As a person living with Multiple Sclerosis (MS), you may experience a wide range of physical and mental symptoms that make it difficult or impossible to continue working. In such situations, group long-term disability benefits provided by your employer can be a lifesaver. However, if your claim for benefits is denied, it can be devastating.
The Employee Retirement Income Security Act (ERISA) is a federal law that governs employee benefits plans. Under ERISA, group long-term disability benefits are considered an employee benefit, and as such, have specific guidelines and procedures for filing claims and appealing denied claims.
If you have been denied long-term disability benefits under an ERISA-covered plan, the first step is to understand your legal rights and options. You have the right to appeal the denial of your claim, and it is essential to have an experienced ERISA attorney on your side who can help you navigate the complex appeals process.
The appeals process for ERISA-covered plans has strict deadlines and requirements that must be followed. The first step in appealing a denial of benefits is to request a review of the decision from the insurance company. This review must be done within a certain time frame, usually 180 days from the date of the denial letter.
During the review process, the insurance company will look at the information in your claim file and any additional information you provide. They will also consider any medical or vocational experts’ opinions and review your medical records to determine if your disability meets the plan’s definition of a covered disability.
If your claim is still denied after the review, the next step is to file an administrative appeal. This appeal must also be done within a certain time frame, usually 60 to 180 days from the date of the denial letter. In the administrative appeal, you will provide additional information, such as medical records, expert opinions, and statements from your employer, to support your claim for benefits.
If the administrative appeal is denied, the final option is to file a lawsuit in federal court. An experienced ERISA attorney can help you evaluate the strength of your case and advise you on the best course of action.
When appealing a denial of long-term disability benefits under ERISA, it is crucial to have an attorney with experience in ERISA litigation. ERISA law is complex, and the appeals process can be challenging. An attorney can help you understand your rights, navigate the appeals process, and fight for your rights to receive the benefits you deserve.
In conclusion, being diagnosed with MS can be a difficult journey. However, there are options available to help you manage your condition, and group long-term disability benefits can provide much-needed financial support. If your claim for benefits has been denied, don’t give up. With the help of an experienced ERISA attorney, you can fight for your rights and appeal the denial of benefits. Contact Walker & Hern today for a free attorney consultation to discuss your case and explore your legal options.