All long-term disability insurance policies contain strict time limits on your ability to file for benefits under those policies. For ERISA-governed long-term disability policies, which are typically those offered as part of a group benefit through your employer, there are various time restrictions on the processing of your claim and appealing any denials of benefits. Since it may take quite some time to be approved for long-term disability benefits, you typically should file your initial claim for benefits as quickly as possible after your disabling illness or injury makes you unable to work.
For instance, insurers under ERISA generally have 45 days in which to make an initial decision on your claim for long-term disability benefits. The plan administrator also can request an additional 30 days to process the claim if it properly notifies of its need for an extension. Likewise, the plan administrator may ask you to provide further information and give you 45 days to do so. Once you have provided any necessary information, the insurer should decide your claim within 30 days or within the timeframe outlined in your policy, whichever comes first.
If you receive an initial denial of LTD benefits, you generally have 180 days in which to file an appeal. Once you submit an appeal with the insurer as required by your plan, the insurer has 45 days to decide your claim. However, the plan administrator can request an additional 45 days in which to determine your claim.
If the administrator again denies your claim, thus exhausting your administrative remedies, then you may have another 180 days in which to file suit in federal court to further appeal the denial of benefits. If you must go through the entire appeals process to get benefits, it can take months or even years to get a final determination on your eligibility for benefits.
Given the initial timeframe for the plan administrator to make decisions on claims, any allowable extensions of time, the need to submit additional information, and the potential need for appeals, you may find yourself waiting a relatively length of time before you become eligible for benefits. As the administrative claims process with the insurer tends to be so lengthy, you likely will have ample time to supplement your medical records and provide additional information as it arises after filing your initial claim.
Bonnici Law Group provides client-focused representation throughout the ERISA claims process. We are here to consider the evidence in support of your ERISA long-term disability claim and evaluate your application. Next, we can develop the most effective strategy for fighting any denials of coverage that you may receive. Allow us to handle your legal needs while you focus on your physical and emotional health. Contact the ERISA long-term disability attorneys of Bonnici Law Group at 619-259-5199 or email@example.com.