What is an ERISA Appeal?
If you’ve purchased a long term disability insurance policy through your employer, it, most likely, is governed by the ERISA law. ERISA is a pro insurance federal law which requires that you submit an ERISA appeal if your claim has been denied. Generally speaking, an ERISA appeal is your only opportunity to submit additional information in support of a denied claim.
Simply writing a letter saying that your appealing the decision or sending a letter from your physician saying that you are disabled wont win your appeal. It is crucial that the appeal addresses the myriad of reasons that long term disability carriers are using to deny your claim. Most long term disability applicants whose claims are denied don’t even know that they can request a copy of the entire claims file, by law, before submitting their appeal. Long term disability claims denial attorney Nancy Cavey obtains your disability file and then carefully uses it to determine the reasons that the long term disability carrier is using to justify your claims denial and the evidence which they believe supports their claim’s denial.
She then works closely with you and your treating physicians to ensure that every one of the reasons that your claim has been denied is addressed. Her appeal letters are “shock and awe” packages that consist of an written appeal letter and hundreds of pages of supporting documents.
Those documents can include statements from you, your physicians, vocational evaluations, functional capacity evaluations, medical literature and research.
If an ERISA lawsuit has to be filed, a federal judge will decide whether or not your disability insurance company unreasonably denied your benefits based only on the information contained in the ERISA appeal record.
The term “unreasonably denied” is a term of art in the ERISA world. Most long term disability policies have a clause in the disability policy that requires the federal judge to give deference to the insurance companies decision regardless of how arbitrary and unreasonable it may seem. The scales of justice are not equal in an ERISA disability case. That’s why it is important that you have an attorney who will relentlessly pursue your disability benefits.
If you have questions about how to appeal a claim that’s been denied, you should contact long term disability attorney Nancy Cavey. Unfortunately, ERISA disability insurance carriers don’t make it easy for the disabled to get the benefits they’ve purchased. If your unable to work and you’ve been denied your long term disability benefits, contact Nancy Cavey today who can help you cut through the red tape fight for your benefits, no matter where you live in the United States contact her today at 727.894.3188.