The appeal process may be your last opportunity to submit evidence in support of your disability. Once the appeal is decided and your file closes, your next step is to file a lawsuit. During litigation, you and the Court will likely be limited to only the information in your claim file at that time.
If your initial short-term or long-term disability claim is denied, or you are paid benefits and then benefits are terminated, you should have a right to appeal. ERISA regulations require you be given an opportunity to appeal the insurance company’s denial or termination of your claim.
In fact, under ERISA you must appeal before filing a lawsuit in court or your case will not be heard. In rare exceptions, you may be able to file a lawsuit before the insurance company makes its final decision of your ERISA LTD appeal.
Putting Together a Strong Appeal
There are several things that you can provide the disability insurance company to help with your appeal of a denial or termination of benefits. This includes:
- medical records,
- support letters from treating doctors, and
- independent examination results.
As part of its review of your appeal, however, the insurance company will likely load up on medical evidence supporting a denial of the claim. This may include conducting:
- Vocational reviews;
- Peer reviews;
- Independent medical evaluations;
- Functional capacity evaluations;
- And other reviews.
Because ERISA law is insurance-company friendly, it is important to hire an experienced long term disability attorney to handle your ERISA LTD appeal to ensure your case is as strong as it can be.
Last Chance to Provide Evidence
It is crucial to provide all evidence, medical or otherwise, during the ERISA LTD appeal process because it is often the last opportunity to submit information supporting your disability claim. This is because you typically cannot add any documentation to your case after an appeal decision is made.
Putting together the strongest appeal possible not only increases the chances of your disability benefits being approved or reinstated, but it also strengthens your case in court.
Most ERISA LTD cases are reviewed under an “arbitrary and capricious” standard, which requires the court to rule in the insurance company’s favor unless there was no reasonable basis not to pay the claim.
Help from a Lawyer with Expertise in Disability Insurance
This law firm was built to be a disability insurance law firm.
That focus means:
- All of our lawyers specialize in disability insurance claims;
- We have experience with every major disability insurance company;
- We have won important long-term disability lawsuits.
Our disability lawyers can help you with:
- Submitting your disability insurance claim,
- Appealing a long-term disability denial,
- Negotiating your lump-sum settlement, or
- Filing a lawsuit against your disability insurance company.
Hiring an experienced disability attorney is important. Because federal law applies to most disability insurance claims, our lawyers do not have to be located in your state.
Call (800) 969-0488 for a free consultation with an experienced disability attorney. Pay no fees or costs unless you get paid.
