Receiving a denial of your long-term disability claim can trigger a flood of anxiety. You are seeking vital benefits and the prospect of not receiving them can be stressful, to say the least. If you have received notice that your long-term disability claim has been denied, you are probably wondering what, if any, options you have available. There is still a chance that you can appeal the denial of your long-term disability claim. How to appeal will largely rest with the nature of your disability insurance policy. The important thing is to know that you have options and not to give up hope. While it may be discouraging to receive that initial denial, it is not the end. Many long-term disability insurance claims that are initially denied end up being successful.
How Do You Appeal a Denial of a Long-Term Disability Claim?
The first step to appealing a denial of a long-term disability claim is to get a copy of your disability insurance policy. If it is through your employer, you may be able to get a copy by contacting your company’s human resource department. In the alternative, you may send a written request for a copy from the plan administrator at the insurance company. The policy will include the procedure for how you can appeal a denial of your claim. It is likely that the insurance company has their own internal protocols for reviewing denied claims. In the vast majority of cases, you will need to exhaust these internal protocols before you have the option of filing a lawsuit such as a federal ERISA case.
In addition to reviewing your policy, review your denial letter. Pay special attention to the reasons why your claim was denied. Reversing the denial could be as simple as providing further information that is necessary to approving your claim. The denial letter should also provide you with how and when to file an appeal. There is likely to be strict deadlines in place for filing appeals. Take care to file your appeal in a timely manner as passing deadlines are an easy way to get your appeal quickly denied once again.
While you are in the process of appealing your claim denial through the insurance carrier’s internal process, be sure to “stack the administrative record.” This means providing as much evidence in support of your claim as possible. Verify that the insurance company has received all relevant medical records and find any records that are missing. Ask the insurance claims adjuster if more radiographic studies and objective testing such as MRIs, blood tests, and other lab work would help support your claim. If it would, undergo said testing and submit the results as soon as they become available. Get letters from your friends, families, and treating medical professionals attesting to the limitations you have as a result of your disabilities. Submit these along with expert testimony such as that of a vocational expert. A vocational expert has specialized knowledge regarding job duties and the effects of certain disabilities on the ability to perform said job duties. Stacking the administrative record during the internal claims appeal process is critical should you need to go on to file a federal ERISA lawsuit later on. In the majority of cases, the court will not admit evidence not available to the insurance company during the claims review process.
Disability Advocates will help you file your disability claim. We are also here to help advocate on your behalf should you need to go through the claims appeal process. For all of your disability benefit needs, we are here for you. Contact us today.