Why Do I Need an Experienced Long Term Disability Lawyer if My Claim is Denied?


You've got a serious illness or injury and can't work - no one questions that.  So you apply for long term disability benefits.  And you're getting benefits for What To Do When Denied Long Term Disability with Guardianawhile, but then you get a long, professional letter from the insurance company and it says they are now denying your claim. You want to know if you need a lawyer, or if you can handle this on your own.


The Short Answer To This Question Is Get a Lawyer Who Handles ERISA Disability Cases.

Here's why - If your group disability policy was provided by the company you work for, it is probably subject to ERISA. If you have an ERISA disability claim (most policies are governed by ERISA, a federal law) you have tight and unforgiving deadlines, on top of a standard that makes these cases difficult on you. As a start, here's some of the procedures and deadlines you're probably dealing with:

  • Your appeal is due 180 days after you receive the denial letter
  • The insurance company has 45 days to respond (and they can get an extension of 45 days)
  • You appeal goes to the insurance company (the same one that just denied or terminated your benefits).
  • If the insurance company doesn't change it's mind, reverse itself and award benefits, your next step is to file a lawsuit in federal court.
  • The federal judge assigned to your case will decide it based upon the administrative record (which is the appeal you filed).
  • The standard of review the judge uses is probably discretionary so the judge will likely just be deciding whether the insurance company decision was reasonable.

If you're dealing with these deadlines you need someone to focus on your appeal. This is not just filling out a form or sending in your doctor's note. It is working with medical and vocational experts, gathering and formulating evidence, interviewing witnesses, analyzing and drafting your best arguments.


Our Experienced ERISA Long Term Disability Lawyers Can Get You the Help You Need Today

Give us a call at (202) 393 - 3320 so we can review your denial letter and you can learn more about the next steps to take.

Frank R. Kearney, Attorney-at-Law
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Experienced DC Workers' Comp, Long Term Disability & Accident Lawyer
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