What are the ERISA disability appeal deadlines and why 180 days?
Disability Insurance Denial and ERISA Appeal Deadlines Prior to Lawsuit
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.
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,
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.
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,
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.