Deadline to Bring an LTD ERISA Denial Lawsuit

Less Time Than You May Expect
When a long-term disability claim is denied, most claimants assume they have years to decide whether to sue. In reality, the clock is often much shorter than they expect, and it may already be running before the claim is even finally denied.
ERISA itself contains no statute of limitations for a benefits suit brought under 29 U.S.C. § 1132(a)(1)(B). Congress left that gap for courts to fill, and for decades the default approach was to borrow the most analogous state limitations period—typically the period governing breach-of-contract claims, which can run anywhere from three to fifteen years depending on the state. That default rule, however, rarely controls in practice today, because nearly every group LTD policy now contains its own contractual limitations clause, and the Supreme Court has made clear that these clauses generally govern instead.
In Heimeshoff v. Hartford Life & Accident Ins. Co., 571 U.S. 99 (2013), the Court held that a plan and participant may agree by contract to a particular limitations period; even one that begins to run before the cause of action has technically accrued, so long as the period is reasonable. Many LTD policies set the clock running from the date “proof of loss” is due, not from the date the plan finally denies the claim on internal appeal. That means the administrative appeals process, which can take months, is eating into the same period a claimant will later have to file suit. The Court in Heimeshoff found nothing unfair in this, reasoning that ERISA’s mandatory internal review process and any contractual limitations period can coexist, and that participants who are diligent will normally have ample time left to sue even after exhausting administrative remedies.
Courts applying Heimeshoff have consistently enforced these contractual periods as written, and have upheld remarkably short windows. In University of Wisconsin Hospitals & Clinics Authority v. Southwest Catholic Health Network Corp., No. 14-cv-780-jdp, 2015 WL 402739 (W.D. Wis. Jan. 28, 2015), the Western District of Wisconsin enforced a 180-day contractual limitations period running from the plan’s final denial letter, dismissing the claim as untimely where the claimant there, a hospital pursuing an assigned benefits claim, waited 211 days to file. The court noted that the Seventh Circuit, in Doe v. Blue Cross & Blue Shield United of Wisconsin, 112 F.3d 869, 875 (7th Cir. 1997), has suggested even a 30- or 60-day window could be reasonable, since an ERISA suit following internal review is analogous to an appeal from an administrative decision. The lesson is straightforward: courts will not second-guess a plan’s chosen limitations period unless it is unreasonably short or a controlling statute displaces it, and 180 days or less is fair game.
A second, related trap involves equitable tolling. Courts have long recognized that contractual limitations periods, like statutory ones, can in rare cases be equitably tolled. For example, where a claimant diligently pursued both internal and judicial review but was prevented from filing suit by extraordinary circumstances. But that doctrine is narrow, and it applies specifically to limitations periods, which is the deadline to file suit. It does not extend to other contractual deadlines within a plan.
This distinction was the crux of Presnal v. Dearborn National Life Insurance Co., No. 3:23-CV-290-CCB, 2025 BL 291858 (N.D. Ind. Aug. 15, 2025). Although Presnal involved a life insurance conversion deadline rather than an LTD claim, the court’s reasoning is instructive for disability claimants because it relied heavily on ERISA limitations-period case law, including the Seventh Circuit’s Di Joseph v. Standard Insurance Co., 776 F. App’x 343 (7th Cir. 2019), an LTD case addressing tolling of a three-year suit-filing deadline. The Presnal court ultimately followed the Fourth Circuit’s decision in Hayes v. Prudential Insurance Co. of America, 60 F.4th 848 (4th Cir. 2023), holding that equitable tolling cannot be used to extend a plan deadline that is not itself a limitations period because no cause of action accrues, and no clock is running, until that kind of deadline is missed. (Id. at 854). The upshot for LTD claimants is that courts draw a sharp line: tolling may rescue a late-filed lawsuit in extraordinary circumstances, but it will not resurrect rights lost by missing other plan deadlines, such as timely submitting proof of continued disability.
For anyone considering an ERISA suit against an LTD carrier, the practical takeaways are simple but critical. First, locate the plan’s limitations provision—usually found in the summary plan description or policy—and calculate the deadline from the date proof of loss was due, not merely from the final denial. Second, do not exhaust the entire administrative appeals process without tracking how much of the contractual limitations period is simultaneously running. Third, do not count on equitable tolling as a backstop; it is reserved for genuinely extraordinary circumstances and diligent claimants, not routine delay. When in doubt, the safest course is to consult counsel as soon as a claim is denied, not after the internal appeal concludes.