The Employee Retirement Income Security Act (ERISA) is a federal law that governs private sector employee benefits, including disability benefits. If you have been denied disability benefits under an ERISA-covered plan, you may feel frustrated and overwhelmed.
Fortunately, a denied claim is not the end of the road. You can get the decision to deny your benefits overturned by taking these steps.
Review your denial letter
The first step is to review the denial letter from the insurance company or your plan administrator. The letter should explain why your claim was denied and provide other helpful information related to your case. Understanding the reasons behind the denial will help you respond appropriately.
Gather medical records
It is advisable to gather all relevant medical documents pertaining to your claim. These may include records from your treating physicians, hospitals and other health care providers. Having your medical reports at hand will help avoid unnecessary delays.
File your appeal
The law requires a claimant to first go through the internal appeal procedures provided by their plan. The appeal process typically involves submitting a written statement explaining why the decision to deny your claim was incorrect and providing any additional evidence in support.
There may be administrative hearings, depending on the level of appeal. It’s important to attend these hearings and present your case as clearly and persuasively as possible. It is also advisable to be prepared for any eventuality, including a trial.
Get help navigating the appeals process
Appealing a denied ERISA claim can be daunting, especially if you do not know what to expect or how things work. In addition, you have limited time to appeal. It explains the importance of having the necessary assistance – to help you get through the process and increase the chances of a positive outcome to your appeal.