How To Appeal A Denied ERISA Disability Claim
When your long-term disability claim is denied, you need to be provided with an opportunity to appeal the adverse determination. Then, there needs to be a full review of the claim. You may be able to file one or two appeals depending on the plan. Then, once the number of appeals that you are allowed to file has been exhausted, you will be allowed to file a lawsuit if you believe that you have not been given a fair hearing.
How The Appeal Process Works
The appeal process is an independent review. The individual who reviews your denial must be different from the individual who originally denied your claim. Your claim is most often denied when it is believed that you are not disabled. However, the definition of what is considered to be a disability can change over time. For example, early on in the claim process, being out of work is what is considered a disability. Later on, disability is based on whether you can perform any work as a result of your disability. Therefore, it is important to prove that you are disabled under the the insurance provider's definition of disability in order to not be considered disabled.
Appeals are important because the insurance provider is required to provide a reason for why your claim was denied. This can provide insight into why you are not qualified to receive disability. In order for the appeal process to be successful, there are strict guidelines and deadlines that you must meet. If you are unable to meet these requirements, you may be unable to appeal your denial.
Why An Attorney Is Necessary
The best way to handle an ERISA disability claim is to contact an attorney. Attorneys are able to use their legal knowledge to review your case and determine if the denial of your disability claim was justified. In order to do this, the attorney will obtain the claim file. The information that is found in the claim file is usually the only information that will be considered by a judge. By knowing what is in your claim file, you will be able to better defend your claim. You will need to fill the record with medical and vocational evidence that you are disabled in order to maximize the chances that your claim will be appealed and you will receive disability. A great lawyer will also allow you to avoid making mistakes that could lead to a denial. For more information, contact companies like Iler and Iler.