Administrative Appeal of a Denial or Termination Of LTD Benefits

Long term disability can impact your quality of life quite dramatically and prevent you from advancing in your career. LTD benefits may mitigate the significant adverse effects of such disability to some extent by helping you fund some of your expenses while you try to regain your health. However, there are situations where your long term disability benefits may be denied or terminated by the insurer. It is in these situations that we can offer you the support and legal assistance you need to gain or reinstate your benefits.

Beware: You Usually Have 180 Days to File Your Appeal — the Process is Complicated

Once a claim is denied or terminated, a person typically has 180 days to file an administrative appeal with the insurance company. Most group benefit policies are governed by the Employee Retirement Income Security Act, a complex Federal Law commonly known as ERISA. It is extremely important to submit a well documented appeal during this 180 day period. Unfortunately, most claimants are deceived into thinking that the administrative appeal process is simple. Many LTD cases are won or lost on the documents and the quality of the arguments submitted on this stage of the process. If the proper evidence is not submitted during this part of your case, you might never be allowed to present it at all to the insurance company.

Preparing an Effective Administrative Appeal on Your Behalf

RamosLaw has the knowledge and experience to submit a solid administrative appeal on your behalf. As part of your administrative appeal, we like to provide the insurance company with a well prepared legal brief stating the reasons why you are entitled to long term disability benefits. We take special care to back every statement with the necessary medical opinions from physicians, as well as providing statements from friends and co-workers and detailed medical reports supporting your eligibility for benefits. The value of a well prepared administrative appeal extends beyond the administrative stage. A good appeal is useful even when it is denied by the insurance company. Once the case moves to Federal Court, the likelihood of the insurance company agreeing to an out-of-court settlement that is in your favor is heightened when you have presented a water tight case during the administrative appeal stage.

Appealing a Wrongful Denial

When your claim has been denied by the insurer, filing an administrative appeal is the only recourse open to you. You cannot omit or waive this part of the process. Choosing to hire a competent and highly experienced lawyer to do the appeal for you, means that you can complete the appeal with the greatest likelihood of gaining/ regaining your benefits while keeping your costs and stress to a minimum. Call us now to get your free evaluation today!

For a free evaluation with a Connecticut or Massachusetts Long Term Disability Lawyer, you can contact us or call toll free (860) 519-5242.

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