The Right to an ERISA Long Term Disability Appeal

All too often, insurance companies find ways to deny benefits that should otherwise be paid. We have seen this time and time again as insurers persistently deny long term disability claims. This is, of course, good for their bottom line and bad for your well-being. Whichever illness or disability impacts your life; the motive behind your long term disability claim probably seems clear and necessary to you, your physicians, family, friends, and even co-workers. Thus, being denied these benefits can be an alarming and worrisome experience. We encourage you to take comfort in the fact that an insurance denial is not the final word. Under the Employee Retirement Income Security Act (ERISA), you have a legal right to appeal the denial of disability benefits…and we can help.

If your long term disability coverage is group coverage, and was provided by your employer, it is probably governed by ERISA. The Federal Regulations governing ERISA mandate that the participant be given a minimum of 180 days to appeal a denial or termination of benefits.

The problematic piece of the appeal process is the amount of diligence, effort, and patience required for communicating with insurance companies…on top of the many symptoms, medication side effects, and complexities of your illness. This process can sometimes feel like an overwhelming and unbearable task. However, you should know that according to Former Insurance Executive Lisa Zamosky (author of Healthcare, Insurance, and You) more than half of all appeals are decided in the insured’s favor. If you do not feel well enough to file an appeal, you may want to reach out to an experienced ERISA attorney for help.

We always suggest that you begin the appeal process by becoming familiar with the terms of your policy. This means requesting a copy of your policy from your insurance company or your employer. For a detailed description on how to file an appeal, see http://www.creakyjoints.org/blogs/insurance-matters/what-to-do-when-your-long-term-disability-claim-has-been-denied.

We understand how emotionally and financially devastating a long term disability insurance denial can be. If you or someone you love has been denied long term disability benefits, please contact Kantor & Kantor for a no-cost consultation.

We understand, and we can help.
www.kantorlaw.net (800) 446-7529

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