I was working for a company in DC and became disabled. How can I win my long term disability appeal?

If your long term disability insurance company denied or terminated your benefits, and you received a letter indicating that your long term disability benefits policy is governed by ERISA, you need to act fast.

You have 180 days to file your appeal to the same insurance company that just denied your benefits.  So there is a lot of work to be done.

You need to request and review the entire claim file - if you were on claim (receiving benefits) for awhile, that file can be several hundred pages of information, or more.  And you need to analyze your long term disability insurance policy - how does that define your occupation, covered illnesses and injuries, exclusions, length of different types of disability, medical information, etc.

You'll need to work with medical experts (your treating physicians and perhaps others), and you may have to research and review medical literature and studies depending on your medical condition, Functional Capacity Evaluations, plus submit interviews, vocational testing and reports.  And there could be a lot more.

Remember, this is your one shot.  By that, I mean that your appeal is not just a form you fill out and send in (please don't make that mistake) - it is all of the evidence of your medical condition or injury and disability.  And if the long term disability insurance company denies your appeal, everything you submitted will become the administrative record that a federal judge will rely on to decide your case (since ERISA is a federal law, any lawsuit against your insurance company will have to be filed in U.S. District Court - and there is no discovery or right to trial by jury in these cases).  

See what I mean about the appeal being your one shot to gather all of the evidence you can to prove you cannot work due to your medical condition or injury?

But there is help available.  If you've received a letter from your long term disability company, send it to us.  We'll review it, in confidence and at no charge, and outline the next steps for you.  Just call us at (202) 393 - 3320 to get started.