Filing an ERISA disability claim in New Jersey can seem like a long, drawn-out process. It’s quite possible that your claim might get denied at first, but you can always file an appeal. The regulations of filing an appeal will depend on your employer as well as the rules in your state.
Why was your claim denied?
ERISA disability claims can be denied for a variety of reasons depending on the rules of the plan as well as the employer. Sometimes, you’re not eligible to receive a disability claim due to the fine print in your plan or something outside of your control. Other times, the service you received isn’t covered by your provider. If the treatment you received or are receiving isn’t in-network, your benefits provider can deny your claim.
Most often, your benefits plan will deny your claim due to a lack of information. In this case, the provider does not have enough information to make a decision on whether the claim should be approved or not. You can always file for an appeal, provide new information and, hopefully, get approved.
How long do you have to appeal the decision?
You usually have at least 180 days from the date of the decision to file an appeal. Sometimes, your plan provides a longer deadline to make a decision based on the type of claim you’re trying to file.
All claims and plans are different, and this can lead to a lot of confusion. If you have questions about why your ERISA claim was denied or you just want guidance, reach out to a lawyer with experience in ERISA claims.