costs like medical record fees or expert witness fees depending on the retainer agreement. Read the agreement carefully before signing.
Can The Standard access my Social Security disability file?
Most Standard LTD plans require you to apply for SSDI as a condition of receiving LTD benefits and to report any SSDI award so the plan can offset its payments. The Standard can ask you to sign an authorization to obtain your Social Security records. Whether you should sign depends on your specific case, so consult an ERISA lawyer before providing broad authorizations.
What is the difference between own-occupation and any-occupation disability in a Standard LTD policy?
Own-occupation coverage pays if you cannot perform the duties of your specific job. Most Standard group plans pay own-occupation benefits for the first 24 months, then switch to any-occupation: you have to be unable to perform any gainful work you are reasonably qualified for by education, training, or experience. The any-occupation standard is much harder to meet, and most denials happen at this transition.
Will a Standard LTD appeal lawyer also handle my SSDI claim?
Some do, but the two systems are completely different. ERISA LTD law is federal civil litigation. SSDI is an administrative process before the Social Security Administration with its own hearing judges, rules, and evidence standards. Some firms handle both. Many ERISA specialists refer SSDI cases to separate counsel. Ask about this specifically during your consultation so you are not left without coverage for one claim or the other.
What does it mean when The Standard says it applied a 'mental health limitation'?
Most group LTD plans contain a provision limiting benefits for disabilities caused by mental health conditions (depression, anxiety, PTSD, etc.) to 24 months. The Standard sometimes characterizes primarily physical conditions like chronic pain or fibromyalgia as 'mental health' claims to invoke this limit. Challenging that characterization with objective medical evidence and specialist opinions is a common focus of appeals in these cases.
Can I sue The Standard after losing my LTD appeal?
Yes, in federal district court under ERISA 29 U.S.C. § 1132(a)(1)(B), but only after you exhaust the administrative appeal process. Most ERISA cases are decided by a judge reviewing the administrative record, not a jury. The standard of review, either de novo or abuse of discretion, depends on whether the plan granted the administrator discretionary authority. Most Standard plans do, which makes the abuse-of-discretion standard apply and makes record-building during the appeal even more important.
How long does a Standard LTD appeal and potential lawsuit take?
The administrative appeal alone can take four to six months after you submit it, because The Standard has 45 to 90 days to respond under ERISA regulations. If the appeal is denied and you file in federal court, add another 12 to 24 months before a likely resolution, though many cases settle before then. Total timeline from denial to resolution is often two to three years in contested cases.
Does The Standard have to tell me why they denied my claim?
Yes. Under 29 C.F.R. § 2560.503-1, a disability plan denial notice must include the specific reasons for denial, reference the specific plan provisions relied on, a description of any additional information needed to perfect the claim, and a description of the plan's appeal procedures. If The Standard's denial letter does not contain all of this, that is a procedural violation your lawyer can use.
What if my employer changed LTD carriers while I was on claim?
Carrier transitions mid-claim are a messy area of ERISA law. Generally, the carrier in place at the date of disability onset is responsible for the claim, but the specific terms of the transition agreement between carriers can create gaps or disputes. If your employer switched from The Standard to another carrier or vice versa while you were already receiving or applying for benefits, flag this immediately for an ERISA lawyer.
Can I get LTD benefits and SSDI at the same time?
You can receive both, but your LTD plan almost certainly offsets its payment by the amount of your SSDI award. So if The Standard is paying $3,000 per month and you are approved for $1,800 per month in SSDI, The Standard typically reduces its payment to $1,200. You do not lose money on net, but The Standard keeps the financial benefit of your SSDI approval. Some plans also seek repayment of past LTD benefits retroactively once your back SSDI payment arrives.
Sources
- Supreme Court of the United States, Metropolitan Life Ins. Co. v. Glenn, 554 U.S. 105 (2008): Courts must weigh the structural conflict of interest when an ERISA plan administrator both funds benefits and decides claims
- U.S. Department of Labor, Employee Retirement Income Security Act of 1974 (ERISA): ERISA governs employer-sponsored group disability plans; 29 U.S.C. § 1132(a)(1)(B) provides right to sue; § 1132(g) allows attorney fee awards; plan must provide claim file free of charge
- U.S. Department of Labor, Employee Benefits Security Administration, 29 C.F.R. § 2560.503-1 claims procedure regulation: Disability plans must give claimants at least 180 days to file an administrative appeal; denial notices must specify reasons, plan provisions, and appeal procedures; 2018 amendments clarified voluntary second-level appeals
- California Department of Insurance, Unum/Provident/Paul Revere multi-state regulatory settlement 2004: Unum, Provident, and Paul Revere entered a 2004 multi-state regulatory settlement requiring reassessment of thousands of denied disability claims following a market conduct examination
- Social Security Administration, Disability Evaluation Under Social Security (Blue Book): SSA publishes medical listing criteria for disability determinations; SSDI approval is not binding on ERISA plan administrators but may carry persuasive weight
- U.S. Department of Labor, Employee Benefits Security Administration: ERISA preempts state insurance laws for employer-sponsored group benefit plans
- Social Security Administration, Disability Benefits (SSA.gov): Social Security Disability Insurance benefits may be offset against LTD plan payments per plan terms
- U.S. Department of Labor, Employee Benefits Security Administration, advisory opinions and resource center: ERISA plans must provide the Summary Plan Description and complete claim file to claimants upon request
- Standard Insurance Company, group long term disability insurance product information: Standard Insurance Company is a Portland, Oregon-based carrier administering group LTD plans nationwide
- U.S. Department of Labor, EBSA publications resource center: Group LTD plans commonly include own-occupation periods of 24 months and mental health benefit limitations of 24 months