Understanding ERISA Disability Appeals

Compiling a disability claim is a daunting process, and once you file it, it can feel like forever before the results get back to you. If your claim is denied, it’s a serious blow, but it’s not the end of the matter. You have the right to file an appeal, and you are well advised to work closely with an experienced ERISA disability appeals attorney. 

The ERISA Appeal

ERISA stands for the Employee Retirement Income Security Act, and it is an important federal law that provides oversight for most of the voluntary benefits that employers offer, including disability coverage. It includes, for example, strict requirements for the information your employer and plan provider must give you regarding your benefits and the claims process. 

ERISA affords employees whose claims have been denied an appeals process as a means of establishing the factual basis of their disability claims. The appeals process generally requires serious supplementation of the original information included in the claim.

Discovery

If you have a disability claim, it’s important to recognize that while the insurance company is paid to fairly cover valid claims like yours, it’s also in the business of turning massive profits and will do what it can to make that happen. This includes denying and seriously limiting claims. Even if your appeal is also denied, the appeal is an opportunity to gain the kind of additional information you need to file a successful ERISA lawsuit, which means that all is not lost. 

Should You File an Appeal?

If you believe you have a valid claim under the disability coverage your employer provides you and your well-considered claim was denied, appealing is your best option. The fact is that insurance companies don’t make it easy to file disability claims, and denials are often based on inadequate information that stems from instructions that are difficult to follow and ambiguous. 

Additional tactics that disability insurance providers often turn to in their efforts to deny claims include:

• Reimagining your job description in a way that theoretically leaves you capable of continuing to perform the job
• Surveilling you to prove that you actually can do what you and your doctor have verified that you can’t – Standing for 3 minutes to pump gas is very different than putting in an 8-hour day on your feet, however
• Failing to share minimum submission standards regarding financial and medical updates that can leave you on the wrong side of their requirements
• Erroneously determining that you caused your condition by engaging in activities that nullify your coverage.

The insurance company is good at what it does, but so is your dedicated ERISA disability appeals attorney – and your rights and rightful benefits are too important to leave to chance. 

Turn to an Experienced ERISA Disability Appeals Attorney for the Help You Need

The formidable ERISA disability appeals attorneys at Monahan Tucker Law take great pride in their impressive record of successfully guiding challenging disability appeals toward advantageous outcomes that support our clients’ brightest futures. Learn more by contacting us today.