Filing a long-term disability claim through insurance provided by your employer? This means your claim is governed by a complicated area of law called ERISA.
Because of the complexities of this area of law, it’s important to have the support of an ERISA disability lawyer. As an ERISA expert, your lawyer can help you to fulfill strict requirements and avoid potential mistakes so you can get the disability benefits you deserve.
Why ERISA is complicated
ERISA stands for the Employee Retirement Income Security Act of 1974, the federal law that regulates employee benefits. ERISA is a continually changing area of law. Its goal is to protect employees and ensure their right to benefits. However, there is nothing straightforward about it.
Your employer generally does not provide your ERISA disability insurance but hires a big insurance company to do that. While you paid for benefits through your employer, it’s the insurance company that is making the decisions. That same insurer will be looking for ways to deny your claim to increase its bottom line.
These insurers hire an army of doctors, experts, and lawyers to go up against you. When you are injured or facing illness, the last thing you want is to traverse this incredibly nuanced and complicated area of law to get the benefits you have paid for and deserve.
If your claim is denied and you are faced with an appeal, you should consider hiring an experienced ERISA disability lawyer.
How ERISA works for you
ERISA sets minimum standards for employee benefit plans provided by employers. It also requires that insurers create and follow a grievance and appeal process.
There are highly specific and strict guidelines and timelines associated with the appeal process. Even one missed deadline could mean a denial of your appeal. Unless you are aware of your rights and responsibilities at each stage of your claim, you may miss one of these deadlines without even realizing it.
ERISA policies are not like other disability benefits. Disability attorneys that do not specialize in ERISA law might not understand both the basic timeline requirements and how to develop an effective strategy that works within the applicable regulations.
Read more: ERISA vs. Individual Disability Insurance: What You Need to Know
Build a solid strategy when you’re denied
In a long-term disability appeal, there is much critical investigative work taking place by your insurer:
- Collection of substantiating evidence that you are disabled
- Analyzing the insurance company’s claim file to figure out, poke holes, and find flaws in its denial
- Filling out extensive questionnaires on your disability and ability to work
- Communications from your doctor or doctors to the insurer’s medical team
- Requests of information from your insurance company
- Writing a persuasive appeal that brings together all of the evidence for your claim, while simultaneously refuting the reasons for the insurance company’s denial
The stringent deadlines through ERISA are inflexible. You have just 180 days to appeal your denial, which may seem like an adequate amount of time. However, each step in the process of preparing a thorough and well-planned appeal needs to be balanced against that deadline.
This is not the time to wait until the last minute, nor is it the time to do-it-yourself.
This is not the time to wait until the last minute, nor is it the time to do it yourself.
When you have a denial of benefits, seek lawyers who specialize in the exact type of support you need. In this case, an ERISA disability lawyer who specializes in this area of the law.
You want someone who will immediately understand the issues surrounding your denial. They should also be able to provide you with expert feedback on how they would pursue your appeal on your behalf.
Fighting big insurance companies
Large insurers make it their business to deny claims like yours.
This includes (among others):
- Mutual of Omaha
- Principal Life Insurance
- Unum
- Reliance Standard
- Sun Life
- MetLife
- Lincoln Financial
- Prudential
- Hartford
- Standard Insurance
- Cigna
Insurance companies might advertise being there for you when you are in need. But the truth is they are always looking for ways to keep your money in their pockets and out of yours.
Also, once your insurance company approves your claim, they will always be watching, always revisiting your claim to see if they can deny you again. Long-term disability is not a set-it-and-forget-it thing – it’s an ongoing process.
Hire the team that knows ERISA disability inside and out
Roy Law Group practices ERISA and long-term disability law – nothing else. Our expert team goes up against big insurance companies every single day.
Don’t let a denial of long-term disability benefits get you down. Hire the best long-term disability attorneys to battle big insurance on your behalf. If we take you on as a client, you can rest assured that we will win or settle your case.
You are not alone. Contact Roy Law Group today and speak with one of our compassionate team members.