Many claimants who have had their Long Term Disability (LTD) benefit application rejected unwittingly think that simply “filing a letter” is sufficient enough for a successful appeal. Unfortunately, they are mistaken. In this respect, claimants’ naivety is a tremendous ally to insurers. In fact, it seems like disability insurance companies count on the insured’s unawareness of the appeal process. One reason why many people tend to believe that appeals are simpler than they appear is that, frankly, they do look like they are very simple. For instance, a typical LTD denial letter includes a statement along the lines of “If you disagree with our decision, you have 180 days to appeal it and tell us why.” Unfortunately claimants are unaware that appeals submitted with a quick response -in which they directly answer what they believe is a relatively direct question-are mostly rejected.
Many of the LTD policies in the United States fall under a very complicated federal law known as the Employee Retirement Income Security Act of 1974. (ERISA) Under ERISA, courts are unable to entertain or allow any new evidence or documentation into a case; aside from what the claimant provided within the 180-day appeal period. Subsequently, once the allotted time has expired, many applicants are surprised to discover that their woefully insufficient appeal is all that they can present before the Court. By then of course, it is probably too late to correct any insufficiencies in the appeal. For this reason, cases with a poor administrative appeal have little chance of success.
It is paramount that an applicant be aware of the importance of the administrative appeal ahead of time. If an LTD claim is denied and subsequent appeals are exhausted, the claimant’s only remaining avenue is to commence a lawsuit in federal district court. For this reason, it is desirable to have the assistance of a long term disability lawyer during the preparation of the administrative appeal.
Ideally a person who has received a denial or termination letter from an insurance company should retain an accomplished, experienced LTD attorney to prepare him or her in the administrative appeal stage. If you have been denied LTD benefits, please contact RamosLaw to see if we can draw up that essential administrative appeal letter on your behalf.
It’s also important for you to know that RamosLaw does not charge at all until you have won your case and have received payment from the insurance company. If it’s ultimately determined that you are not eligible for benefits, we will not charge you for our legal fees.
