Appealing the Denial of Group Long-Term Disability Benefits Governed by ERISA: A Guide for Disabled Individuals with Parkinson’s Disease

Parkinson’s Disease is a debilitating condition that affects millions of people worldwide, including many individuals in the United States. For those living with Parkinson’s, everyday life can be a struggle, making it difficult to maintain employment and support oneself financially. This is where long-term disability benefits come into play. These benefits provide financial support to those who are unable to work due to their disability. Unfortunately, not all claims for long-term disability benefits are approved, and this can be devastating for those who are counting on this support to make ends meet. If you or a loved one has been denied long-term disability benefits for Parkinson’s Disease, you may have legal recourse under ERISA.

What is ERISA?

ERISA stands for the Employee Retirement Income Security Act of 1974. This federal law regulates employer-sponsored benefit plans, including long-term disability insurance. ERISA sets minimum standards for these plans, including requirements for plan administration, funding, and disclosure. ERISA also provides a framework for resolving disputes between plan participants and plan sponsors or administrators.

Why was your long-term disability claim denied?

There are many reasons why a long-term disability claim might be denied. Common reasons include:

• Insufficient medical evidence: To qualify for long-term disability benefits, you must provide medical evidence that proves your Parkinson’s Disease prevents you from working. If your medical records are incomplete or do not clearly demonstrate the severity of your condition, your claim may be denied.
• Failure to meet the definition of disability: Your long-term disability policy will define what constitutes a disability. If your condition does not meet this definition, you may be denied benefits.
• Pre-existing condition exclusion: Some long-term disability policies exclude coverage for pre-existing conditions. If your Parkinson’s Disease was diagnosed before you enrolled in the plan, you may not be eligible for benefits.
• Failure to follow treatment: If you fail to follow your doctor’s prescribed treatment plan, your claim may be denied.

What can you do if your long-term disability claim is denied?

If your long-term disability claim is denied, you have the right to appeal the decision under ERISA. The appeals process can be complicated, and it is essential to work with an experienced attorney who understands ERISA and disability insurance law.

As your attorney, I can help you with the following:

• Review your long-term disability policy and the denial letter to understand the reasons for the denial.
• Gather additional medical evidence to support your claim.
• Draft a detailed appeal letter that addresses each reason for the denial.
• Prepare you for any interviews or examinations that may be required during the appeal process.
• Represent you in administrative hearings or court proceedings, if necessary.

Time is of the essence when appealing a long-term disability claim denial. Under ERISA, you generally have only 180 days from the date of the denial to file an appeal. If you miss this deadline, you may forfeit your right to appeal.

Conclusion

Living with Parkinson’s Disease is challenging, and the denial of long-term disability benefits can make it even harder. Fortunately, ERISA provides a framework for appealing a denial and seeking the benefits you deserve. If you or a loved one has been denied long-term disability benefits for Parkinson’s Disease, don’t give up hope. Contact an experienced ERISA attorney today to discuss your options. Call Walker & Hern today for a free attorney consultation.