If you work for a private employer and have benefits like healthcare and disability insurance, the federal Employee Retirement Income Security Act (ERISA) likely governs your benefits. ERISA gives you certain rights, but it also imposes rigid procedures.
Working with an experienced ERISA attorney can ensure that you do not endanger your claim through noncompliance with the rules. At Sasser Law Firm, PA, we know when to file an ERISA disability claim in Charlotte and how to craft a robust argument supporting your claim for benefits. Contact us today for legal guidance.
ERISA governs how insurance companies and employers handle disability claims, but it does not mandate a timeframe for making an initial claim. You must find the procedures and timeframes for making your initial claim in the long-term disability plan summary. ERISA requires that employers provide you a plan summary with all the relevant information.
Read the summary carefully to understand any exclusions that may apply to you. Some plans limit coverage for specified diagnoses or exclude them entirely.
You will not qualify for long-term disability benefits unless you have a medical condition that prevents you from doing your job. You should speak with your doctor about whether you can work in your current condition. Then, speak with one of the Charlotte ERISA attorneys at our firm about whether you have adequate documentation to support filing a claim.
Long-term disability insurance providers deny a significant percentage of initial claims. A denial does not mean that you are not entitled to benefits in most cases. Insurance companies are incentivized to look for reasons to deny a claim, and in some cases, a legal professional can help to overturn a denial.
An ERISA provision at 29 Code of Federal Regulations 2560.503-1(h) requires insurers to allow you 180 days from the date of the denial to file an appeal. It is important to consult our ERISA attorneys in Charlotte as quickly as possible after receiving the denial notice to determine when to file an appeal and determine what information to include in your appeal.
We may ask your doctor to write a narrative statement about the degree of your disability and suggest you get additional tests or evaluations that may take several months to schedule and complete. The 180-day deadline is strictly enforced, so allow us plenty of time to compile all the information we need to craft the most persuasive appeal possible.
The law gives the disability insurer 45 days to review your application and make a decision. The insurer can take an additional 45 days when necessary, but it must notify you of the delay and the reason for it. The same deadlines apply when the insurer is evaluating an appeal of an earlier denial.
If the insurer fails to meet these deadlines, the law allows you to consider the insurance company’s failure to act timely as a denial. You can sue the company in federal court seeking your benefits plus costs and attorneys’ fees.
However, your application and supporting documents are the only information a court can review in these cases. Consult a Charlotte ERISA disability attorney when you plan to file a claim in court. Our legal professionals can review the documents you have submitted to determine whether they make a compelling case, or whether you should continue to work with the insurance company before deciding to sue.
Life with a disabling condition is already challenging. Do not risk being denied your benefits because of a preventable error. Consult an attorney at Sasser Law Firm, PA about when to file an ERISA disability claim in Charlotte today.
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