When disability insurance companies deny claims for long-term disability benefits, they typically send you a letter that outlines the rights that you have and the steps that you can take to appeal the denial of benefits. For most group disability plans offered through employers, ERISA, a federal law, requires that individuals who have received a denial of benefits go through an administrative appeal process before they can file a lawsuit to challenge the denial in court.
Once you receive a denial of benefits, you should begin preparing your administrative appeal as quickly as possible. There are strict deadlines for appealing the denial of long-term disability (LTD) benefits, so you must make note of those deadlines to ensure that you do not miss them. As a result of these deadlines, you should collect the documents and information that you need to appeal as soon as you can. Most ERISA plans limit the time period to appeal a denial to 180 days from receipt of the denial letter. Thus, one must act quickly after receiving a long-term disability denial letter.
Next, you should visit your doctor and bring your denial letter with you. Your doctor may be able to specifically respond to the letter and explain to the insurance company why their denial of LTD benefits is incorrect. There also may be additional medical records to submit to the insurance company, diagnostic tests that your doctor can order, and other medical evidence that you can use to support your claim.
You also should determine if any medical records, tests, or evidence is missing from your insurance file that the insurance company relied on in making its decision on your claim. The insurance company must disclose all the information or documents that it used to make its decision. From this, you can determine if any necessary information is missing from your file or if the insurance company failed to consider it in making its decision.
Long-term disability claims are complex matters that require intensive knowledge of ERISA laws and regulations. As a result, you will need experienced legal representation and advice to pursue an ERISA-governed disability claim. Bonnici Law Group is a law firm focusing on ERISA long-term disability benefits and bicycle injury cases in San Diego, CA. When you need effective legal representation, contact Bonnici Law Group at 619-259-5199 or email us at email@example.com.