What Evidence Does The Standard Consider When Reviewing a Denial Appeal?

When The Standard denies a long-term disability (LTD) claim, the appeal process becomes your one critical chance to correct the record and present the strongest evidence possible. Many claimants don’t realize that ERISA appeals are closed-record—meaning whatever you submit during your appeal is often the only evidence a court can review later. That makes it essential to understand exactly what The Standard looks for and what documentation can strengthen your case.

1. Complete Medical Records

The Standard will closely review all medical records related to your condition, including:

• Office visit notes
• Specialist evaluations
• Hospitalization and surgical records
• Diagnostic imaging (MRI, CT scan, X-rays)
• Lab results
• Treatment plans and referrals

However, note that insurers don’t just want records—they want objective proof of functional impairment. If your medical file lacks detail, The Standard may argue your symptoms aren’t severe enough to prevent work, even if your doctor believes you’re disabled.

2. Detailed Physician Statements

Doctor support is one of the most influential components of a successful appeal.

The Standard pays close attention to:

• Narrative statements explaining your diagnosis
• Specific physical or cognitive limitations
• Prognosis and expected recovery timeline
• Why you cannot perform the essential duties of your occupation
• Any restrictions related to stamina, pain, concentration, or mobility

Generic statements like “patient is unable to work” rarely help. Insurers want precise, functional descriptions tied directly to job duties.

3. Functional Capacity Evaluations (FCEs)

An FCE can provide objective data about your ability to lift, stand, walk, sit, focus, and perform other work-related tasks.

A strong FCE can counter The Standard’s claims that:

• Your symptoms are “subjective only”
• You are capable of sedentary or light work
• Your reported limitations don’t match your medical records

Poorly performed or insurer-arranged FCEs can actually hurt your case. An attorney can help you determine whether an FCE will strengthen your file.

4. Vocational Evidence

Because The Standard evaluates whether you can perform your own occupation (and later, any occupation), vocational analysis is key.

Vocational evidence may include:

• A formal vocational assessment
• Job descriptions from your employer
• Industry-standard occupational requirements
• Evidence of diminished earning capacity

This helps show how your condition prevents you from performing the material duties of your job—not just that you have a medical diagnosis.

5. Symptom Diaries & Daily Activity Logs

For conditions such as chronic pain, migraines, autoimmune disorders, long COVID, or cognitive impairments, daily activity logs can be powerful.

Your diary should document:

• Pain levels
• Triggering activities
• Fatigue patterns
• Medication side effects
• Mental clarity or brain fog episodes
• Recovery time after routine tasks

These records help fill gaps when symptoms fluctuate or don’t show up on diagnostic imaging.

6. Testimony From Family, Friends, or Coworkers

The Standard sometimes discounts self-reported symptoms. Third-party statements offer additional credibility.

Helpful details may include:

• What tasks you can no longer perform
• How your condition affects your work performance
• Changes in your physical or cognitive abilities
• Attendance issues before your leave
• Observations of pain, fatigue, or mental decline
• Signed statements add context that medical records alone cannot capture.

7. Independent Medical Opinions (IME / Peer Review Responses)

If The Standard relied on:

• A paper review by one of their hired doctors
• An adverse IME
• A biased peer review

…you can submit rebuttal opinions from your own treating physicians or independent specialists.

These rebuttals can challenge:

• Incorrect assumptions
• Misinterpretations of your records
• Outdated or inaccurate medical conclusions

A strong rebuttal can significantly shift the weight of evidence in your favor.

8. Evidence The Standard May Not Request — But You Should Include

Insurers rarely ask for the documents that help you win. Consider adding:

• Social Security Disability (SSDI) approvals
• Pharmacy records showing long-term medication use
• Emergency room visits tied to flare-ups
• Physical therapy progress notes
• Neuropsychological testing (for cognitive claims)
• Pain management records
• Employment records confirming job limitations

If The Standard overlooked evidence during the initial claim, now is the time to submit it.

Why Submitting the Right Evidence Matters

In an LTD appeal with The Standard, you typically get one shot to build the administrative record. Once the appeal decision is issued, the file usually closes—and judges can only review what’s already inside it.

That’s why working with a disability attorney during your appeal can make the difference between a reversal and a permanent denial. Your lawyer can help ensure:

• All missing medical records are gathered
• Provider statements address the right legal standard
• Vocational experts are used when needed
• The insurer’s conclusions are challenged effectively

A well-documented appeal file puts pressure on The Standard to reconsider the denial and improves your chances of success in court if the insurer refuses to reverse course.

Need Help Appealing a Denial From The Standard?

If The Standard has denied your LTD claim, you don’t have to navigate the appeal alone. An experienced disability attorney can help you build a compelling, evidence-driven appeal that meets ERISA’s strict standards and gives you the strongest chance of getting benefits restored.