Submit A Strong Appeal Package
If your long-term disability insurance benefits have been denied, then I know that you will find some relief after speaking with one our disability benefit attorneys. Our law firm’s goal is to get your disability benefits reinstated and paid until you decide that you can return to work. We win more than 75% of our disability benefit appeals and we have represented thousands of claimants with their ERISA governed disability benefit appeals and/or lawsuits since 1979. We would like to review your disability benefit denial letter and provide an immediate free phone consultation to discuss how we could help get your disability benefits paid. In order to help you understand the disability appeal process following a claim denial, we invite you read about How To Win Your Disability Benefit Appeal. We look forward to discussing your disability appeal.
The challenge is that The Employee Retirement Income Security Act of 1974 (ERISA) is a horrible nationwide federal law that gives disability insurance companies an unfair advantage over disability insurance claimants.
If you obtained either your short or long-term disability insurance coverage as employee benefit through your employer then your disability claim will be governed by the ERISA. The ERISA regulations for disability claims were modified in 2018, but these changes have only made it more difficult for claimants to win appeals and prevail in litigation.
The Insurance Companies
Our lawyers know the claim handling techniques of every disability insurance company and we are highly skilled at defeating them at their own game. Through our personal experience we have created and constantly maintain the most extensive resource on the internet for information about every disability insurance company.
We want you to search below to learn as much as possible about your disability company, review our resolved cases against your insurance company and our experience in helping people with a situation similar to yours.
The ERISA Facts
If your ERISA governed long-term disability claim has been denied following your initial application for disability benefits, ERISA regulations require the insurance company to establish and maintain a procedure by which a claimant shall have a reasonable opportunity to appeal an adverse benefit determination to an appropriate named fiduciary of the plan, and under which there will be a full and fair review of the claim and the adverse benefit determination.
This means that your ERISA appeal must be reviewed by a person different than the original person that denied the claim.
The idea is that a claimant is supposed to receive a full and fair review by the insurance company when an appeal is filed. Many people want to sue their insurance company and not bother with an appeal, but the law requires at least one appeal be filed and possibly two depending on your disability policy language.
Why Is It Important to Submit a Great Appeal?
The insurance companies want you to draft and submit your own appeal, but it is nothing but a trap. The information submitted in an ERISA disability appeal is extremely important, as all of the documents submitted become part of what is known as the “administrative record”.
In the event that your ERISA appeal(s) are denied and a lawsuit is filed, the court in most cases will be limited to their review of the administrative record. This means that if you were to have surgery after a final appeal decision is made by the disability company, then the court cannot review or consider any information about the surgery if it was not presented during the appeal.
ERISA does not allow for a jury trial, therefore if a lawsuit is filed it will be decided by a Judge. A non-jury ERISA trial is usually a disadvantage for a claimant, because the Judge does not get to hear live testimony and the Judge is basically just reviewing documents in the administrative record.
When submitting an appeal it is essential that a claimant submits every piece of information in support of a claim for disability benefits that the claimant would want a Judge to consider. The submission of a great appeal is an art and our disability attorneys are highly skilled at knowing what needs to be in an appeal and helping claimants to obtain the information needed to have the best chance to win an appeal.
How Do We Help?
In order to present our client’s appeal in a light most favorable to the insured, Attorneys Dell & Schaefer work very closely with our clients and their treating physicians, to ensure that the appeals are submitted with an overwhelming amount of information and detail.
Every case is unique and we work with your doctors to prepare statements that are specific to your medical condition and occupation. We make sure that every possible piece of objective medical evidence is obtained and we often recommend additional medical testing that could help prove your eligibility for benefits. In many cases, Attorneys Dell & Schaefer will retain a medical doctor or nurse to review all of our client’s medical records and make recommendations regarding additional evidence that would strengthen our client’s claim.
The insurance companies often hire their own doctors to either review your records or examine you. We work very closely with your doctors and our nationwide medical experts to rebut the reports created by these insurance company hired gun medical doctors. In most disability appeals, Attorneys Dell & Schaefer will retain a vocational expert in order to determine what vocational skills a claimant can perform in light of the claimant’s medical restrictions and limitations.
The vocational expert will also perform a labor market study in order to determine the availability of specific jobs in a particular market. We spend a great deal of time explaining the occupational requirements of a claimant’s occupation in order to make the insurance company understand why a claimant cannot work. We have access to all available medical research and we often rely on medical studies as further support for a client’s restrictions and limitations.
The drafting of personal statements and statements from co-workers, family members and friends can be an important piece of an appeal we submit for you. In certain appeals we will submit a custom video to further explain the difficulties you are experiencing. We exhaust every option in order to submit the best possible appeal for you. We think outside the box and when we finally submit an appeal it is hard for the insurance company to disagree with us.
What Are The Important ERISA Timeframes?
ERISA provides extremely strict guidelines and deadlines for disabled claimants seeking disability insurance benefits under their group policies. If sufficient information is not submitted within these timelines, a claimant may be forever barred from introducing the documentation to prove their disability. The disability insurance company is required to give a claimant 180 days from the date of initial denial to submit a first appeal.
While 180 days seems like a long time to prepare a disability appeal, most of this time is required to submit an appropriate appeal. The appeal process is long because it often takes time to receive all of the claimant’s medical records, obtain new medical support and review the entire claim file provided by the disability insurance company.
Once an appeal is submitted, the disability insurance company has 45 days to respond to a claimant’s appeal. However, the insurance company may request an extension for good cause. Attorneys Dell & Schaefer understand the importance of trying to obtain benefits for our clients in an expedient and efficient manner.
Frustrating as it may seem, the disability carrier will not tell you what is necessary to perfect your claim. Moreover, group disability income policies are drafted with ambiguous and confusing contractual terms. These ambiguities provide insurance companies with multiple reasons for delaying and denying disability income benefits. Furthermore, most policies provide the insurance company with full discretion in deciding whether sufficient information has been provided by claimants prior to approving a claim.
Given the complexity of the legal issues involved and the tendency of insurance companies to vigorously defend claim denials, evaluation of any potential legal claim on behalf of an insured should be handled by a law firm experienced in ERISA disability insurance claims.
Attorneys Dell & Schaefer are available to provide you with a free consultation and review of your long term disability policy. Please keep in mind that there are time deadlines with ERISA disability claims and we must have sufficient time to evaluate your claim and take the appropriate legal actions on your behalf.
Resources to Help You Win Disability Benefits
Get Your Disability Application Approved
Prevent a Disability Benefit Denial
Negotiate a Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Q: My employer terminated me 11/14/23 while my LTD claim is being appealed by the Hartford. Does my appeals process get terminated as well?
Q: How can I mount a successful appeal to a denial of coverage under my employer's Insurance carriers EOI review for Long Term Disability. Or is it a losing battle?
Q: Before I present my appeal, can I acquire exams and conduct an IME on my own (to avoid bribery/bias from Hartford)?
Q: Are there any circumstances in which I can appeal LTD after the number of days Aetna gives you to appeal?
Does my insurance company have to consider my SSDI award if I received the award after my ERISA appeal was denied?
Attorney Alexander Palamara of Dell Disability Lawyers gets LTD Benefits Reinstated for former Walmart Manager who is now found disabled from Any Occupation
NFL Disability Review Board Ignores Evidence of Disability and Appeal Court Reverses Lower Court Decision
Court Rules Plaintiff's Medical Records Was Replete With Evidence Supporting Claim of MS & Was Not A Pre-Existing Condition
Court Rules That Aetna’s Failure To Consider Plaintiff’s Actual Job Duties Was Arbitrary And Capricious
Court Finds Video Surveillance Renders Claimant’s Self-Reporting Unreliable and Upholds Hartford’s Termination of LTD Benefits
Reviews from Our Clients
Very satisfied with the work of this team. Took well care of my case and took all the necessary time to be responsive and attentive when I had questions. Guided me through recovery and returning to normalcy. All thanks to Jason & Tabitha, thank you!
I’m extremely satisfied with the experience I have had with this firm from day one. The lawyer who has handled my case, Alex, is very efficient and attentive to all my questions and concerns. They are always aware of how my case has gone and they care about my health. I feel optimistic with them because they are very attentive during the process of my claim. I would not hesitate to recommend families and friends if in any situation they need their services. Kathleen as well has been very well and assisted me with this case. I highly appreciate everything they have done for me.
It’s unfortunate when disability insurance companies come after older disabled policyholders just to help their bottom line. It can be a living nightmare the damage they can do to a family. Dell Disability Lawyers are polite, understanding and knowledgeable. They call you back and answer any question you have no matter how unimportant it can be. The amount of stress they took off of myself and family was incalculable. I recommend them highly to take care of any disability case whether it be filing for benefits or reversing a claim decision. They are outstanding.
I could not have been happier or more appreciative of the hard work they performed on my behalf. I was well briefed on my case and it was closed in a timely manner with a financially successful resolution.
Mr. Symonds and Sonia as well as everyone else we have worked with throughout this process have been very helpful, professional and caring to our situation. We are very thankful to have this great team on our side.
Without them my LTD company was dropping my plan with me still suffering from my accident, even with doctor’s statements I’m still disabled. The LTD company didn’t want to advance my policy to the next stage of years of pay. Dell Disability Lawyers saved my policy, and helped to enforce the LTD company’s own policy (for its policy holder, me) that I would be covered still under the LTD policy I had paid for at my previous job, when my accident occurred. These lawyers know what they are doing and can help you too. LTD companies will try to drop you when you still need coverage just because they don’t want to pay on your policy anymore. Don’t let them break contract with ya because they are trying to get out of it. Hit em with legal action to ensure the continuation of your policy you paid for. Dell Disability worked very well for me and continue to do so.
I was denied long term disability benefits from The Hartford after being on it for years. I found Dell Disability Lawyers after doing research online. In a matter of days they responded and explained to me everything that would be done. Dell Disability Lawyers were able to settle my suit against The Hartford very quickly and responded to me quickly. I would definitely recommend this team of lawyers for anyone that is fighting for their disability insurance.
I have had nothing but a great experience with Dell Disability Law Firm. Mr. Alex Palamara and his team went above and beyond my expectations. They will respond to emails and phone calls in a timely manner. Thank you once again for taking my case.
This law firm is the best so far. MetLife denied me two times, they appealed two times for me and they won of course. So if you are on disability and want a chance at winning your case use this firm Dell disability lawyers, kind courteous understanding and they get the job done. You won’t be disappointed.