Can I Appeal the Insurance Company’s Decision if I am Denied Long Term Disability Insurance?

If you find yourself physically or mentally unable to return work, you most likely have several concerns. Will you receive long term disability insurance? Will you be able to afford your way if life if not? These are all common, though serious concerns. If you are denied your long term disability insurance, you may find yourself in a very complicated situation. This is why you must contact an experienced long term disability attorney today who will fight for the benefits you deserve. If your long term disability claim has been denied, here are some of the questions you may have:

What is ERISA?

ERISA stands for the Employee Retirement Income Security Act. ERISA is the governing law over long term disability insurance claims. If your insurance company denied you of the benefits you feel entitled to, you may file an administrative appeal. Once your long term disability claim is denied, you will have 180 days to file this appeal. You will receive a letter from your insurance company stating you can “request a review” of the decision, where you may be able to include additional information that may support your claim. Do not do this. The review is not an informal process. It is a formal administrative appeal required by federal law, which essentially places the appeal right back into the hands of the insurance company. Since they denied you the first time, they very well may deny you again, regardless of the information you provide. Once you file an administrative appeal with the insurance company, you may not submit any other information regarding your case, and this record will serve as the sole evidentiary basis for a judge to decide whether or not the insurance company should have paid your benefits. 

Can I write an appeal letter myself?

While you are allowed to do so, insurance companies will probably hope you do so as well. If you hire an attorney, he or she will write your appeal letter, work with your doctors, gather all the necessary information, and will help you build your case. 

Can I receive long term disability insurance even if my claim has been denied after going through the appeals process?

If you are still denied your long term disability benefits after you have made your appeal, you may wish to consider a lawsuit against the insurance company. You generally have to appeal your claim once before you are allowed to file a lawsuit. Your lawsuit will take place in federal court and a judge will make a decision without a jury present. This is why it is so important you hire a knowledgeable attorney who will optimize your results of winning your claim.

Contact our experienced firm

If you or someone you know is looking to receive long term disability benefits and needs the help of an experienced attorney, contact Walker & Hern today.

Our firm has significant experience helping people just like you retain or defend their Long Term Disability Benefits. Contact Walker & Hern for a free consultation.

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