Yes. If your long term disability benefits are provided by your employer, they are probably governed by a federal law called ERISA. And there are a number of requirements under ERISA and your insurance policy that you need to understand, comply with and work through to give yourself the best shot at winning on appeal.
Because of that, this is one area of the law where it is very difficult to appeal your case after you get a letter denying benefits from your disability insurance company.
You need a lawyer who really understands how the appeals process works, the medicine, can work with experts and (most important) can work with you to help you tell your story.
Here are 5 red flags that tell you your lawyer doesn't understand long term disability cases:
1. In your first meeting or phone call, he needs to do some research (and may want to bill you for this) to explain how the process works, from the time you get the letter denying or terminating your benefits through the mechanics of what filing an ERISA disability lawsuit looks like.
2. He does not mention ERISA (the federal law that employer sponsored disability plans fall under) or doesn't know what it stands for.
3. Talks with you about whether to file a lawsuit in Superior Court (in D.C.) or some other state court, whether you will have depositions, be able to develop your case through discovery and go to "trial" and thinks you can sue the disability insurance company for bad faith or punitive damages to increase the amount of your award.
4. Doesn't tell you how and when to get the entire claim file from the insurance company, and why that is critical.
5. Doesn't tell you his plan for filing your appeal - what it should contain, how long it will be, how it will be developed and drafted, and how long it will take - or leads you to believe it is a simple matter of writing a letter saying you disagree with the insurance company's decision denying or terminating your disability benefits.
Don't risk everything you've worked so hard for because of a serious injury or illness - if you received a denial letter from the disability insurance company call us so we can review it for you and give you our thoughts on how to get started (this is both free and confidential).
Remember, under ERISA, you only have 180 days to appeal after you get the denial letter. So call us today at (202) 393 - 3320 to get started.