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What to Expect From the ERISA Appeal Process

Tucker Law Group
May 28, 2020

Have you purchased disability insurance through your employer? If so, then it is likely governed by the Employee Retirement Income Security Act (ERISA). Under ERISA, employees enjoy certain benefits and protections. Yet, claims for long term disability benefits are often rejected. If this occurs, then you have a choice to make. Will you accept the decision? Or will you file an ERISA appeal? If you choose the latter, then here is what you can expect from the ERISA appeal process.

Filing an Administrative Appeal

After receiving a denial for long term disability benefits, ERISA law takes over. First, the insurance company must provide you with certain information after a denial. After receiving this information, you have 180 days to file an administrative appeal.

Filing an administrative appeal is crucial. It could make or break your ability to obtain disability benefits. Thus, it is extremely important. Additionally, you must include certain information in your appeal. If you do not, then your appeal may not proceed. An experienced ERISA lawyer can help you include any important information. He or she can also ensure that you meet any critical deadlines.

Writing an ERISA Appeal Letter

It is important to make your administrative appeal comprehensive. You should provide evidence supporting your reasons for appealing the claim denial. You should also provide a succinct summary of your argument. This will give the plan administrator a clear understanding of why you deserve to receive long term disability benefits.

One way to accomplish this is to write an ERISA appeal letter. This letter should address the reasons that the disability insurance carrier is using to deny your claim. Our ERISA lawyers can help you draft a well-written appeal letter. We are a nationally recognized law firm with experience guiding people through the ERISA appeal process.

What Comes Next?

After filing an administrative appeal, you will receive a determination within 45 days. Yet, there are exceptions. For example, the insurance company can receive two 30-day automatic extensions. Unfortunately, ERISA often favors insurance companies. Most insurance companies take full advantage of this fact.

If you lose your appeal, then you can file a lawsuit in federal court. However, ERISA requires that you exhaust every option available to you before doing so. A judge will review the evidence submitted during the appeals process. Thus, you need an experienced attorney from the very beginning. He or she will help you file a comprehensive administrative appeal.

Contact Our ERISA Lawyers Today

Is your disability insurance policy governed by ERISA? Did you file a claim for long term disability benefits? Was your claim denied? If so, then we understand how frustrating this can seem. Fortunately, you do have options. You can begin the ERISA appeal process. Our nationally recognized law firm can help you throughout the entirety of this process. Contact us today at (866) 233-5044 to schedule a free initial consultation. You can also contact us online. We promise to answer your questions and look forward to meeting you in-person or over the phone. Call today!