Issues That Can Arise During an ERISA Appeal: Things To Do Before You Hire an Attorney

Posted by: Beth A. Davis

If you have a long term disability claim through a policy provided by your employer, ERISA most likely governs that claim. As such, if your claim is denied and you have to pursue your benefits, there are very specific rules and regulations about how – and sometimes whether – you will be able to provide evidence of your disability to the insurer.  Also, the quality of the evidence matters very much.  This blog will give you some pointers on what to gather before you hire an ERISA attorney to assist you with your appeal – and you should definitely hire an ERISA attorney to help you because the appeal is your only opportunity to provide the insurer with the necessary evidence to properly support your claim.

  • Request your claim file – if your claim has been denied, you should request a complete copy of your claim file from your insurer. This will help the attorneys to ascertain whether you have a case they can assist you with and what evidence you will need to support your claim;
  • Obtain copies of your medical records – you should have copies of all of your relevant medical records to help the attorneys determine whether you have sufficient medical evidence of disability;
  • Discuss support from your treating physician(s) – you should have a conversation with your treating physician(s) about whether and to what extent she would be willing to assist you with this claim. Often, you will need a letter of support from her along with her opinion on reports generated by the insurance company’s reviewing physician(s);
  • Know that time is of the essence – if your appeal is governed by ERISA, you will have a deadline by which you must appeal the denial or your rights will be forever lost. The longer you delay in hiring an ERISA attorney, the less time he or she will have to properly prepare your appeal.

If you are currently struggling with a denied or delayed insurance claim, our California disability attorneys are here to help. Contact Kantor & Kantor, LLP to request a FREE consultation. We can be reached at (818) 886-2525 or via our online contact form. You don’t pay unless we win your claim, so you have nothing to lose!

Contact Information