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When to File a Texas ERISA Long Term Disability Claim

When to File a Texas ERISA Long Term Disability Claim

A person who was recently injured or suffered an illness may want to focus strongly on healing and physical health. However, if someone’s medical condition requires them to be out of work for some time, a person may want to access their ERISA disability benefits. If a person has questions about when to file a Texas ERISA long term disability claim, they may want to contact a skilled legal representative.

An experienced ERISA attorney may be able to answer questions and help get the claim approved. Benefits could pay a portion of a person’s salary while they are physically unable to work. As such, receiving these benefits as soon as possible could be important to an individual’s financial well-being and their peace of mind.

Waiting Periods

Nearly all long term disability policies have an elimination period or waiting period written into their contracts. Typically, these last three to six months or the same length of time as the applicant’s short-term disability coverage.

Most insurance companies and employers may require applicants to exhaust all their sick leave prior to filing for short-term disability benefits. In the same vein, injured persons must typically use the entire short-term disability period prior to being eligible to apply for long term disability benefits.

Disability Date

The date an ERISA disability applicant became disabled generally determines when proof of a claim must be filed and when disability payments may start. Someone applying for benefits may want to carefully review their policy documents to ensure that no deadlines are missed and confirm the date that the insurance company would consider them to be disabled. Moving forward, being mindful of deadlines like these could help a person know when to file a Texas ERISA long term disability claim.

Last Day of Work

Also referred to as LDW, the last day of work should typically be carefully selected. If a person who is a disability applicant stops working without gathering supporting documents and information to validate their disability claim, they may have their application denied. An ERISA disability attorney could assist applicants in determining when to file an ERISA long term disability claim in Texas.

After the Filing

No later than 45 days after receiving a claim, the insurance carrier must generally approve or deny that claim. However, this time period could be extended for 30 days but is commonly dependent on if the insurer informs the applicant how much longer is needed to resolve the claim, if more information is needed, and when a final decision will be made, as per 29 C.F.R. § 2560.503-1 (f)(3).

The insurance company may need new or additional information, the person seeking benefits may also have 45 days to respond. After the information is provided to the carrier, a decision could be made within 30 days.

If the insured party received a denial, they may have 180 days to appeal. After the person files their appeal, the insurance company could have another 45 days to respond. Just as they could with the initial application, the carrier may request additional time to make a decision. In some cases, a second appeal is allowed.

Understanding When to File an ERISA Long Term Disability Claim in Texas

Filing a disability claim may require a person to take carefully timed steps. Not taking these steps or not taking them in the correct order or at the right time could be detrimental to a person’s disability claim.

However, hiring a skilled Texas ERISA attorney might increase the chances of a claim approval. A well-versed ERISA lawyer could potentially review someone’s disability case and possibly assist them in taking the proper steps at the right times in the process. Call today to learn more about when to file a Texas ERISA long term disability claim.

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