The ERISA long-term disability appeal is much different from the standard insurance denial case. Many people think that they do not need to take the appeal seriously because the insurance company will not overturn their own decision and rule in your favor. However, this misses the importance of the appeal. Without a strong appeal, you will not get disability benefits, and a long term disability attorney in Oakland can help.
While ERISA seemingly gives injured employees benefits, the law is not as generous as it appears on the surface. The insurance companies may as well have written the bill themselves with the amount of power that they are given. ERISA allows them to reject claims without having to worry about lawsuits for acting in bad faith.
The law does give you appeal rights, but these are also not unlimited. However, you must bring everything that you have to the appeal process because you may not get another chance to make your case.
ERISA allows for an appeal directly to the insurance company. You must include everything possible that would support your claim. This includes:
Your attorney would assist you in assembling everything that you need to make your case that you were improperly denied benefits.
The ERISA appeal can have very tight timelines. Never assume that you do not have any chance of success with the appeal. In fact, many people who initially were denied benefits receive them through the appeals process. The insurance company may end up in court if they continue to deny benefits, and that costs them money.
If you did not have an attorney when you filed your claim, you will need one for the appeal. This process is the only chance that you have to build a record that supports your claim. Therefore, you must include everything that is relevant framed as precisely as possible.
If you lose your appeal, you can take your case to court. However, you will not be allowed to introduce additional documentation to your file. The court will analyze the same record that was in front of the review board and will simply be deciding if they reached the wrong decision.
You should speak with an ERISA appeals attorney right after your claim was denied because you need to be prepared to move quickly. Some denials may be the result of a misunderstanding, and an attorney could get down to the bottom of it quickly. In any event, if you do not make a strong appeal, you may not end up with the benefits that you need.
To discuss your ERISA long-term disability case, contact Roberts Disability Law. We can review the facts of your claim and help you appeal.
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