Denied Claims and Appeals, Don’t Waste Your Chance
Many employers offer group coverage long-term disability insurance as part of their employee compensation packages, providing a source of income for workers who are unable to work as a result of an injury or illness. Long-term disability insurance kicks in when short-term disability benefits expire, often after a period three or six months, depending on the policy.
Long-term disability provides benefits equal to a certain percentage of the person’s salary, and continue for a fixed number of years or until the person is able to return to work.
ERISA law adds complexity to disability claims
Most employer-provided long-term disability policies are governed by a federal law known as the Employee Retirement Income Security Act of 1974¹, which is more frequently known as ERISA.
Because ERISA is quite complex, it is not unusual for disabled individuals to be denied benefits as a result of application errors or incomplete documentation of their disabilities. Many others are denied benefits because administrators claim that the applicant’s disability is not covered by his or her policy.
When a long-term disability claim is denied, it is often still possible for the applicant to receive benefits by filing an appeal. However, if the appeal is not handled quickly and correctly, the employee can be permanently barred from recovering benefits for his or her disability. All too often, people who have been denied disability benefits wait too long to seek help and miss out on their chance to file an appeal. Many others attempt to handle the appeals process themselves and are barred from receiving benefits when their appeals are not successful.
How an attorney can help with an appeal
To preserve the best possible chances of having a denied claim approved on appeal, it is wise to contact a Philadelphia ERISA disability lawyer right away after being notified of the denial.
Typically, an appeal must be filed within 180 days after a claim has been denied. Because the process of preparing a successful appeal can be time consuming, it is important to take action quickly to make sure that the opportunity is not lost.
A lawyer who has an in-depth understanding of the ERISA law and is experienced handling long-term disability claims can handle the appeals process and make sure that the materials provided for the appeal are accurate and complete.
In addition, a disability lawyer can be a powerful advocate for a disabled individual when communicating with policy administrators. Because administrators are typically far more knowledgeable about ERISA than policyholders are, people seeking benefits are typically at a substantial disadvantage when attempting to handle an appeal on their own. A skilled Philadelphia ERISA disability lawyer can go a long way toward correcting this imbalance and helping disabled workers obtain the benefits they are entitled to.
Employee Retirement Income Security Act of 1974¹ – https://www.dol.gov/general/topic/retirement/erisa