If you have received a denial letter from your employer’s long-term disability company or plan, here is what you need to know:
1) You typically have 180 days to appeal the denial.
We say “typically,” because some policies may limit your period for denial. You could have more, or less than, 180 days to appeal your denial. Review your contract carefully to discover the deadline. If you don’t see a deadline for appeal in your policy or denial letter, contact an experienced long-term disability attorney to find out more.
2) “Appeal” does not mean writing a letter that says “I appeal.”
Appeals require more than just a statement that you disagree with the reasons for denial. You need to show that you have good reason to appeal and for the insurance company to reconsider your claim for disability benefits. If you cannot support your reasons for appeal, you may not be successful in securing benefits.
3) “Appeal” does not mean having your doctor write one letter saying “Mary is disabled.”
Disability insurance companies don’t always place a high value on your doctor’s opinion. In fact, they hire their own medical experts to evaluate your condition, many times without that “expert” examining you.
4) Federal judges have said that you are better off having an attorney handle your appeal.
A federal judge in evaluating a long-term disability claim said that individuals who appeal their disability claims without an attorney are “facing a loaded deck”. It is a good idea to speak with an attorney about your appeal before responding to the insurance company.
5) You should find an attorney who is experienced in “ERISA long-term disability cases.”
Not many attorneys specialize in ERISA disability claims. Do your research before you speak to an attorney and make sure that attorney has prior experience taking these cases to court.
6) Be aware that there are very few lawyers who have substantial experience in this type of disability work.
ERISA is very different from social security disability or workers compensation. However, many claimants assume these lawyers will have enough experience to help with their disability claims. This is simply not the case.
7) This is NOT social security, worker’s compensation, or retirement disability; this is a highly specialized practice area.
ERISA long-term disability is a world on its own. If you have been denied benefits, you should speak to someone who has very specific experience in this area of law. There are no substitutes, and someone who has experience in a tangential practice may not be prepared to handle your claim.
8) We also recommend that your attorney be board certified in civil trial advocacy and be highly rated on Avvo.com.
Treat shopping for an attorney like you are shopping for a car. Do your research and find one that fits your specific needs and has high ratings. You may be working with this attorney for many months, even years, so make your choice carefully.
9) Other good attorney rating sites are BestLawyers.com; SuperLawyers.com.
Avvo is not the only place to find attorney ratings. You can use the options mentioned above or search on Google, Yelp, and Facebook for lawyer ratings and reviews.
10) Finally, act quickly. 180 days seems like a long time. It’s not in the ERISA disability world.
For other practice areas, the statute of limitations is longer. For ERISA appeals, you have at max 180 days to file an appeal to get benefits. Once that window closes, you cannot take back the decision and are stuck with the outcome.
If you’ve received a denial letter, give us a call and let us help.