You work hard to support your family. If you suffer a devastating injury that takes away your ability to work, you’ll likely depend upon long-term disability benefits (LTD) to get your family through until you can get back to work.
But sometimes the applications for these benefits get denied, leading to significant stress and uncertainty for workers. If this happens to you and your family, you need to know what your options and legal rights are before you accept defeat.
California state and federal labor laws
In California, long-term disability insurance is regulated under various state and federal laws, including the Employee Retirement Income Security Act (ERISA), for most employer-provided benefits. One of the most important aspects of ERISA is that it creates the right for claimants to be given a full and fair review of any denied claims.
When a claim is denied, the insurer is required to provide a written explanation of the reasons for denial, reference the specific policy provisions on which the denial is based, and outline the process for an appeal.
The appeals process
Typically, claimants have at least 180 days to file an appeal after a denial. During this time, your attorney can walk you through the process of gathering additional medical evidence, expert opinions, and any other information that can help give your appeal the best chance of success possible, so that you can enjoy the disability benefits that you deserve.
Your attorney will handle the filing of the appeal, any necessary negotiations with the insurance company, and even litigation, if it comes to that. The sooner they get started, the better for your case, so it’s critical that you contact your attorney as soon as you receive notice of your claim denial.
Dealing with a long-term disability claim denial can be a daunting process, but understanding one’s rights and the steps to contest the denial is necessary in order to fight for your access to those benefits. With decisive action to show the insurance company that you won’t take no for an answer, you’ll stand a much better chance of ensuring that you receive the benefits that your family needs until you recover.