Appealing the Denial of Group Long-Term Disability Benefits Governed by ERISA: A Guide for Disabled People Represented by a Lawyer

As a disabled person, you depend on your long-term disability benefits to help you make ends meet and cover your medical expenses. Unfortunately, these benefits are not always easy to obtain, especially when they are governed by the Employee Retirement Income Security Act (ERISA). If your long-term disability benefits have been denied, don’t lose hope. With the help of a skilled lawyer, you may be able to appeal the denial and get the benefits you deserve.

Understanding ERISA

ERISA is a federal law that regulates most employee benefit plans, including long-term disability insurance plans. Under ERISA, insurance companies are required to act in good faith and fairly evaluate claims for benefits. If they deny a claim, they must provide a detailed explanation of the reasons for the denial.

Appealing a Denial

If your claim for long-term disability benefits has been denied, the first step is to review the denial letter carefully. The letter should explain the specific reasons for the denial, and it should also include information on how to appeal the decision. You will typically have 180 days from the date of the denial letter to file an appeal.

When preparing your appeal, it’s important to gather as much information as possible to support your claim. This may include medical records, letters from doctors, and statements from co-workers or family members about your disability and how it affects your ability to work. Your lawyer can help you gather and organize this information.

In addition, your lawyer can help you prepare a strong legal argument to support your appeal. This may involve reviewing the language of the insurance policy to ensure that the insurance company’s decision was not arbitrary or capricious. Your lawyer may also argue that the insurance company failed to give proper weight to medical evidence or that the decision was based on inaccurate or incomplete information.

Going to Court

If your appeal is denied, you may have the option to file a lawsuit in federal court. This can be a complex and time-consuming process, but it may be necessary to obtain the benefits you deserve. Your lawyer can represent you in court and help you navigate the legal system.

Conclusion

If your long-term disability benefits have been denied, don’t give up hope. With the help of a skilled lawyer, you may be able to appeal the decision and get the benefits you deserve. Remember, ERISA provides important protections for disabled individuals, and insurance companies must act in good faith when evaluating claims for benefits. By working with a lawyer, you can ensure that your rights are protected and that you have the best possible chance of obtaining the benefits you need to support yourself and your family.

Don’t go it alone! Contact Walker & Hern today for a free attorney consultation!