Michigan ERISA Appeal Lawyer
When you encountered a serious health problem that took you out of work, you were grateful for the long-term disability (LTD) insurance benefit at your job.
That is, until the insurance company denied your claim. Or they terminated your claim after providing benefits for a while. Now you’re frustrated trying to secure the long-term disability income you need to keep your financial life on steady ground.
Your policy through your employer is probably governed by the federal law called ERISA—the Employee Retirement Income Security Act.
You can appeal your denial. But under ERISA, you must follow specific procedures.
The Levine Benjamin Law Firm’s experienced LTD lawyers can fight this fight for you.
We’ve been helping workers in Detroit, Flint, Lansing and Grand Rapids, MI, as well as Toledo, OH, since 1964.
What would you like to do?
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Tips for Appealing Your Denial Under ERISA
Following these guidelines can make your appeal of a long-term disability denial more successful:
- Add all the evidence you can to your record.
- Address the reasons the insurance company gives for your denial.
- Meet all the deadlines.
- Complete every step of the insurer’s appeals process.
- Go to court, if that’s what it takes to get the benefits you need.
1. Gather All Your Evidence
While you’re appealing a denial of LTD insurance under ERISA, make sure to add all the evidence you can to your record. That means documents from doctor visits, medical tests, hospital stays and more.
If you eventually have to file a lawsuit to get the disability income you need, you’ll no longer be able to add new evidence to your file at that point. So you want to enter as much evidence as possible while you’re still appealing with the insurance company.
That evidence can also include reports from your doctor about your health limitations and statements from friends and family about your day-to-day abilities and needs for assistance.
2. Pay Attention to the Insurer’s Reasons for Denial
The letter saying your claim was denied will usually provide reasons. As you appeal that decision, make sure to address those reasons.
It could be a lack of a certain kind of evidence—like medical reports from procedures or tests you’ve had. Information you add to your file could counter the insurance company’s rationale for denying you.
3. Don’t Miss Important Deadlines
Missing a deadline to appeal could put your long-term disability income at risk. Federal law requires your insurer to allow at least 60 days to appeal a denial.
Some insurance companies will give you more time. Pay attention to the deadline that applies in your case.
Your insurer should also give you directions for properly filing an appeal. Make sure to follow their requirements, so they can’t hold any mistakes against you.
4. Go All the Way through the Process
Long-term disability plans governed by ERISA require you to complete every step in the insurance company’s internal appeals process before you can sue the company.
So to protect all your rights and options, go all the way through the insurance company’s process.
5. Take Your Claim to Court
If you make it all the way through the insurance company’s appeals process—and they still deny your long-term disability benefits—your next step is going to court.
With an ERISA policy, federal court is where you can sue the insurance company, arguing that the insurer should be ordered to honor your claim.
Once you’re at the federal court level, you’ll need an attorney who can convince a judge that the insurance company made a mistake or lacked the evidence it needed to deny you.
Why You Want a Lawyer
When you’re fighting a long-term disability denial, be careful how you deal with the insurance company.
They could ask you to sign papers saying you automatically accept their decision if you don’t respond by a certain time. They could push you into arbitration proceedings that bar you from suing. They could offer a partial settlement in exchange for you giving up your right to pursue more.
Sometimes, they’ll drag out the appeals process so long that you miss a deadline to file a lawsuit. Or they’ll try to tell you all you need to resolve your situation is to write them a letter.
Get a lawyer to look over anything the insurance company sends you.
An experienced LTD attorney knows their tactics and how to protect your rights. Your lawyer can gather the evidence you need, keep your appeal on track and fight for the maximum benefits available to you.
Levine Benjamin Law Firm will evaluate your case for free. And we don’t charge a fee until you win.