HAVE YOU BEEN DENIED SHORT-TERM OR LONG-TERM DISABILITY BENEFITS?
If you have received a denial letter from an insurance company or plan administrator stating that you do not meet the definition of disability for either your "own occupation" or "any occupation", you must appeal within 180 days under the ERISA regulations. There are limited exceptions but you must submit all relevant medical, vocational and other evidence in this administrative phase before filing a lawsuit in court.
Once you have appealed to the insurance company or plan administrator, you will receive a final denial letter stating that you have exhausted all administrative remedies under the Employee Retirement Income Security Act or ERISA. You may now file a lawsuit in federal court to seek judicial review of the insurance company's or plan administrator's refusal to pay your short-term and/or long-term disability benefits. Depending upon the policy and applicable statute of limitations, the time that you have to file a lawsuit in federal court must be reviewed specifically.
Contact us if you would like an evaluation of your potential case for short-term and/or long-term disability benefits. The first step is usually a review of the denial letter which is at no cost to you. Under ERISA, you or your representative have the right to request a complete copy of the administrative or claims file which contains the documents used to deny your claim. Once this file is requested, the plan administrator must send the administrative file within 30 days.