ERISA Experience You Can Rely On.

What Happens When My Long Term Disability Claim is Denied?

On Behalf of | Aug 16, 2016 | Firm News

Unfortunately, many individuals who apply for disability under the federal Employee Retirement Income Security Act (ERISA) are denied the benefits they need. This is often a result of applications being evaluated by claims administrators who work for insurance companies and have an inherent conflict of interest.

When denials do happen, applicants have rights and protections they can assert. At ERISA Law Center, we work with clients across the nation to help them during all phases of appealing, litigating, and settling claims.

Although every case is different, and while the state in which you filed your application may play a role in how you handle the process, there are certain general steps to take after your long term disability claim is denied. These include

  • Get a copy of your claim file – Insurance companies are required by law to provide you with a copy of your claims file at no cost. This can help you and your attorney, should you choose to work with one, as you move forward after an appeal.
  • Filing an appeal – Under ERISA, you must file one or more appeals following a denial, depending on your insurance policy, before you may be eligible to file a lawsuit against an insurance company.
  • Compiling evidence – Insufficient medical evidence is one of the most common reasons for having a long term disability claim denied. To strengthen an appeal, make sure all medical records, doctors’ statements, and evidence of regular medical treatment are provided. This helps bolster your claim and prove that you meet the insurance company’s definition of disability. Personal statements, video recordings of you describing your limitations, and independent medical reviews can also provide additional support during your appeal.
  • Working with an attorney – Working with an experienced attorney can make all the difference in your case. By getting a lawyer involved as soon as possible after a denial, you can ensure you have help meeting evidentiary requirements, deadlines, and other legal elements involved in your appeal process and the best possible chances of securing a favorable resolution.

At ERISA Law Center, our clients benefit from working with caring and compassionate professionals who have extensive experience handling successful claims. If you have been denied long term disability benefits and want to learn more about your rights and next steps, we encourage you to reach out to us as soon as you can. Contact us to get immediate help.