If your employer provided disability insurance carrier has denied your claim, the results could be disastrous. Assuming you have a valid claim, and you truly are suffering from a long-term disability, you need those benefits. They might be the only means you have of paying for your residence or providing for your family.
The good news is that a long-term disability benefits claim denial is not the end of the story. Although the appeals process can be long and daunting, you still have a chance to get the benefits you need and deserve.
Understanding the appeals process
It is important to understand the basics of the appeals process. Although each case is unique, the general process moves forward like this:
- Initial application and denial: Of course, the process starts with your initial application for benefits. Although many claims are denied upon the initial application, you can do a lot here by getting proper medical reports and all the supporting documents in order. This stage is very important.
- Appeal preparation: Once you receive the denial letter, it is time to start planning for the appeal. Often, the letter itself will give a some indication of what you can do to successfully appeal. It is optimal, at this stage, to work with an experienced lawyer who can interpret the letter in light of the relevant policy terms for your specific long term disability insurance policy, to help you determine your next steps.
- Administrative appeal: In employer-provided insurance disputes regarding claim denials, you cannot legally bring a lawsuit until you have gone through the administrative appeal process. The administrative appeal process involves your submission of your appeal and the insurance company’s review of your appeal.
- Federal court case: If your claim is denied on the administrative level, this is the time to consider whether you want to bring the case to court. Again, you should not even consider this move without first talking with an experienced attorney you trust to talk you through your options.
While employer-provided disability insurance is a great idea, and it is a wonderful benefit when it works, disabled claimants should generally have an attorney on their side to make sure the insurance company follows the rules so that you can obtain the benefits you need.