Long Term Disability
Benefits Denial

Alabama, Georgia, Tennessee, Florida

Long-term Disability Benefits Denials
Long-term Disability insurance is intended to protect workers in the unfortunate event that they become disabled or are unable to work before retirement. While most Long-term Disability policies are offered by employers in a typical benefits package, others are purchased directly from insurance companies. Sadly, not all Long-term Disability insurers pay you the benefits to which you are entitled.

When you suffer a disabling injury or condition, you expect your policy terms will be honored, but unfortunately this isn't always the case. Benefits denials often arise at a time when you are most vulnerable and least able to handle such a threat to your financial stability. You're battling with your current or former employer, trying to understand why you've been denied the Long-term Disability benefits claim that you should rightfully receive, and struggling in the meantime to make ends meet as best you can.

Appealing a Denial
Any disability plan you received through your employer is required by law to maintain an appeal procedure. Before you are allowed to sue for disability benefits, you must appeal. This process can allow your insurance agency to reverse the initial denial, but can also be detrimental. If you do not create a strong record during this time, it could adversely affect your chance of winning in court. During the appeal, we recommend that you seek the advice of a qualified attorney.

When you are denied Long-term Disability insurance, you must receive in writing the exact reason for your denial, including:

• The specific policy provision on which the denial is based
• The plan's detailed review procedures
• The guideline or criteria that is referenced when making your denial determination
• Any additional material that is pertinent to your situation or is needed before the insurer will pay the claim.

Read your denial carefully, and make sure it includes all of these requirements, as they are mandated by the Employee Retirement Income Security Act (ERISA).

If your denial letter does not satisfy these conditions, send a copy to the insurance company, along with a complaint within 180 days. If your letter states that your case was reviewed by an insurance company doctor you should also request that doctor's report and other material or information that he or she used in making a recommendation. Also demand copies of the policy for your records.

Show your denial letter to your doctor immediately. He or she should address each and every concern and detail mentioned in your letter. After your examination, have your doctor dictate a response of the visit for your records. You should also gather any medical advice that supports your claim, such as notes, medical records, x-rays, administered medications, etc.

It is possible to fight a Long-term Disability benefits denial and win; but you need to proceed with care and enlist the help of an experienced attorney. At Burke, Harvey & Frankowski, we know what it takes to win a Long-term Disability case. Our qualified and experienced attorneys can help you review you insurance plan to ensure that your claim meets your policy's requirements. We offer free consultations and can help you recover what you lawfully deserve.

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