Assisting with ERISA Appeals
Your employer offered long-term disability insurance as part of your benefit package. You accepted this, believing that the insurance would be there when you needed it. Now you are unable to work and the insurance company has denied your claim for disability coverage and may have even discontinued your insurance all together. They have also told you your claim is governed by a complicated federal law called the Employee Retirement and Income Security Act (ERISA). If you find yourself in this situation, you need the help of an experienced attorney in order to obtain the benefits you deserve.
To learn about your rights and options after your ERISA long-term disability insurance claim was denied, contact a knowledgeable lawyer at Burnside Wall LLP. We have been helping people appeal claim denials for many years, and have the knowledge and experience needed to develop a strong case on your behalf.
An ERISA Appeal Requires Special Knowledge
Unlike other long-term disability appeals, an appeal of a rejected claim under ERISA must be submitted under special rules, rather than by filing a breach of contract lawsuit under state law. Success requires a detailed understanding of these rules. For example, proper documentation must be prepared and submitted in support of your claim so the court will have an adequate administrative record upon which to rule. If the administrative record is not sufficient, the chances of prevailing are slim. If any piece is missing, the insurance company may use that to deny your appeal and the court may affirm that decision. It is important that your ERISA appeals lawyer understands all these details.
Timing is also very important. Every item supporting your claim should be submitted to the insurance company during the window of time provided for an appeal. For instance, when the long term disability insurance company denies your claim or terminates your benefits, they may provide you 180 days to appeal their decision and submit additional information. This may be your only chance to perfect the administrative record which the court will ultimately use to decide your case. Consulting an experienced ERISA attorney at this point will significantly improve your chances of prevailing. If you wait until your appeal is denied and your administrative remedies are exhausted, it may be too late.
In addition to filing all the required reports, we work with vocational rehab experts to document disability — you need to prove that you are unable to perform your current job, or any job, depending on the type of claim. We help obtain a narrative report from the rehabilitation expert and other documentation that builds an administrative record on which an appeal is based.
Speak with an attorney with experience handling long term disability insurance claims and ERISA appeals. Contact Burnside Wall in Augusta, Georgia. Call us toll-free at 866-284-8226 for help with any matter involving ERISA.
