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Does a disability carrier need to consider my Social Security Disability approval after they have made a final decision on my final ERISA appeal?

Attorney Cesar GavidiaAuthor: Attorney Cesar Gavidia

Following a denial of disability benefits and after all administrative appeals with the disability insurance company have been exhausted, the insurance company’s final appeal denial typically signals the closing of the administrative record. Once the administrative record has been closed no further evidence, documentation or information can be added or supplemented to the disability claim. This means that if you receive a favorable determination from the social security administration regarding your claim for social security disability benefits, it is in your best interest to ensure that the social security disability file, and more importantly the supportive evidence in the file, is received by the disability insurance company before it makes its decision on the final appeal.

It is a misconception that the insurance company must give deference to a favorable social security disability determination. In fact, the disability insurance company does not have to defer to social security’s decision. However, the additional evidence sometimes associated with your social security disability claim, such as, an independent medical review and an opinion from an administrative law judge must be taken into consideration by the disability insurance company if it receives it while the claim is open.

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