The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that provides employees with protections of their long-term disability benefits. Thus, ERISA’s long-term disability benefits are extremely important for individuals who can’t work due to disability. When a person is out of work for an extended period of time due to a disability, ERISA provides monetary benefits to that individual until he or she can return to work. Typically, a person who is eligible for ERISA benefits will receive between 50 and 80 percent of his or her salary. ERISA long-term disability benefits are available after short-term disability benefits runs out. But what happens when an ERISA disability claim is denied?
Reasons for Denial
An ERISA disability claim denial can be devastating, and unfortunately, there are many reasons why such claims are denied. If you have recently suffered an ERISA disability claim denial, it is imperative that you hire an experienced long-term disability attorney to help you appeal the decision. Denials are often made in error, and a long-term disability attorney can identify whether mistakes were made during the claim review process. Common justifications for ERISA disability claim denials include:
- Unauthorized treatment
- Contradicting evidence
- Policy exclusions
- No medical evidence of a disabling condition
- Incomplete information or errors in the claim
- Missed deadlines
- Pre-existing conditions
- Self-reported symptoms without medical documentation
Can I Appeal My Denial?
As noted above, denials are sometimes made in error. And unfortunately, the rules governing ERISA disability claims are highly favorable to the insurance companies, giving them leeway to provide broad or vague reasons for denials. In addition, these companies are immune to civil lawsuits unless a denied applicant can prove that a denial decision was arbitrary and capricious. Luckily, however, there is an appeal process available to individuals who’ve had their claims denied. The appeal process, though, is extremely complex and often stacked in favor of insurance companies. Therefore, if you have recently suffered an ERISA disability claim denial, it is imperative that you hire an experienced long-term disability attorney to help you appeal the decision.
Contact Our Long-Term Disability Benefits Attorney
Has your ERISA disability claim been denied? If so, Cox & Stansberry is here to help. Our firm is highly experienced in the long-term disability appeals process and has a proven track record of success in ERISA litigation. Once you begin receiving your long-term disability benefits, we will provide ongoing advice and counsel to ensure that your rights are protected. At Cox & Stansberry, we understand the effect that a disabling physical or mental condition can have on your life, and we will seek benefits that assist you as you move forward. We handle each case on an individual basis, as we understand that everyone’s circumstances are different. Whether inside or outside of the courtroom, our experienced attorney is prepared to fight for you. Please contact our experienced attorney as soon as possible to set up a free consultation.