If you have an ERISA disability policy and your claim has been denied there are two reasons why you should appeal the denial of your disability benefits within 180 days of the date of the denial.
What Are The Two Reasons I Should Appeal My Denial of My ERISA Disability Claim?
1. The ERISA law requires a policy holder to “exhaust” their administrative remedies before filing a lawsuit. Your appeal is considered your “administrative remedy.” If you fail to timely appeal the insurance company may say that you can’t sue because you failed to exhaust your administrative remedies. Appealing preserves your right to sue your insurance company if they deny your claim again on appeal.
2. Your appeal is the last chance to submit medical, vocational and other relevant evidence of your disability to the insurance company. Before filing an appeal you should get an entire copy of the carriers file, and, if your smart, you should retain a disability attorney like Nancy Cavey.
Why You Should Have An Attorney Prepare Your Appeal If Your ERISA Disability Benefits Have Been paid.
Ms. Cavey does a comprehensive review of the denial letter and the Carrier’s file to determine all of the reasons why the Carrier improperly denied your claim. She’ll even develop the medical evidence necessary including submitting medical literature, have you undergo a functional capacity evaluation and even take the statement of your physician. It’s crucial that your appeal be thoroughly developed and documented because this is the last chance you’ll have to submit evidence if you have to file a lawsuit.
Under the ERISA statute the Court will decide your case entirely based on what was in the insurance companies claim file at the time of the final denial. In an ERISA case, you don’t get to testify nor do your doctors. The Judge only is able to perform a paper review of the case in making a decision whether to reverse the claims denial. If you don’t submit any new evidence, it’s more likely that a federal judge will uphold the denial.
What Should You Do If Your Claim Has Been Denied?
Its time for you to contact an experienced ERISA disability attorney. For a free 30 minute consultation like Nancy Cavey, who can help you get the disability benefits you deserve call (727)894-3188.