The Employee Retirement Income Security Act of 1974 (ERISA) is an important federal law that is supposed to protect employees dependent on employer-sponsored benefits. ERISA creates certain rights for employees and their dependents and certain responsibilities for companies offering certain kinds of benefits.
If your employer offers long-term disability benefits governed by ERISA, you have various rights and protections. That includes the right to file an appeal after what you deem to be an unfair denial of a benefit request.
How can you prepare for an ERISA appeal to improve your chances of success?
Review the policy paperwork
Although your rights are the same, the possible outcomes vary depending on the benefits you actually have available. Understanding what benefits you can qualify for will be crucial during the appeals process. If you have unrealistic expectations, that could affect your likelihood of success or your satisfaction with an otherwise positive outcome.
Understand what led to the denial
The insurance company should provide you with an explanation for the denial of your benefits. Perhaps they claim there is inadequate medical documentation to affirm your claim of total disability, or maybe there was just a technical issue with your paperwork.
When you understand why you didn’t get your benefits, you can then take steps to correct the issue during the appeal process.
Gather evidence to support your claim
Medical records, car crash/police report data or even expert testimony can play a role in a successful disability appeal. The more evidence you have established as to the severity of your condition and its impact on your daily life, the better your chances of success during an ERISA disability benefits appeal.
Connecting with ERISA disability benefits can help you support yourself and your loved ones when you can’t currently go back to work, so these benefits can be crucial to your family’s future. Have no illusions: insurers do not want to pay your claim unless they have to. Make sure they have to.