Principal Long-Term Disability Claim Denials

In the realm of securing one’s financial future against unforeseen health crises, long-term disability insurance stands as a beacon of hope. Yet, the path to claiming these benefits is fraught with complexity, particularly when dealing with denials from insurance giants like Principal. If you find yourself in the throes of such a predicament, undertaking the appeal fight requires not just perseverance but a strategy crafted with precision. Working with the law firm of Robinson & Warncke greatly increases the odds of you getting the benefits you deserve.

Understanding the Gravity of Your Denied Claim

Appealing a Denied Principal Long-Term Disability Claim
The moment you’re faced with a Principal long-term disability claim denial you need to understand the importance of hiring an experienced firm to help you handle the appeal. The implications extend beyond immediate financial strain, touching upon your future security and well-being. Handling the appeal is a very specialized process.  We do not recommend you attempt to appeal on your own.  We have seen many unrepresented claimants do irreversible harm to their claims by failing to recognize their procedural obligations and pitfalls or the substantive evidentiary requirements to support a disability insurance appeal.  Insurers such as Principal will offer only vague statements regarding the type of evidence that will support an appeal and often mislead through omission.

The Bedrock of Your Appeal: Knowing Your Policy Inside Out

Diving Deep into Policy Details: The first layer of your strategy lies in a detailed understanding of your policy terms. It’s not just a document; it’s your playbook for the appeal. Each clause and condition outlines the roadmap of what’s expected from you and what you can demand from Principal. Often, the claim denial rests on a misinterpretation of those terms or overlooked details within your medical records or policy stipulations. Identifying these discrepancies forms the cornerstone of your appeal narrative.

Medical Evidence:

Compiling a Comprehensive Medical Portfolio: A denied claim is often traced back to gaps in medical evidence. Thus, assembling a robust medical dossier that includes every supportive doctor’s visit, test result, and treatment note, becomes your priority. Keeping a detailed history of your medical treatments, issues and outcomes is critical to the success of your claim.

Expert Opinions: In most cases, your existing medical records are not enough on their own to achieve success on a disability insurance appeal.  Instead, you should obtain additional expert medical opinions and testing to reinforce your claim. This means creating new medical evidence that is highly technical in nature. Nonlawyers often rely on their treating physicians to write a supporting statement or letter which the physician mistakenly believes will be sufficient.  These types of letters are often conclusory and lack the specific objective support and detail as to how that evidence translates into specific work impairments.   The experienced attorneys at Robinson & Warncke specialize in long-term disability claim appeals and can assist you in identifying and arranging the best experts and medical or functional testing to support your claim. Their insights can often make the difference between winning and losing your appeal.

The Legal Front: Allies in Your Fight Against Claim Denials

The Role of Disability Attorneys: Navigating the labyrinth of insurance law is daunting. Here, disability attorneys step in as invaluable allies, offering expertise to fine-tune your appeal and anticipate Principal’s counter-arguments.

Understanding the ERISA Overlay: For many, the Employee Retirement Income Security Act (ERISA) governs their disability claims. Knowledge of ERISA’s nuances can significantly influence the appeal process, especially in strategizing your approach based on its strict timelines and procedural quirks. Omitting important evidence during the appeal can cause otherwise valid claims to become impossible to overturn.

Crafting Your Appeal:

Personal Narratives: Connecting the Dots: Your appeal isn’t just a collection of documents; it’s your story. Personalizing your narrative with the real-life impact of your disability adds a compelling dimension that raw data alone cannot convey. Robinson & Warncke will help you and your corroborating witnesses get critical testimony into the evidentiary record.

Meeting Deadlines: Timeliness is not optional. Adhering to Principal’s and, if applicable, ERISA’s strict deadlines ensures your appeal doesn’t fail on procedural grounds.

Beyond the Appeal:

Potential for Litigation: Should the appeal not sway Principal, ERISA authorizes you to file a lawsuit.  And sometimes filing a lawsuit without appealing is in your best interests, especially where Principal violates its ERISA regulatory obligations when deciding your claim.

Under the Department of Labor’s ERISA claim regulations, Principal must “strictly comply” with several regulatory obligations in handling your original claim and appeal.  These obligations include meeting strict deadlines and giving timely and specific written notices when seeking to extend those deadlines.

If Principal fails to comply with these obligations the regulations authorize an immediate lawsuit, with some significant legal advantages for doing so. Analyzing these issues requires very specialized knowledge. It is highly unlikely that a non-expert will recognize the issues, much less know how to act on them.  This is another way that the specialist attorneys at Robinson & Warncke can add tremendous value.

Staying Resilient

The Emotional Toll of the Process: We are very much aware of the emotional toll this process takes on our clients.  You are too sick to work and the insurer, by denying your claim, has basically said “we don;t believe you and your doctors.” You are in a cash crunch because you are not receiving the income replacement you expected from your disability insurance. One of the intangible benefits of hiring a specialist law firm is that you are no longer trying to navigate the unfamiliar minefield of proving an ERISA disability claim. We have been told by countless clients that the act of hiring an attorney removes a great deal of stress. They can then focus on their physical and mental well-being while we deal with the insurance company.

Insurance Policies and the Fine Print: A Closer Look

Policy Updates and Amendments: Insurance policies are not set in stone. Keeping abreast of any updates or amendments to your policy or Principal’s general guidelines can reveal new avenues for your appeal or important procedural changes.

Understanding Exclusions and Limitations: A deep dive into the fine print of your policy might uncover specific exclusions or limitations that were the basis for your claim’s denial. This knowledge allows for a targeted approach in addressing these issues in your appeal.

The Final Push: Submitting Your Appeal

Organizing Your Documentation: As the submission deadline approaches, ensuring that your documentation is organized, comprehensive, and follows Principal’s submission guidelines is critical. A well-organized appeal can facilitate a smoother review process by the appeals committee.

Following Up Diligently: Once your appeal is submitted, the waiting game begins. However, passive waiting is not advisable. Regular follow-ups with Principal, while not overstepping bounds, can keep your case active in their minds and demonstrate your commitment to pursuing your claim.

Appealing a denied Principal long-term disability claim is a journey marked by legal complexities, emotional resilience, and strategic planning. It’s a battle not just for financial benefits, but for recognition of your lived reality. Working with the attorneys at Robinson & Warncke can make the difference between winning and losing your claim. Call us today and let us fight for you.