FAQ – Filing Your LTD/ERISA Appeal | Bellaire Beach Long Term Disability Lawyer

You’ve gotten the dreaded Notice of Denial letter and you are shattered. You can’t believe the long term carrier/ERISA carrier has denied your claim. You think that if you just give them the information they are asking  for they will just pay your claim.

That is very unlikely and wishful thinking on your part.

You will have 180 days following the receipt of the notice of denial to letter to submit your appeal. You should do the following:

1. Consult with an experienced long-term disability/ERISA attorney.

2. Keep the envelope the notice of denial letter came in. Sometimes letters are dated differently than actually mailed and this can make a difference if the plan administrator or carrier refuses to give you additional time to appeal.

3. Write a letter to an administrator asking for a copy of your summary plan description and policy.

4. Write a letter to the disability insurance company asking for a copy of your file cover to cover with adjusting notes, medical records by peer-reviewed doctors that have looked at your file, surveillance reports and any material the carrier has relied on in denying your case. Send the letter certified mail return receipt requested.

5.Review what you get from the carrier. Compare a policy terms to your denial letter and see if they are citing the right policy provisions. Look at the job description they used. Look at the peer review physician reports. Look at the vocational reports.

6. Figure out the real reason they denied your claim and how you’re going to get evidence to rebut the disability carrier’s reasoning.

7. Whatever evidence you get make sure that it specifically addresses the basis of the denial.

8. Submit your appeal letter with your supporting documentation to the own term disability care within 180 days sending certified mail return receipt requested.

While I have outlined the steps you should take, those steps are more complex.

This will be your ONLY chance to get it right. Don’t mess it up. There are no “do-overs.”

If you have any questions, please give us a call at 727.894.3188 or contact us online by clicking here.

  • 2.0 (1 person)
    Be Sociable, Share!

    Leave a Reply