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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.

There are 4 opinions so far. Add your comment below.

Ken:

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?

Attorney Stephen Jessup:

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.

Patty:

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.”

Attorney Stephen Jessup:

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.

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