If your claim for employer-provided long-term disability benefits has been denied under ERISA, you have the choice either to accept the decision or to request its reversal through an administrative appeal. You cannot file a lawsuit seeking benefits until you have exhausted all administrative remedies as detailed in your summary plan description (SPD). During this vital stage of the ERISA appeal process, you will be gathering evidence that will be added to the administrative record, which will be the only evidence considered by the court if your appeal is denied and you decide to proceed with litigation.
If this seems like a huge amount of work to take on by yourself, you’re right. Fortunately, you don’t have to go through the ERISA appeals process on your own. Texas long-term disability attorney J. Price McNamara can help you to prepare and present the strongest appeal possible, giving you the best chance of obtaining the benefits that are rightfully yours to claim.
We invite you to read through the information about ERISA claim denials and appeals contained in our website, and then to contact the Law Offices of J. Price McNamara to arrange your free, no-obligation case review.
Filing an Administrative Appeal
The administrative appeal is the single most important factor in your ability to obtain disability benefits after your initial claim has been denied. The appeal must provide all of the information requested by the plan administrator along with any other compelling evidence of the condition that prohibits you from performing your assigned job duties. Ultimately, your appeal will make or break your ability to collect the benefits you deserve.
How Insurance Companies Use ERISA
ERISA favors insurance companies, and the insurance companies take full advantage of this fact. They know that potential litigation must take place in a federal court, and that the judge who has sole discretion over the outcome of the case is compelled by law to give deference to their adverse rulings. The surest way to balance the scales of justice is to hire an experienced ERISA attorney such as J. Price McNamara.
The Administrative Record
A well-written, thoroughly supported appeal letter can improve your chances of winning your ERISA appeal. It can guide the plan administrator thought the evidence you are providing in support of your appeal and provide a succinct summary of your argument. If your ERISA case goes to trial, it will allow you to present your case to the judge in a concise, persuasive manner and make a good overall impression.
Writing the Appeal Letter
A well-written, thoroughly supported appeal letter can improve your chances of winning your ERISA appeal. It can guide the plan administrator thought the evidence you are providing in support of your appeal and provide a succinct summary of your argument. If your ERISA case goes to trial, it will allow you to present your case to the judge in a concise, persuasive manner and make a good overall impression.
Important Deadlines
Although each plan document will differ in terms of the procedure claimants must follow in filing an appeal, it is essential that these terms be followed to the letter. This is especially true of important deadlines. Failure to meet specified deadlines without the request for an extension can be grounds for denial of your appeal and forfeiture of your right to file an ERISA lawsuit seeking benefits.