Why Should I Appeal the Denial of my Disability Benefits?

You purchased a long term disability policy to provide you and your family peace of mind. Unfortunately, long term disability carriers are not in the business of paying disability benefits to their policy holders. They would rather collect the premium. So, what happens after you have submitted your claim and you have been denied? There are two reasons why you should appeal the denial of your disability benefits. Why?

1. Your appeal is your last chance to submit evidence of your disability.

You can actually get a copy of your file from your disability carrier which will help you determine the real reasons why your plan got denied. It isn’t uncommon for claim’s to be denied on the following basis: 1. No objective basis for diagnosis; 2. No objective basis of your restrictions and limitations; 3. No casual relationship between the diagnosis or restrictions and your inability to do your own or any occupation.

There is no trial in an ERISA case and, as a result, the court will decide your case entirely based on what was in the insurance companies claim file at the time of your last appeal.

That’s why it’s important that you secure the services of an experienced long term disability attorney.

Screwing up your appeal by handling it yourself only screws up the appeal but potentially screws up your lawsuit. There are many things that can and should be done to develop the medical and vocational evidence. This can include:

– Undergoing a functional capacity evaluation;
– Vocational evaluations;
– Statement from your physician addressing the reasons why your claim was denied;
– Statements of family, friends and even your employer.

2. If you fail to timely submit an appeal, you may be barred from suing your insurance company. This sounds weird but if you have fail to timely appeal the denial, the long term disability carrier may say that you fail to “exhaust your administrative remedies”. That appeal is your administrative remedy and if you do not use it, you can’t get back and fix it once the appeal deadline has passed. So, appealing the denial of benefits in time only gives you a chance to get your benefits reinstated but preserves your right to sue the disability insurance company.

To learn more about appealing the wrongful denial of your disability claim, contact Boston Mutual disability claims attorney Nancy Cavey who can help you regardless of where you live in the United States.