If You Don’t Understand the ERISA Regulations Requiring the Disability Carrier to Make a Timely Decision On Your Claim, You’ll Hate Yourself!
If your short or long term disability claim is ERISA claim covered by federal law, the ERISA regulations provide, that “in the case of a plaintiff disability benefits, the plan administrators shall notify the claimant… of the claimant’s adverse benefit determination within a reasonable period of time, but no later 45 days after the receipt of the claim by the plan. This period may be extended by the plan for up to 30 days, provided that plan administrator both determines that such an extension is necessary that it matters in the control of plan and notifies the claimant prior the expiration after the initial 45 day period, the circumstance requiring the extension the time and the date by which the plan expects to render a decision.”
Further, the rules provide for two 45 day extension periods.
The notice of extension, must “specifically explain the standards on which the entitlement to a benefit is based, the unresolved issues the present the decision on the claim, and the additional information needed to resolve those issues.” You will be given at least 45 days in which to provide that information.
If you have filed a long term disability claim and the carrier is making too long to make a decision or they have told you that there is more information that they need, and you have 45 days to respond, you should contact Cavey and Barrett, Florida’s long term disability claim delayed or denied attorneys who can assist you in securing the benefits that you may be entitled to as a result of a disability.