When an ERISA case is brought before a federal judge, the administrative record represents the only evidence that will be considered. The record contains every form, record, letter, and other types of document provided by the claimant or created by the plan administrator, from the filing of the original claim for disability benefits to the final denial of the appeal. Either side can file a motion contesting the inclusion of certain documents, along with a brief explaining the supporting case law. In most cases, however, the administrative record contains every piece of information relevant to the disability claim.
If your ERISA claim has been denied and you are currently preparing your ERISA appeal, you should assume that:
This is why it is essential that you provide as much specific, detailed information in support of your claim as possible at every stage of the ERISA process. An experienced Louisiana ERISA attorney can help to ensure that your administrative record contains comprehensive evidence of your disability and your right to collect the benefits due to you.
In general, the administrative record includes any document available to orreviewed by the plan administrator during the evaluation of your claim, such as:
In order to ensure that your case is fairly represented in the administrative record, it is important that you do not rely exclusively on the forms provided by the insurance company, especially those that require information from your doctor. While it is necessary that your doctor answer the questions contained in these forms, these responses alone will probably not tell your entire story. In fact, these forms generally include very little space for detailed responses, which is no accident. If your doctor does not provide sufficient information regarding your injury and your inability to perform your professional duties as defined by your job description, your plan administrator will have defensible cause to deny your claim or appeal.
As you collect evidence of your debilitating injury to present to your plan administrator, keep the following tips in mind:
While this may seem like a lot of work, you can be assured that the insurance company has the resources to fill the administrative record with substantial and compelling evidence that contradicts yours. In fact, the insurance company is prepared for possible litigation from the moment you submit your initial claim.
An experienced ERISA attorney can take the burden of collecting and organizing all of this evidence off your shoulders and make sure that it is submitted in accordance with the terms of the summary plan description.
ERISA lawyer J. Price McNamara has extensive experience in presenting the strongest cases possible on behalf of injured workers. He can make sure that your evidence measures up to that collected by the insurance company and that the administrative record represents your evidence fairly, accurately, and thoroughly.
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