We do not handle Social Security Disability (SSDI) claims.

2 important steps to prepare for an ERISA disability appeal

Shawn E. McDermott

Many employees take certain benefits for granted, not realizing that their employer or other business could defraud them. The government has many laws in place to reduce the likelihood of people becoming indigent because of lies or misconduct by businesses. The Employee Retirement Income Security Act of 1974 (ERISA) is a landmark federal law that regulates certain employer-provided benefits.

Although ERISA largely serves to protect pensions and retirement benefits, it also applies to employer-provided disability insurance coverage. Supplemental short-term and long-term disability insurance policies are often part of the benefits package offered to employees. Such benefits help cover someone’s wages if they become unable to work and ensure improved financial stability regardless of unexpected medical issues that may arise.

Unfortunately, especially with long-term disability claims, applicants often face a lot of scrutiny and may have a hard time getting benefits at first. An appeal may be necessary, and ERISA guarantees your right to an appeal. What kind of documentation will you need to obtain during the appeals process?

Proof of coverage

One of the most important considerations when making a long-term disability insurance claim is validating that you should have coverage through your employer. Sometimes, mistakes by a manager or someone in Human Resources might mean that you have to prove you requested or contributed toward that coverage.

Medical evidence

If you want insurance benefits because you cannot work, you need to show that you can no longer perform your job effectively or safely. Although it may be frustrating to have to undergo an extensive evaluation and represent a cost that you have to temporarily absorb out of pocket, a thorough medical exam establishing the extent of your injuries and their impact on your functionality can make a big difference when appealing denied disability claim.

Having the right help is also important. Many applicants don’t understand the nuance of the law and they have a hard time remaining calm when negotiating benefits that will have a long-term impact on their personal financial security. A lawyer not only understands the benefits available to you but has the negotiation skills to facilitate a speedy resolution to your claim and the ability to fight back against inappropriate insurance company tactics.

Learning more about your options when appealing a denied ERISA disability claim will help you connect with the coverage you need.

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