Prudential Denied Your Long-Term Disability Claim. Now What?

The envelope is official, the letterhead familiar. But the words inside are cold, impersonal, and devastating: “denied.”

After months of providing medical records, filling out forms, and hoping for a lifeline, Prudential Financial has rejected your long-term disability (LTD) claim. In a few sterile paragraphs, they have dismissed your medical condition, ignored your doctor’s opinions, and left you without the financial safety net you’ve likely paid for over your entire career.

You are left feeling betrayed, terrified, and overwhelmed. What do you do next?

This is not a simple customer service issue. It is a complex legal battle against one of the largest and most experienced insurance carriers in the world. Prudential has a team of in-house doctors, lawyers, and claims adjusters, and they have a financial incentive to deny claims. They are counting on you to be too sick, too tired, and too intimidated to fight back effectively.

At Uscher, Quiat, Uscher & Russo, P.C. (UQUR), we have been fighting and winning these battles for decades. We are not general-practice lawyers; we are seasoned ERISA attorneys who focus specifically on disability claims. We know Prudential’s playbook. We know their tactics. And we know exactly how to build a case that forces them to pay the benefits you are owed.

Before you make a single move, you need to understand what you’re up against.

Common Tactics Used to Deny Claims

Your denial letter is not just a rejection; it is a legal strategy. Prudential’s denial is built on a specific set of tactics designed to create a record that will hold up in court.

Some of their most common tactics include:

  1. The “No Objective Evidence” Argument This is the number one weapon used to deny claims for “invisible” illnesses. If you suffer from fibromyalgia, chronic fatigue syndrome (ME/CFS), mental health conditions (like depression or anxiety), long-COVID, or complex cognitive disorders, Prudential will argue there is no “objective evidence” (like an X-ray or blood test) to “prove” your limitations. They will dismiss your reported pain, fatigue, and cognitive fog as “subjective complaints” and deny your claim.
  2. The “Paper-Only” Medical Review Prudential will have your file reviewed by an in-house “consulting physician” or a third-party vendor. This doctor, who has never met you, spoken to you, or examined you, will review your records for a few hours. They will then issue a report—often full of flawed assumptions—that concludes your condition is not severe enough to prevent you from working. Prudential will then use this “paper-only” review to override the opinions of your own treating doctors who have cared for you for years.
  3. Mischaracterizing Your “Own Occupation” This is a critical tactic used against high-earning professionals. If you are a surgeon, an attorney, an executive, or an engineer, Prudential will try to redefine your job into its lightest possible duties. They will argue that even if your back pain stops you from standing in an OR for 10 hours, you can still “review charts” or “do administrative work.” They are intentionally ignoring the material and substantial duties of your specific, high-stakes profession to argue that you can still perform some “sedentary” part of it.
  4. The “24-Month Switch” to “Any Occupation” Many Prudential policies change the definition of “disability” after 24 months. For the first two years, you are disabled if you cannot perform your own occupation. After that, the definition often switches to being disabled if you cannot perform any occupation for which you are reasonably suited by education, training, or experience. Prudential will use this date to terminate benefits, claiming their vocational expert has identified several “light duty” jobs you can do, even if they pay a fraction of your former salary.
  5. Video Surveillance and Social Media Audits Prudential frequently hires private investigators to follow claimants. They will film you taking out the trash, carrying a bag of groceries, or driving to a doctor’s appointment. They will take this brief, out-of-context footage on one of your “good days” and argue that it “proves” you are not as disabled as you claim. They will also meticulously scan your social media for any photos or posts that contradict your reported limitations.

Why Your Appeal Is Your One and Only Trial

If your long-term disability policy is from your employer, your claim is governed by a complex and unforgiving federal law called ERISA (Employee Retirement Income Security Act).

This is the most important, and most dangerous, part of your case.

Under ERISA, the rules are stacked against you. You do not get a “do-over.” When Prudential denies your claim, you have 180 days to file an appeal. This appeal is not a simple letter asking them to reconsider.

This appeal is your one and only chance to build your case.

This is what’s known as the “Administrative Record.” Every document, every medical record, every expert report, and every legal argument you want to use must be submitted as part of this one appeal.

If Prudential denies your appeal and you are forced to file a federal lawsuit, the judge is not allowed to see any new evidence. They can only review the Administrative Record you (or your attorney) built during that 180-day appeal window.

This means your appeal is your trial. If you submit a weak, incomplete, or “do-it-yourself” appeal, you have likely lost your case forever.

This is why hiring an expert ERISA attorney immediately is not a luxury—it is an absolute necessity.

How UQUR Fights Prudential

When you hire Uscher, Quiat, Uscher & Russo, P.C., you are hiring a team of veteran ERISA litigators who know this process inside and out. We do not just “file an appeal.” We build a trial-ready case designed to systematically dismantle Prudential’s denial and leave them with no choice but to reverse their decision or face a losing lawsuit.

Our process is a comprehensive legal and medical strategy:

  1. We Deconstruct Their File, Not Just Their Letter The first thing we do is use our rights under ERISA to demand your entire claim file from Prudential. This includes not just your denial letter, but all their internal notes, their “paper-only” doctor’s full report, and every other document they generated. We forensically analyze this file to find their procedural errors, their logical fallacies, and the evidence they “conveniently” ignored.
  2. We Build the “Objective” Medical Case We directly attack Prudential’s “no objective evidence” tactic. We don’t just resubmit your old records. We commission new, powerful, objective evidence to support your claim. This may include:
  • A Functional Capacity Evaluation (FCE): A comprehensive, multi-day test by a physical therapist that provides objective data on your physical ability to sit, stand, lift, carry, and more.
  • A Neuropsychological Evaluation: For cognitive claims (“brain fog,” memory loss, TBI, or mental health), this provides extensive, objective data on your memory, processing speed, and executive function.
  • Independent Medical Examinations (IMEs): We retain our own network of respected medical specialists to review your file, examine you, and write a powerful report that directly refutes Prudential’s paid reviewer.
  1. We Prove Your “True Occupation” We do not let Prudential redefine your career. We hire an independent Vocational Expert to write a detailed report on the actual material and substantial duties of your specific job. This report analyzes the physical, cognitive, mental, and stress-related demands of your profession, proving exactly why your medical condition makes it impossible to perform.
  2. We Arm Your Treating Physicians Your doctors want to help, but they are not lawyers. They don’t know how to “speak ERISA.” We don’t just ask them for a “note.” We arm them. We send them the denial letter, Prudential’s flawed medical review, and our vocational report. We then pose specific, detailed questions for them to answer, allowing them to legally and medically rebut Prudential’s “paper-only” doctor point by point.
  3. We Write the Final Legal Brief Finally, we package all this new evidence—the FCE, the neuropsych report, the vocational analysis, and the new physician statements—into a comprehensive legal brief, often 50-100 pages long. This brief methodically dismantles every point of Prudential’s denial, cites relevant case law, and proves, with overwhelming evidence, that you meet your policy’s definition of disability.

You Are Not Alone in This Fight

Prudential is a formidable opponent, but they are not unbeatable. They are counting on you to be intimidated by their denial letter. They are not expecting you to return with a team of experienced ERISA attorneys and a mountain of new evidence.

At UQUR, we know what is at stake. This is not just a claim; it is your financial future. It’s your home. It’s your family’s security. We have built our careers on holding these insurance giants accountable.

Do not let your 180-day appeal window close. Do not try to fight this battle on your own.

If Prudential has denied your long-term disability claim, contact Uscher, Quiat, Uscher & Russo, P.C. today for a free and confidential consultation. Let us review your denial letter and show you the path to winning the benefits you deserve.