It isn’t unusual for a long-term disability claim to be denied; it is estimated that about 53% are initially rejected. The good news is you can appeal the denial, and it is possible to prevail if you follow specific steps and have effective legal counsel. Below are essential steps to follow when filing your appeal.
If you have been denied long-term disability benefits, you must work with an experienced attorney to file your appeal. Contact Roberts Disability Law, P.C., if you have questions about a long-term disability appeal.
It is critical to file your long-term disability denial appeal by the deadline. Most of the time, you have only 180 days to file the appeal. Unfortunately, the insurance company is not required to provide you with more time.
If your appeal falls outside this deadline, you may not be able to submit critical evidence if going to court is necessary. The appeal is usually your final opportunity to provide evidence to support the claim. Work closely with your Oakland long-term disability lawyer to get all evidence in on time.
Your physician involvement is critical in your appeal. Speak to your doctor immediately to determine whether they agree or disagree with the decision. Unfortunately, insurance companies often won’t contact your doctor. Or they will not give the doctor enough time to respond.
Ask your physician to answer the insurance company’s denial with a detailed letter that explains your limitations and restrictions. Further, ask the doctor to explain why they disagree with the decision by citing the insurance company’s medical reports.
It is vital to get medical reports from your own experts. If you or your attorney submit your own expert medical report, the insurance company is required by law to consider it. Remember, the appeal is probably your last chance to have your expert weigh in.
The most common reports that medical experts file to support a disability appeal are:
Review the disability denial letter and respond to every reason they cite. The most common reasons for a long-term disability denial are:
You and your attorney should carefully address every reason they denied your claim. Further, make sure your doctor addresses every reason, too.
Suppose you have been denied benefits under the Employee Retirement Income Security Act (ERISA). In that case, you need to work with an Oakland long-term disability lawyer who knows how to assemble the best appeal.
The long-term disability attorneys at Roberts Disability Law, P.C., will fight for your legal rights with the goal of getting the claim paid before filing a lawsuit. But if a lawsuit is needed, we know how to win your case in federal district court. So please contact our long-term disability attorneys now.
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