When a serious illness or injury keeps you from working, long-term disability (LTD) benefits can be a financial lifeline. These benefits are designed to replace a portion of your income so you can focus on your health instead of worrying about how to pay the bills.
But getting those benefits is not always straightforward. Insurance companies routinely deny valid claims, delay payments, and use confusing policy language to avoid paying what they owe. If you are dealing with an LTD benefits dispute, our Wisconsin long-term disability benefits lawyers are here to help you fight for the income you deserve.
At Hawks Quindel, we have spent over 60 years standing up for the rights of Wisconsin workers and families. We understand what is at stake when your paycheck suddenly stops, and we are committed to holding insurance companies accountable.
Securing Long Term Disability Benefits Rightfully Owed to Wisconsin Workers
Why Choose Hawks Quindel for Your Long-Term Disability Claim?
Since 1959, we have built our reputation on one simple promise: we work for you. When you are struggling with a disabling condition and battling an insurance company at the same time, you need a legal team that genuinely cares about your well-being and your financial future. Here is what sets us apart.
- A track record of results against major insurers. We have successfully recovered long-term disability benefits from some of the largest insurance companies in the country, including Unum, CIGNA, Hartford, MetLife, Sun Life, Lincoln Financial, Mutual of Omaha, and many others.
- Client-centered approach. We take the time to understand your medical condition, your policy, and your goals. Every case is personal to us because every client is a real person facing real hardship.
- Contingent fee representation. We handle long-term disability cases on a contingent fee basis, which means you do not pay attorney fees unless we recover benefits for you.
- Convenient locations across Wisconsin. With offices in Madison, Milwaukee, Appleton, and Waukesha, we are easy to reach no matter where you live in the state.
When your financial security is on the line, having a dedicated legal team in your corner makes all the difference.
Hear From Our Clients
“happy with our settlement”
Bill Parsons and Brook Tylka and the rest of the staff from Hawks Quindel were very helpful with our case. They kept me up to date on the progress of my claim from the very beginning. After our first conciliation, we felt very confident we had the right attorney to...
“a practice someone can trust”
Hawks and Quindel are an amazing law firm to deal with. It’s a scary time and everyone there puts you at rest that they have your best interest at heart. They never make you feel like you are bothering them and they kept me in the loop with answers before... “thoroughness, patience, and insight”
I can’t praise Aaron Halstead and Connor Clegg enough for their work on my legal matter. I especially appreciated their thoroughness, patience, and insight. They were always responsive to my questions. They helped me navigate a challenging workplace issue and obtain a good outcome. I would and do recommend them. “highly recommend seeking the services of this firm”
During this very difficult time, the staff at Hawks and Quindel kept me reassured and informed every step of the way. I had the pleasure of working with Attorneys Jessa Victor and Brook Tylka. Jessa, Brook, Matt, and Hadley, thank you for all of your hard work, professionalism and compassion!... “my case was won”
From our first phone call with Donnie Malchow, we knew we'd found the right person to help us. I had filed for disability and been denied. He was willing to walk beside us and thoroughly explain the entire process (lasted over a year and a half) and expectations (gave us... “I would wholeheartedly recommend HQ”
I had another law firm representing me on a non-compete, and when it became clear that I needed new representation, I reached out to Hawks Quindel. Aaron Bibb took my case and he represented me extremely well to an agreeable resolution of the case, and costs were extremely reasonable and... “went above and beyond”
Attorney Halstead and his team went above and beyond to not only win my case, but because of certain circumstances I had going on, they did everything they could to help and rush the settlement through. They were always quick at responding to emails and phone calls with questions I... “I highly suggest this firm”
I can't imagine using any other firm after having Hawks Quindel, they were so knowledgeable and experienced but yet so down to earth to talk with. They kept me informed every step of the way and always answered when I had a question. What a staff, so many great people,... “empathy, intelligence, and professionalism”
I reside in New Mexico but drove a semi-truck coast to coast for an unscrupulous trucking company out of Wisconsin. This logistics company harassed, bullied lied and discriminated against me, keeping my earned wages, and leaving me in a financial hole. Devastated I called and left a message for the... “people treat you like family”
Top notch law firm Jacob and Natalie were my 2 attorneys that represented me on both of my cases? They did a fantastic job. Speaking up for me as they do for thousands of people and especially the little guys down-to-earth, people treat you like family, these people are godsons. “Way beyond my expectations”
Many thanks from my family to all of you at the firm!!! Hawks Quindel, S.C. is the only place I would consider for LTD, disability, SSDI, ERISA, EEOC, DRoW legal help!! Jessa Victor and her team got me all the answers and results when I didn't think it was possible!!!... “His team were patient and professional”
I had the pleasure of being represented by Aaron N. Halstead, Shareholder, on my discrimination case. His team were patient and professional. I would highly recommend this firm for the professionalism and efficiency for working through my case. “If there were 10 stars”
If there were 10 stars I would give them that. There are not enough words to express my gratitude for Aaron, Ben and their team. I felt strong with them behind me. Exceeded expectations is an understatement. “wonderful to work with”
I had mauve she was wonderful to work with! She helped me with my long battle to get SSI and SSDI. Which thankfully I now have! She's a delight and really helps boost anyone's confidents. “Extremely knowledgeable”
I had an incredible experience regarding my workers compensation case with Jakob Feltham! It was my first workers compensation case (*or first case ever), and I didn't know anything about the legalities surrounding my issue, or what I was entitled to? Jake Feltham had ALL my answers, and made it... “I’m happy with the work they did”
They were extremely responsive and good at communication throughout the process. They were accommodating of my disability and explained things well, taking time to answer all my questions. I'm happy with the work they did. Felt like I really had people on my side during a confusing and difficult time. “consistently responsive and professional”
My recent experience with Hawk Quindel, and in particular with John Leppanen in the Milwaukee office. He, was extremely valuable. The support/intake staff responded quickly to my initial inquiry, and John was responsive and made time soon after our initial contact to begin work on my case. John was able... “the best lawyers, trustworthy”
Excellent people, the best lawyers, trustworthy, always seeking the best results in the shortest possible time. I highly recommend them. “Very Helpful”
Eze the intake coordinator was awesome, very helpful and connected me with the right people to help with my situation! Thank you Eze! “Had My Back”
In 2010, I returned home from my second deployment. In 2012, I was told by the VA I couldn’t return to the job I was working at. It is now 2019, and through 7 years of needing legal representation, Hawks had my back through 3 separate issues: short term disability,... “Best Decision”
I really don’t know how to put this in words to express how happy, satisfied, and really just overwhelmed with a sense of justice being handed out on my behalf. This big corporate work comp insurer treated me wrong, but before I decided to give up I contacted Hawks Quindel,... “Highly Recommend”
The attorneys at Hawks Quindel worked tirelessly on my behalf. They were transparent at every step of the way, and answered any questions I had directly and in ways that someone without a legal background could easily understand. Although I would highly recommend them to anyone who is potentially facing... What Is Long-Term Disability Insurance?
Long-term disability insurance, often called LTD insurance, is a type of coverage that replaces a portion of your income if a medical condition prevents you from doing your job. Most LTD policies pay between 50% and 70% of your pre-disability earnings, depending on the terms of your plan.
There are two main ways people get LTD coverage. Many workers receive it as part of an employee benefits package offered by their employer. Others purchase an individual policy directly from an insurance company.
The source of your policy matters because employer-sponsored group plans are often governed by a federal law called the Employee Retirement Income Security Act of 1974 (ERISA), which has its own set of rules for claims, appeals, and lawsuits. Individual policies purchased on your own are typically governed by Wisconsin state insurance law instead.
Regardless of where your coverage comes from, the basic idea is the same: if you become too sick or too injured to work, LTD insurance is supposed to provide you with a steady income until you recover, reach retirement age, or meet some other milestone defined in your policy.
Common Conditions Covered by Long-Term Disability
Long-term disability benefits can apply to a wide range of medical conditions. You do not need to have suffered a dramatic accident to qualify. Many of the most common LTD claims involve chronic illnesses and conditions that develop gradually over time. Examples include:
- Back and spine injuries, including herniated discs and degenerative disc disease
- Autoimmune disorders such as lupus, multiple sclerosis, and rheumatoid arthritis
- Cancer and complications from cancer treatment
- Heart disease and cardiovascular conditions
- Mental health conditions, including severe depression, anxiety, and PTSD
- Neurological conditions such as Parkinson's disease and traumatic brain injuries
The key question is whether your condition prevents you from performing the duties of your job (or, in some cases, any job). Your treating physician's opinion plays a central role in that determination.
"Own Occupation" vs. "Any Occupation"
One of the most important parts of any long-term disability policy is how it defines "disability." This definition determines whether you qualify for benefits, and it can change over the life of your claim.
Most policies use two different standards at different stages, and the differences between them are significant.
| Own Occupation | Any Occupation | |
|---|---|---|
| Definition of disability | You cannot perform the specific duties of your own job | You cannot perform the duties of any job you are reasonably qualified for |
| When it typically applies | The first 1 to 2 years of a claim | After the own occupation period ends, for the remainder of the benefit period |
| Standard of proof | Lower: focuses only on your specific job duties | Higher: considers all work you could potentially do based on your education, training, and experience |
| Example | A registered nurse in Milwaukee with a back injury who cannot stand for long shifts may qualify, even if seated work is possible | That same nurse would need to show that no suitable job exists given her qualifications and restrictions |
| Risk of denial | Moderate: insurers may dispute the severity of your condition | High: this is the most common point where insurers terminate benefits |
Understanding when your policy makes this switch is critical. Many Wisconsin workers lose their benefits at the transition point simply because they were not prepared for the change in definition.
An experienced long-term disability lawyer can help you build the right medical and vocational evidence well before the transition happens.
Why Long-Term Disability Claims Get Denied in Wisconsin
Insurance companies deny LTD claims for many reasons, and not all of those reasons are legitimate. Some of the most frequent grounds for denial include:
- Insufficient medical evidence. The insurer may argue that your medical records do not adequately prove your condition is disabling. This is especially common with conditions like chronic pain, fibromyalgia, and mental health disorders, where symptoms are difficult to measure objectively.
- Surveillance and social media monitoring. Insurance companies sometimes hire investigators to watch claimants or comb through their social media accounts, looking for activity that seems inconsistent with the claimed disability.
- Policy exclusions and limitations. Some policies exclude certain conditions or limit the duration of benefits for specific diagnoses. Mental health conditions, for example, often carry a benefit cap of 24 months under many LTD policies.
- The own-to-any occupation transition. As discussed above, many claims are terminated when the policy's definition of disability shifts from "own occupation" to "any occupation."
- Reliance on paper reviews. Some insurers deny claims based solely on an in-house doctor's review of your medical records, without ever examining you in person.
If your claim has been denied, it does not mean your fight is over. Many initial denials are reversed during the appeals process, especially when a knowledgeable attorney helps strengthen the supporting evidence.
How ERISA Affects Your Long-Term Disability Claim
If your LTD policy was provided through your employer, it is very likely governed by ERISA. This federal law creates a specific framework for how disability claims must be handled, and it comes with both protections and limitations that are important to understand.
On the protective side, ERISA requires your insurance company to follow specific timelines when reviewing your claim. The insurer must provide a detailed written explanation if your claim is denied, including the specific reasons for the denial and information about your appeal rights. You are also entitled to request copies of all documents the insurer used to make its decision.
ERISA Limitations
However, ERISA also imposes significant restrictions. If your appeal is denied and you need to file a lawsuit, the case must be brought in federal court. There are no jury trials in ERISA cases; instead, a federal judge reviews the claim.
In many situations, the judge's review is limited to the evidence that was in front of the insurance company at the time it made its decision. This means the administrative appeal is often the most important stage of the entire process, because new evidence generally cannot be introduced later in court.
ERISA also limits the financial recovery available to claimants. Unlike state law claims, ERISA does not typically allow for punitive damages or compensation for emotional distress. The most you can usually recover is the benefits you were wrongly denied, plus interest and attorney fees.
Because ERISA claims are so procedure-driven, the decisions you make early in the process can have lasting consequences. Working with an attorney who understands ERISA deadlines and evidentiary requirements can make a significant difference in the outcome of your case.
The Appeals Process for Denied Long-Term Disability Benefits
If your long-term disability claim is denied, you generally have the right to file an administrative appeal. For ERISA-governed plans, the appeal deadline is typically 180 days from the date you receive the denial letter. Missing this deadline can permanently forfeit your right to pursue benefits, so acting quickly is essential.
A strong appeal involves much more than simply resubmitting the same paperwork. Here is what a well-prepared appeal typically includes:
- Updated medical records and test results that directly address the insurer's stated reasons for denial
- Detailed statements from your treating physicians explaining your specific functional limitations and restrictions, and how those limitations prevent you from working
- Personal statements describing how your condition affects your daily life, including household tasks, hobbies, and the ability to care for yourself or your family
- Vocational evidence, when relevant, showing that no suitable jobs exist given your medical restrictions, age, education, and work history
Each of these components needs to speak directly to the insurer's reasons for denying your claim. A generic letter from your doctor saying "my patient is disabled" is rarely enough to overturn a denial. Insurance companies respond to specific, well-documented evidence that connects your diagnosis to concrete functional limitations.
Throughout this process, it is important to continue receiving medical treatment and documenting your condition. Gaps in treatment can be used by the insurance company to argue that your condition has improved or is not as severe as you claim.
After you submit your appeal, the insurance company typically has 45 days to issue a decision, with the possibility of one 45-day extension. If the appeal is denied, your next step under an ERISA plan is to file a lawsuit in federal court.
How a Wisconsin Long-Term Disability Lawyer Can Help
Challenging an insurance company on your own can feel like an uphill battle, especially when you are already dealing with a serious health condition. A long-term disability attorney can level the playing field in several important ways:
- Analyzing your policy language. LTD policies are dense and full of defined terms. An attorney can identify provisions that support your claim and spot areas where the insurer may be misinterpreting or misapplying the policy.
- Strengthening your medical evidence. An attorney can work with your treating physicians to develop detailed functional capacity evidence that translates your diagnosis into the specific "restrictions and limitations" language insurance companies and courts rely on.
- Managing deadlines and procedures. Whether your claim falls under ERISA or Wisconsin state law, there are strict timelines for appeals and litigation. Missing a single deadline can permanently forfeit your rights.
- Representing you in court. If your case goes to litigation, an experienced long term disability lawyer knows how to present your claim effectively before a federal or state court judge.
Having a knowledgeable legal advocate on your side from the earliest stages of your claim gives you the strongest possible foundation, whether your case is resolved during the appeal or requires litigation
FAQs for Wisconsin Long Term Disability Benefits
Here are answers to some of the questions we hear most often from people dealing with long-term disability issues in Wisconsin.
How long do long-term disability benefits last?
The duration of LTD benefits depends on the terms of your specific policy. Some policies pay benefits for a set number of years, such as two, five, or 10 years. Others continue paying until you reach age 65 or your Social Security normal retirement age. Review the "maximum benefit period" section of your plan documents for your specific timeline.
Can I receive long-term disability benefits and Social Security Disability Insurance (SSDI) at the same time?
Yes, it is possible to receive both. However, most LTD policies include an "offset" provision that reduces your LTD payment by the amount of your SSDI benefit. Many insurers actually require you to apply for SSDI as a condition of receiving LTD benefits, because the offset lowers the amount the insurer has to pay.
What if my long-term disability claim is denied because of a pre-existing condition exclusion?
Many LTD policies contain a pre-existing condition clause that excludes coverage for conditions that were treated or diagnosed within a specific window before the policy's effective date, often three to twelve months. If your claim was denied on this basis, it is worth having an attorney review whether the exclusion was correctly applied based on the specific policy language and your medical history.
Do I need a lawyer to file a long-term disability appeal?
You are not legally required to have an attorney, but the appeal stage is critically important, especially in ERISA cases. Because courts often limit their review to the evidence submitted during the appeal, this may be your best and only opportunity to build a complete record. An attorney can help make sure nothing important is overlooked.
What does it cost to hire a long-term disability benefits lawyer?
Many long-term disability attorneys, including those at Hawks Quindel, work on a contingent fee basis. This means you pay no upfront fees and no hourly charges. Your attorney receives a fee only if benefits are successfully recovered on your behalf. This arrangement makes legal representation accessible even when you are not receiving income.
Long Term Disability Benefits Resources
Reach Out to Our Wisconsin Long-Term Disability Benefits Attorney Today
Dealing with a denied or terminated long-term disability claim is stressful, especially when your health and your family's financial stability are on the line. You do not have to take on the insurance company by yourself.
At Hawks Quindel, our attorneys have been fighting for the rights of disabled Wisconsin workers for over six decades. We understand the tactics insurance companies use, and we know how to build strong claims that hold up during appeals and in court. Whether you are filing a new claim, appealing a denial, or challenging a benefit termination, we are ready to stand with you.
Contact us today to see if you qualify for a free consultation. We represent clients on a contingent fee basis throughout Wisconsin, so there is no financial risk in reaching out to learn about your options.