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Are you challenged or perplexed by the ERISA disability claims process?

| Jan 21, 2021 | ERISA

As a North Carolina disability claimant, you might be a bit confused – candidly, even bewildered – by the various ins and outs relevant to your claim’s processing.

There are a lot of them, aren’t there? And they can feature every step of the way, from the initial application stage onward.

Many individuals first find that out only when they face shock linked with the denial or termination of what they view in good faith as a legitimate claim. They envision a straightforward and streamlined avenue available to contest an adverse result and feel understandably stymied when that turns out to be far from the case.

Company-sponsored disability benefits for most workers across the country are governed by and administered through federal law operative under the Employee Retirement Income Security Act. ERISA rules provide for an exacting and detailed regimen that claimants must follow when applying for disability and when contesting negative outcomes. A rigid and almost lock-step process must be adhered to, especially by an individual fighting back against an insurer’s denial or severing of disability benefits.

ERISA case study spotlighting denied disability benefits

The following story concerning denied disability benefits was recently reported.

The crux of the tale focuses on a claimant’s disability claim repeatedly denied by her employer and insurance examiners. That individual followed initial claim denial with a subsequent administrative appeal, which was additionally denied. She followed up that rejection with yet another appeal featuring updated medical information supporting a right to benefits.

That effort was also shot down, which ultimately led to a recently filed lawsuit alleging unfair claim rejection. The litigation is currently ongoing.

A few takeaways tied to the ERISA disability appeal process

An authoritative and in-depth legal source on ERISA disability filing, disputes and appeals underscores the challenges that disabled individuals sometimes face. Candidly, it notes that, “Insurance companies are not on your side.”

And there is also this to note, which is implicit from the above case narrative:

  • An administrative appeal is required under ERISA prior to the filing of a lawsuit
  • It is critically important for a claimant to submit relevant and updated information in an appeal that supports claim approval
  • The clock is ticking on the period remaining open for filing an appeal, so time is of the essence
  • On-point and tailored input from a proven disability law legal team can be vital for a lawsuit filing and ultimate case resolution

Legions of disability claimants suffer frustration and setbacks relevant to their challenges contesting claim denial or termination.

Those downsides are far from automatically permanent. Experienced and aggressive disability law attorneys can often secure reinstatement of benefits or a meaningful settlement in court.

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