The Two Reasons Why You Need To Appeal The Denial Of Your Erisa Disability Claims

appeal denial of ERISA disability claims

If you have an ERISA disability policy and your claim has been denied there are two reasons why you should appeal the denial of your disability benefits within 180 days of the date of the denial. What Are The Two Reasons I Should Appeal My Denial of My ERISA Disability Claim? 1. The ERISA law requires a policy holder to “exhaust” their administrative remedies before filing a lawsuit. Your appeal is considered your “administrative remedy.” If you fail to timely appeal the insurance company may say that you can’t sue because you failed to exhaust your administrative remedies. Appealing preserves your right...

30 March

0 Comments

Sticky

What Does The Term “Disability” Mean In My Disability?

Posted by Nancy Cavey

in Uncategorized

There is no uniform definition of disability. You have to get your policy and review it closely. Disability is one of the most litigated policy terms because when you file a claim for disability, the insurer has to determine if you’re disabled based on the definition of disability within the policy. What are all the Various Types of Disability Policies? There are “Own Occupation” disability policies which will pay a policy holder if they’re unable to engage in his or her own occupation. Other policies are known as “Any Occupation” policies that pay if you’re unable to engage in any occupation but you’re...

26 February

0 Comments

Sticky

Do I Have To Cooperate During A Functional Capacity Evaluation In A Long Term Disability Claim?

Posted by Nancy Cavey

in Long Term Disability

FCE and IME disability long term disability

Disability policies generally require policy holders who apply for disability benefits to undergo an Independent Medical Evaluation or even a Functional Capacity Evaluation. If your policy allows for these and you’ve been requested to undergo such an examination, you have the duty to cooperate. What Happens if you Refuse to Perform Tasks Requested or Don’t try Hard Enough During the FCE? Your claim can potentially be denied for “lack of cooperation.” In the case of Ortega-Candelaria v. Johnson & Johnson, 2014 WL 2696725 (1st Cir. June 16, 2014), Mr. Ortega-Candelaria applied for disability benefits and was asked to undergo a Functional Capacity...

Blog