If you cannot work due to a disabling medical condition and are covered under long-term disability (LTD) insurance, it is important to know your rights. Although employer-sponsored disability plans are governed by the Employee Retirement Security Act of 1974 (ERISA), insurance companies frequently deny claims. At Disability Advocates Group, we regularly guide clients through all phases of LTD claims, including filing administrative long-term disability appeals under ERISA. When you become our client, our disability lawyers will stand by you every step of the way and help you obtain the benefits you deserve.
What is are ERISA/Long Term Disability Appeals?
ERISA sets guidelines and timelines for processing benefit claims of employer-sponsored disability plans. If your LTD benefits claim is denied, ERISA provides for an appeals process and the regulation requires a full and fair review of an adverse benefit determination. In particular, an ERISA appeal must be reviewed by a different claims examiner than the one who initially reviewed the claim.
On the other hand, ERISA gives insurers an unfair advantage over disabled workers. An appeal is a lengthy process with strict deadlines and exacting procedural rules. If you miss a deadline or make any missteps, your appeal will likely be denied. For this reason, it is crucial to have an experienced disability lawyer by your side.
At Disability Advocates Group, our legal team has handled long term disability appeals with all the major insurance companies. We have insight into the tactics insurers use to deny claims and a proven history of helping our clients obtain the LTD benefits they deserve. Our legal team will eliminate the stress from the process by handling the details of your appeal, including all dealings with the insurance company.
We are well-aware that submitting a well-conceived appeal increases the likelihood of having your claim approved. At the same, it is critically important to establish a comprehensive administrative record in the event your claim is denied and ERISA litigation becomes necessary — the court will not consider any information or evidence that was not submitted in the appeal.
Our disability lawyers have the skills and experience to win an ERISA appeal. We will work closely with your doctor to present convincing medical evidence and to prepare the necessary statements regarding your medical condition. Depending on the circumstances, we may recommend additional medical testing to substantiate your claim. We also routinely collaborate with a respected network of vocational experts who can provide information about the limitations your disability imposes on your ability to work.
In addition, we will work with you to prepare a personal statement detailing how your disability limits your daily activities; it may also be helpful to have family members, friends, and coworkers prepare similar statements. While we are confident we can win long term disability appeals, your claim may be denied, in which case we will consider filing a second appeal or litigating your claim in federal court.
Before you can proceed with a lawsuit, ERISA requires that you file at least one appeal; the terms of your LTD policy may even require a second appeal. It is important to note that ERISA litigation does not involve a jury trial or witness testimony. Instead, your case will be in the hands of a judge whose final decision is based solely on a review of the administrative record. While a federal judge may rule against you, pursuing a lawsuit may also convince the insurance company to negotiate a settlement.
Contact Our Los Angeles Long Term Disability Appeals Attorney
If your long-term disability benefits claim has been denied, you have a right to be frustrated. A LTD policy is a contract and insurers have an obligation to abide by its terms. Unfortunately, these policies are often tilted in their favor, which is why you should never go up against an insurance company alone. At Disability Advocates Group, we know how to level the playing field and have a proven history of pursuing successful ERISA appeals.
We understand the financial burden you are likely experiencing from not being able to work, which is why we will not charge any attorney fees until we win your appeal. If your long-term disability claim has been denied, you may be frustrated and not know where to turn. Please contact our office today to learn how we can help.