If your long-term disability claim has been denied, you're not alone. Many people face this situation, but you must take a critical step to fight back: filing an administrative appeal. Almost every time a disability claim or benefits are denied, the next move is to submit an appeal directly to the insurance company. This appeal is not just a simple rebuttal—it's a comprehensive and strategic document crucial in overturning the denial. Here's what you need to know about filing an administrative appeal and how a skilled attorney can improve your chances of success.
Understanding the 180-Day Window for an Appeal
When a long-term disability claim is denied, you have 180 days to file your appeal. This deadline is extremely important—missing it could prevent you from being able to pursue your claim further. During these 180 days, you and your legal team must work together to compile all the necessary information and make the strongest possible case for why the denial was wrong. The appeal itself is a written document that outlines why you disagree with the denial and explains why the insurance company made an error in denying your benefits. Filing a well-prepared appeal is essential because it could be your last chance to secure your benefits before considering further legal action.Key Steps in Preparing a Strong Appeal
At Bonnici Law Group, we take several key steps to ensure that our clients' appeals have the best chance of success. Here's how we approach every case:- Dissecting Your Administrative File: The first step is thoroughly reviewing your entire administrative file. This includes every piece of information that the insurance company had when they decided to deny your claim. By carefully analyzing what evidence was considered, we can better understand the basis for their decision and identify any gaps in their assessment.
- Examining the Denial Letter: The denial letter issued by the insurance company will explain why they denied your benefits. We review this letter in detail, looking for any errors, inaccuracies, or misstatements. These mistakes can be exploited in the appeal to show that the insurance company's decision was flawed.
- Ordering Additional Medical Records: Medical records are crucial evidence in any disability claim. We go beyond just reviewing the records the insurance company used in their decision. If you have continued receiving treatment after the denial, we gather any new medical records that can support your claim. This ensures that your appeal includes the most up-to-date information about your condition.
- Recording In-Person Testimony: One unique approach we take at Bonnici Law Group is gathering testimony from our clients. We conduct in-person video recordings of the disabled claimant under oath, allowing you to tell your story in your own words. This allows the insurance company to see more than just paperwork—they see a real person with a life impacted by the disability. This human element can be incredibly persuasive in showing the insurance company that you are more than just a file.