If you’ve been wrongfully denied long term disability payments, you won’t want to wait too long to pursue an appeal. As soon as long term coverage is denied, the clock starts ticking on the time frame to make an eligible objection to that decision.

Are All Long Term Disability Plans the Same?

No. According to federal law, any employer-provided long term disability insurance plan falls under the Employee Retirement Income Security Act (ERISA), which means certain procedures must be followed by employees who wish to appeal a denial of LTD benefits.

Individually, independently purchased LTD insurance plans and those overseen by a school, church or government are not usually subject to ERISA law.

The majority of employees are covered by ERISA-governed long term disability insurance plans.

How Can I Combat a Long Term Disability Denial?

If you’ve been denied long term disability, the plan administrator is required to provide you a detailed explanation for denying your claim. You also should receive a notice of your legal right to receive a copy of your claim file and instructions regarding how to submit a proper appeal.

How Long Do I Have to File My Appeal?

An appeal should be filed within 180 days of receiving notice of a wrongfully denied claim. The plan administrator usually must respond within 45 days of your appeal.

What Types of Information Should I Include?

Include as many details as possible to support your claim. Medical and occupational evidence may be accompanied by your medical records from before and after you submitted the original claim, test results, pharmacy history and a detailed explanation from your doctor on why you’re not able to work. Continued regular visits to the doctor may be required as proof your disability is still preventing you from working.

You also may wish to include witness statements regarding your disability as they have seen it impact your life or even photos or video that prove you’re unable to perform the duties of your job.

If I’m Denied Long Term Disability Upon My Appeal, May I File a Lawsuit?

According to ERISA, you must submit all relevant evidence at the time of your appeal because no new evidence is allowed to be brought forth by you if you file a federal ERISA lawsuit. There is no jury, and there are no witnesses called. A federal judge reviews the information you submitted to the insurance company usually will overturn the insurance company’s decision if their denial is deemed arbitrary and inconsistent.

Do I Need to Consult an Attorney?

A disability insurance attorney will fully understand your legal rights under ERISA and even can help you file the original paperwork for a long term disability claim. In today’s world, insurance companies are known for turning down legitimate claims of injury and illness. You can help level the playing field by engaging with a long term disability attorney before filing your initial claim or upon receiving a denial.

What Are the Chances Any Employee Will Need to Make a Long Term Disability Claim?

The Council for Disability Awareness says 25 percent of people 20-years-old today will suffer some sort of disability before retirement, and the average long term disability claim is about three years.

Get Help With Your Long Term Disability Insurance Appeal

If an insurance company denied your long-term disability insurance claim within the past 180 days, a knowledgeable insurance attorney can help you appeal.

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