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When you elect to have disability insurance through your employer, you are being mindful of what the future might hold and being responsible. In doing so, you trust that you would be able to use this valuable benefit if and when the time came.
Unfortunately, when you became sick or injured and left unable to work, you submitted your claim accordingly and were denied. You may feel like there is no hope or no other options.
However, you do have the right to appeal this decision. ERISA disability appeals are a potentially powerful option available to you, and hiring a veteran ERISA disability attorney can help you properly prepare your appeal.
The Employee Retirement Income Security Act of 1974 (ERISA) sets the laws for insurance plans that employers provide, such as health, life, and disability. Under ERISA, applicants have the right to an appeal if their claim is denied.
Being denied ERISA disability is far more common than some people might expect. In fact, one study found that from 2006 to 2015 only 23% of applicants were approved upon their initial application. In light of this, applicants can and should submit an appeal if they are denied ERISA disability benefits.
ERISA disability appeals can be a complicated process often best overseen by an attorney experienced in this field. Primary factors in this complexity include the strict deadlines and rules for appealing a claim for ERISA benefits.
For instance, if an appeal is denied and an applicant subsequently takes their case to trial, no new evidence can be submitted at that point. This means it is often critical to submit as much quality information and evidence during the initial application and appeal as reasonably possible.
The clock starts ticking once an applicant receives their letter of denial from the insurance company. This letter should include certain details about why the disability claim was denied, as well as the specific policy provision for denial, whether the applicant can provide additional materials or evidence to make their claim valid, and directions for how and where to file an appeal. In addition, this denial letter should include information on the applicant’s right to bring a lawsuit under ERISA law.
Following receipt of this letter, applicants have 180 days to file your appeal. Once the appeal request is received, a decision will typically be made within 45 days, although, the law does allow for two 30-day extensions under qualifying circumstances. If the appeal is denied, some insurance companies have provisions that require applicants to appeal a second time. Other insurance companies do not, however, meaning they could move on to a trial at that point.
While 180 days may seem like a generous amount of time when preparing an appeal and a possible lawsuit, time is of the essence when it comes to ERISA benefits. In order to increase your chances of being approved or winning at trial, it may be a wise move to hire an ERISA disability appeals lawyer.
Our compassionate legal team has knowledge and experience in this particular area of law and could work to build the best case possible for you. Furthermore, we know all too well how stressful and draining this process can be. Our goal is to not only make it successful for you but to also relieve you of some of your stress during this challenging time of life.
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I am a current client of Mr. McNamara’s. He is very accessible and responds to my emails and phone calls in a timely manner. I find him to be very professional and knowledgeable, as well as ready, willing and able to address all of my questions and/or concerns.
I am an attorney. Price represented me, and in a separate suit represented my daughter, for injuries. He moved the cases at lightning speed and obtained maximum recovery. I was grateful and surprised. I would recommend Price to anyone who wants a top-notch attorney who gets results.
I would recommend Mr. Mcnanmara to anyone at any time. He was the best attorney that my family and I came in contact with. About three years ago we had a very tragic, accidental death in our family and the company knew that it was their fault but of course tried passing the buck. Mr.
Price and Sara are great. They helped us in a time of need. Their communication was always spot on and I never felt out of the loop with what was going on with our case.
Price is very professional, honest, and reliable. Whatever he says, he will follow through with the utmost integrity. He will turn over every stone and pays close attention to even the smallest detail. I’m glad I secured his services.
Without going into the painful details regarding the reason for having to hire Price, his compassion and communication helped my family during an extremely difficult time. If you need legal help because you or a family member was injured by something or someone else, don’t hesitate to call him.
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