If you have learned that your long term disability benefits have been denied, then you will receive a denial letter from the insurance company or claims administrator. A denial of long term disability benefits is understandably met with frustration, and a common knee-jerk reaction is to immediately appeal the insurance company's wrongful denial. But before you submit an appeal, it is important to first consult with an experienced long term disability attorney.
An Attorney Can Provide Vital Help During the Appeals Process
The insurance company's denial letter will inform you of your appeal rights. Be sure to carefully review this section of the denial letter—which is typically at the end of the letter—as it will explain the deadline in which to submit an appeal, where to send the appeal, and which documentation is needed. Keep in mind that if you fail to timely appeal, your claim for long term disability benefits will be forfeited.
Unfortunately for long term disability claims that fall under the Employee Retirement Income Security Act (ERISA), the appeal process is generally the only time that an individual can produce evidence to refute the insurance company's denial. In other words, the individual must submit all supportive documentation with their appeal, or else this information will never be considered by the insurance company or a court of law.
All too often, I speak with individuals who sent a hastily handwritten appeal letter to the insurance company. Sometimes the appeal letter is submitted to the insurance company without any medical evidence or other documentation that explains why the insurance company’s decision is wrong. This can be a devastating mistake. If the insurance company denies the appeal, which is very common, then the only recourse is to file a lawsuit in federal court.
The appeal letter and the exhibits submitted with the appeal may affect the outcome of a lawsuit. In its review of the insurance company's denial of benefits, the court will consider only the information that the insurance company had in its claim file. Normally, the court will not consider any new medical evidence that the insurance company did not have at the time of their final decision. Thus, failing to provide all evidence with your appeal can reduce or eliminate your chance of succeeding in a lawsuit for long term disability benefits.
The Importantce of Consulting an Attorney
An experienced long term disability attorney can carefully review the insurance company's denial letter and claim file, determine which medical evidence or other documentation is needed to prove disability under the terms of the insurance policy, and obtain all of the necessary evidence to appeal the insurance company's denial. Insurance companies and claims administrators have numerous tactics to deny long term disability claims, but a trained advocate can quickly identify the insurance company's errors and make compelling counterarguments to support approval of disability benefits. Finding the right long term disability lawyer can be the difference between you receiving long term disability benefits or being denied.
If your long term disability benefits have been denied, contact Keller & Keller, LLP immediately for a free, no-obligation consultation. Our disability attorneys will fight to make sure you receive the benefits you need. Call 317-926-1111 or 1-800-253-5537 to speak with a long term disability lawyer today.