In New Jersey, you have a right to file a claim for disability benefits through ERISA. If you have been injured or become ill and cannot work, you can get the benefits you need. Unfortunately, it’s not unusual for your claim to be denied. However, you have a right to appeal the decision.
How do you appeal a denied ERISA claim?
There are a variety of reasons why your claim for disability might be denied. It could be that you are not eligible or something as simple as your plan needing additional information about your claim. No matter what the exact reason, however, ERISA appeals give you the opportunity to continue trying to get the benefits you need.
ERISA appeals must be made by using all the information in a claim denial notice. Read over the entire notice and make sure that all the information is correct. Your plan is required to provide you with all relevant copies of documents, records and anything else pertinent to your claim when you request it. If the claim denial notice states that an expert was used in the decision to deny your claim, you have a right to request the identity of that expert. You have 180 days to get any and all information you need to send it to the expert as part of your appeal.
Once you have sent in your appeal, your claim is reviewed by someone new. That person will look over all of the information you have submitted and speak with medical professionals if there has been a medical judgment made.
What if your appeal is denied?
ERISA appeals are sometimes denied. If this happens to you, the best thing you can do is to obtain legal advice from an attorney. An attorney can advise you of your rights and help you if you choose to go to court to get the benefits you need.