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Disability Lawyers’ Tips for Long-Term Disability Appeals

Disability Lawyers’ Tips for ERISA Appeals

What do you do now that your long-term disability claim is denied?

If your policy was part of an employer covered long-term disability plan, you are almost certainly covered by a federal law known as ERISA. ERISA provides a roadmap that the long-term disability insurance companies must follow in assessing, deciding upon, and acting upon the appeal of your claim.

ERISA is in some ways a powerful protection for consumers like you. It provides structure for an appeal, and a guaranteed process for you to do just that. However, it is also very nuanced, not incredibly transparent, and worst of all, most people do not even know about it, or how it affects their long-term disability claims.

This situation is where and why ERISA disability lawyers become essential. ERISA disability lawyers specialize in helping claimants who have received adverse benefits determinations (denials) to get the big insurance companies to actually pay out the benefits they (you) have earned.

While you take a look at our ERISA appeal blog and the rest of the Roy Law website, here are some ERISA disability lawyers’ tips for you to consider.


Take some Time to Understand Your Long-Term Disability Denial Letter

This particular tip is going to be at the top of any disability lawyers’ list of “must-dos” after a denial of benefits. It is imperative that you understand your denial letter as best you are able. In part, understanding your denial helps you take ownership of your claim and appeal. Though, in practicality, it helps you to become a more informed advocate for yourself when you reach out to engage the services of an ERISA attorney.

If you understand the details of your denial, you can start shopping disability attorneys with a degree of confidence and knowledge of your options, that you otherwise might not have. Moreover, the denial should layout your options for appealing and give you the basic timeline you will have to work with.


Do Not Start Telling Your Long-Term Disability Insurer Your Plans Without Consulting A Couple Disability Attorneys

Insurance companies have people on staff who are there to be nice. To be friendly and provide excellent emotional support. However, they are also taking notes on everything you say. Including, how you mention things, and when you say it. They do this because you can often be your own worst enemy with what you say, even if you do not mean it.

If you tell the insurance company, in no uncertain terms, that you are appealing, they could assume that statement is your appeal. You could accidentally shoot yourself in your own foot, figuratively, by using a common phrase that has other potential meanings in this legal fight. If you want to tell someone that you intend to appeal, make it a disability attorney. In fact, tell us, and we will help you figure out your options.


Stack The Record, Now!

You have up to 180 days to appeal and send in any additional evidence to make your benefits claim as stout as you can. 180 days is a very short window when you consider making doctor appointments, finding medical records, requesting documents, and figuring out a strategy & plan for making them foolproof to the insurer’s adjudicator.

Note on this point – never, ever, ever miss the 180-day deadline.

Your goal should be to send in more than just the bare minimum amount the insurer needs too. If your appeal is denied, the grounds for reconsideration in a lawsuit are tied to the evidence you made available in your claim and appeal. Meaning, you are not going to be able to keep bringing new evidence after this step.

You want to start as soon as possible though. It takes time to collect additional evidence, and if you are using ERISA disability lawyers, they will need time to do their part as well.

Here are some things you might want to look for when stacking the disability appeal record:

  • ER Reports
  • X-rays
  • CT Scans
  • Labs
  • Blood Work
  • Physical Therapy, Occupational Therapy, Speech Therapy Notes
  • Third party statements
  • Opinions from the doctors that have treated you
  • Workplace notes
  • Plans for accommodations at work, school, or even in the home
  • Receipts, as relevant
  • Schedules (work schedules)
  • Job Descriptions


There are many other items that might help as well. Reach out to Roy Law today, and we will help you in getting these figured out.


Retain Experienced ERISA Disability Lawyers

Appealing your denial is crucial if you want to be able to collect your long-term disability. You may feel defeated, but a staggering percentage of all long-term disability claims are denied, initially, and need to go through the appeals process! You are NOT alone. If you are feeling overwhelmed, consulting with competent and experience ERISA disability lawyers will help.


Additional Reading

The 2014 Council for Disability Awareness: Long Term Disability Claims Review

About the Author
In 1998, Chris obtained his law degree from the University of Oregon, and in 1999, he accepted his first job as an attorney with the Washington State Attorney General’s Office. In 2000, Chris entered a private litigation practice in Vancouver, Washington. In private practice, Chris litigated a variety matters including administrative, criminal, real estate, construction, business, and insurance.