Long-Term Disability Appeals Legal in Metairie, Louisiana
Long-term disability insurance is a terrific benefit to have. However, obtaining benefits can be a challenge. Special federal laws apply when you receive long-term disability (LTD) insurance through an employer, and these laws have tight deadlines that all applicants must follow.
Please contact our law firm today to speak with a Los Angeles long-term disability appeals attorney. We understand all relevant laws and will do everything possible to ensure that you put your best foot forward when making a claim.
Long-Term Disability is Not Social Security Disability
The Social Security Disability program is administered by the federal government and provides benefits to those with qualifying disabilities. However, many employers also offer LTD policies through private insurers.
Generally, a person will qualify for LTD benefits if they are injured in a non-work accident or incident that prevents them from working. Obtaining benefits from a private insurer is not easy, with many insurers denying legitimate claims. However, workers have the right to an appeal, and they should meet with a lawyer for assistance.
Federal Law Regulates the Appeals Process
The Employee Retirement Income Security Act (ERISA) governs the administration of employer-sponsored benefit plans, including long-term disability. If you get your LTD policy through an employer, you are covered under this law.
Congress passed ERISA to protect workers. However, the law is confusing for many people, even for inexperienced lawyers.
Under ERISA, you generally get only 180 days from the day you received your denial letter to file an appeal with your insurance company. They should have a process in place and notify you of what you need to do. But you absolutely cannot miss this deadline.
You also need to fully build the evidentiary record for your claim. For example, an insurer might have denied benefits on the grounds that your injury is not serious enough. You need evidence—medical records, test results, statements from a doctor, etc.—to support your claim. However, you cannot delay obtaining this evidence. You have a brief window of opportunity to build an evidentiary record, and without this evidence any appeal will be difficult.
There Are Many Levels of Appeal
The appeals process is not a one-and-done affair. However, you need to follow the right steps, otherwise you lose rights.
First, you must exhaust any administrative appeals process. These are internal appeals with your insurer, not a judge. The administrative appeals process can be cumbersome, and there might be multiple opportunities to have the insurance company look again at whether you qualify for benefits.
Second, you can file a lawsuit in court—but only once you exhaust all administrative appeals. If you jump the gun, a judge will dismiss your case, and you might receive no benefits.
Furthermore, you don’t get to supplement the evidentiary record when you go to court. Instead, a federal judge will only look at what is in your file. As mentioned above, you need to get all supporting documentation early to your insurer.
Why a Long-Term Disability Appeals Lawyer is So Important
Insurance companies have grown so large because they are stingy when paying out benefits. They also have boatloads of lawyers fighting for their interests. Without the right legal counsel in your own corner, you face an uphill battle getting the benefits you need.
Please call our firm today. We offer a free consultation to discuss your disability.