What are the ERISA disability appeal deadlines and why 180 days?

ERISA regulations provide a claimant with 180 days to submit an appeal following a disability denial.

In this video, attorneys Alex Palamara and Gregory Dell discuss the initial steps that our lawyers take when representing a claimant following a disability benefit denial.

While an Appeal could be completed in a matter of days, we discuss what a claimant should expect and why it can take a few months to prepare an outstanding Appeal. It is always hard for a claimant to wait for the submission of a strong appeal, but you only get one opportunity to submit a great appeal.

Comments (4)

Patty,
Some carriers, Lincoln specifically, has a mandatory second appeal that is 60 days. If your plan is only stating 60 days it may not be subject to ERISA.
Stephen Jessup Sep 8, 2013 #4
Can an ERISA plan restrict the time to much less than 180 days to appeal? Can it be 60 days? The language in my ERISA policy states: “On any denied claim, you or your representative may appeal for a full and fair review. You may: (1) request a review upon written application within 60 days of the claim denial; (2) review pertinent documents; and (3) submit issues and documents in writing.”
Patty Sep 7, 2013 #3
Ken,
Prudential’s standard LTD claim procedure with respect to denials and appeals is one mandated administrative appeal as required under ERISA, and often a second voluntary appeal. After two denials the only option left is usually bringing civil lawsuit under ERISA. However, please note that without seeing your policy I cannot know for certain the procedures that may specifically pertain to your policy. Our website has extensive information regarding ERISA based appeals and lawsuits.
Stephen Jessup May 3, 2013 #2
What is Prudential LTD’s standard procedure for denials and appeals? After two appeals and denials does it go directly to an independent lawyer review or is there more I would need to do?
Ken May 2, 2013 #1

FAQ

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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.

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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.

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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.

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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.

Dell & Schaefer Client Reviews *****

Gail T.

I contacted Dell & Schaefer after my insurance provider stated that they were coming to visit me at my home to see how I was doing. I was so worried about what this meant after being on claim with them for three years. I always felt like I was always waiting for the other shoe to drop with them after going through a very stressful claim application process. Gregory Dell promptly jumped in and got to work at creating a solution to streamline and ensure my claim was not in jeopardy.

The staff has worked with me every step of the way to make sure that the process of receiving my benefits is a positive one for me. I no longer dread dealing with my insurance claim representative as they handle everything for me. They clarified that I could also apply for SSDI and with their help I started receiving SSDI benefits within months. This firm has been a great advocate for me and I highly recommend them.

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