Can I add more information to my claim file in anticipation of filing a lawsuit after an insurance company enters a final denial of benefits?

For all intents and purposes, no. The law is pretty clear that following a final denial of benefits no additional information can be added to the administrative record in anticipation of trial, as the administrative record consists only of the evidence that was before the carrier when it rendered its final decision to deny benefits.

A recent ruling by a Federal Magistrate Judge from New Jersey in the case of McCann v. Unum Provident, echoes this accepted proposition. In an interesting twist, the plaintiff filed a Motion to Strike a letter from his doctor, which was received by Unum forty-five minutes AFTER a final denial of his claim for long term disability benefits was rendered by Unum. Normally, it would be the insurance company who would presumably want a letter from an insured’s doctor being kept out of the administrative record for being untimely. However, Unum argued that it was appropriate to keep the letter from McCann’s doctor in the administrative record to be reviewed by Judge at trial. Although the Court’s opinion does not give detail as to the contents of the letter, it would seem that the letter may not have been favorable for McCann if Unum wanted it to be part of the record. Regardless of the contents of the letter, the Court determined that the administrative record, as it pertained to the lawsuit against Unum was effectively closed 45 minutes before the letter from McCann’s doctor was received by Unum, and as such should be stricken from the administrative record.

The importance of filing an ERISA Appeal

If your long term disability policy is governed by ERISA, one cannot stress enough the importance of filing as complete an Appeal as possible. As discussed throughout our website, your ERISA administrative appeal is essentially your last chance to present your evidence of disability not only to the disability carrier, but also to a federal judge should the case go to trial.

Many people who receive a denial letter from their insurance company detrimentally rely on the assertions made by the claims manager that all they have to do is “send a letter saying you disagree with the decision.” Not surprising, this usually results in a rubber stamped upholding of the initial denial. If there is no mandatory or voluntary second appeal under the policy – there is no chance to supplement the file with additional evidence of disability. Due to the nature of ERISA litigation and the requirements of meeting your burden of proof at trial this could be disastrous to your case and prevent you from collecting additional benefits under the policy as the above case reminds us.

If your claim has been denied, please feel free to contact our office to discuss how we may be able to assist you in filing your appeal.

Dell & Schaefer had no involvement in Dr. McCann’s claim for benefits.

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FAQ

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Reviews

Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Jeff P. (Oklahoma)

After a very long and frustrating ordeal to keep my LTD payments coming I decided to seek assistance from and attorney. After much research and asking those in the legal profession Dell & Schaefer seemed to be the top choice. I reached out and Alex Palamara was the attorney assigned to my case. All I can say is the experience was outstanding. Both Alex and his Paralegal, Danielle Lauria were excellent to work with. They were very kind, concerned, understanding of my frustrations and treated me with the utmost respect. Communication was excellent with regular updates and telling me what I could expect in each stage of the process.

Alex was also very straight forward with what to expect and no pie in the sky promises or expectations were made. In the end we won our case and I believe it was solely due to their experience and knowledge of not only the laws but the insurance companies as a whole. I would highly recommend them and am very grateful for the help they afforded to me.

Chad B. (Illinois)

I originally spoke with 3 other long term disability lawyers about my case before contacting Dell and Schaefer. None of those law firms would take it. They said the chances of me winning was not good. After finding Dell and Schaefer online I spoke with one of the attorneys that has since left. He did take my case but later it was picked up by Rachel Alters. Rachel is amazing and a very intelligent attorney. She not only won my case but also was able to get my back pay for 6 months.

I also cannot say enough about Sonia Nogueira. Sonia was always quick to answer any of my questions. I would usually hear back from her within hours of sending her a email. I do not know where I would be if I hadn’t contacted them. My family and I cannot thank them enough. Don’t let an insurance company tell you they are not responsible for paying you. I paid them for 20 years monthly and they looked for any reason they could not to have to pay me when I needed my benefit. Thank you Rachel and Sonia for all you guys do.

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