Long-term disability denials are different than Social Security and Worker's Compensation. Long-term disability denials are insurance companies telling you that your injury does not meet the requirements of your long-term disability insurance that you have purchased either through your employer or individually. Once denied, in most cases, it can be a complicated process to appeal and get a decision in your favor. The primary goal of the long-term disability insurance provider is to make a significant profit, and they won't make a profit if they pay out your claim, and so they deny, deny, deny.
What can you do to appeal a denial of a long-term disability claim?
Well for starters, you can review this information here. It is our opinion that you should never try to file an appeal to a denial without first speaking with an experienced, ERISA long-term disability lawyer. The laws surrounding long-term disability claims are very complex and have led to the rejection of many claims and appeals. You not only are fighting the insurance company, but there are deadlines that you also have to meet, and many of them are short. Failing to file an appeal in the correct manner and before your deadline can result in the failure of the appeal before you even begin.
Do you know what ERISA stands for and how it relates to your long-term disability claim?
ERISA stands for Employee Retirement Income Security Act. It was created by Congress to help protect private health and pension plans. It also applies to some long-term and short-term disability plans. ERISA regulates explicitly how the disability plan claims are processed, deadlines and the individual's rights to appeal. Under most circumstances, you should have received a document or a brochure explaining your rights under your long-term disability plan that should notify you if your plan is covered under ERISA.
My ERISA Long-Term Disability Claim was DENIED, How can you help me?
An experienced ERISA lawyer has many tools available that you can use to file an appeal to your denial. Once your claim was denied, you will receive a notice of denial in the mail. This letter should outline why your claim was denied and provide you with a deadline date for an appeal. The letter you receive denying your benefits is the key to your appeal.
After receiving the denial letter, the first thing you should do is get in contact with an ERISA attorney. We can help you with that process right now; this is how:
- We can review your denial letter and provide you with a detailed strategy about how you should move forward with your appeal or if you should appeal it at all. (This step is the most important one and you must do this as soon as possible. Waiting will affect your appeal.)
- If you are even thinking about filing, we can provide you with information on what conversations you need to have with your doctors. This information is valuable and will help you have the best chance for your long-term disability claim to be approved.
- If by chance you were denied and then appealed on your own, don't lose hope. There still may be a second appeal available to you, and we should get started on that right away. (We suggest never getting to this point, it becomes problematic for you when someone has to untangle the mess that a prior appeal has created.)
I am ready to appeal my Long-Term Disability ERISA denial. What do I do now?
Contact our office, and we will get the ball rolling for you. We will ask you a couple of questions and request that you send us your denial letter. Once we have done an initial review of the letter, we will then let you know your next steps. If after the review you decide to move forward with an appeal, we will begin the steps necessary to get that done, including contacting the appropriate people to get the ball rolling.
Do not wait until it is too late; make sure you protect all of your available options once denied. There is a strict timeline as to when you have to file an appeal. We can provide you with the tools necessary to do that, but if you wait until it is too late, we may not be able to help you.