FAQ – The Notice of Denial letter | Pinellas Park Long Term Disability Attorney

Unfortunately, you have gotten the dreaded letter. It is the letter you hoped you would never get — the Notice of Denial letter. What are you going to do next?

I hope you have the sense to retain an experienced long-term disability/ERISA attorney as this is not a do-it-yourself project.

The ERISA regulations require a denial letter to have certain information. It should be understandable, have specific reasons for denial of your claim, refer to specific plan provisions upon which the denial is based, describe any additional material or information you need to submit and why it is necessary, a description of the appeal process and time limits, and your right to bring an ERISA civil action once you’ve completed all the appeals.

However, the reality is completely different. Any denial letter is a cut and paste job and don’t make a lot of sense. Many times the denial letter fails to explain the specific reasons for your denial and the additional information you need to submit. I hardly ever see long term disability carriers explain why you need to submit the information.

You should understand that the most common reasons for denial are based on the long term disability carrier’s argument that you have not submitted objective evidence of your diagnosis, objective evidence of your disability, and objective evidence of a causal relationship between your disability and your inability to work.

You will have 180 days in which to perfect your appeal. DO NOT sent a letter to the long-term disability care saying you want to appeal. Tell the long-term disability carrier that you plan on appealing and then, immediately consult experienced long-term disability/ERISA attorney.

While Cavey and Barrett, based in the Tampa Bay area, represents disability applicants nationwide, Nancy Cavey can help you find an experienced attorney in your area. She can be contacted by clicking here or by calling 727.894.3188.

  • 2.0 (1 person)
    Be Sociable, Share!

    Leave a Reply