Why It’s Critical to Hire an Attorney Before Appealing a Denied ERISA Claim
On Behalf of Disability Insurance Law Group | | Denied ERISA ClaimsIf your long-term disability claim has been denied under an employer-sponsored plan, you are not alone. Thousands of employees each year receive denial letters under ERISA — the Employee Retirement Income Security Act — which governs most group disability insurance plans in the United States.
What many people do not realize is that once their claim is denied, the appeal process becomes the most critical phase of the entire case. Mistakes made during this stage can permanently limit your rights and prevent you from ever taking your case to court. That is why hiring an experienced attorney before filing your ERISA appeal is critical.
At Disability Insurance Law Group, we represent clients nationwide who are fighting wrongful ERISA denials. Our attorneys understand the strict legal requirements for these appeals and how to build a complete and compelling administrative record that protects your right to benefits.
ERISA Appeals Are Not Like Ordinary Insurance Disputes
Unlike private disability policies, ERISA claims are governed by federal law. That means the rules are highly technical, and the process is designed to favor insurance companies.
When you appeal a denied ERISA claim, the insurance company, not an independent body, reviews your appeal. You are asking the same insurer that denied your benefits to reconsider its decision. This underscores the importance of the quality and completeness of your appeal.
In addition, once the appeal is submitted, you cannot add new evidence later if your case goes to court. The judge will only review what is already in the administrative record. If critical medical records, statements, or expert reports are missing, your chances of success are significantly reduced.
Our experienced attorneys ensure your appeal file includes all necessary documentation, legal arguments, and expert opinions before it is finalized.
Strict Deadlines and Procedural Traps Can Cost You Your Case
ERISA appeals are bound by strict deadlines, typically requiring submission within 180 days of the denial letter. Missing this deadline almost always results in losing the right to appeal.
However, even if you file on time, procedural errors can still harm your claim. Common mistakes include:
- Submitting incomplete medical documentation.
- Failing to address the specific reasons for denial listed in the insurer’s letter.
- Not obtaining supportive opinions from treating physicians.
- Misunderstanding the insurer’s interpretation of “disability.”
Our attorneys handle every step of the process, ensuring your appeal meets all procedural requirements and is supported by strong, persuasive evidence.
Insurers Use Complex Tactics to Uphold Denials
Insurance companies often justify denials by relying on selective medical reviews, surveillance footage, or vocational assessments that underestimate your limitations. Without legal guidance, claimants may not know how to effectively challenge this evidence.
Our knowledgeable ERISA attorneys can identify and counter these tactics by:
- Highlighting inconsistencies in insurer evaluations.
- Providing detailed medical and vocational evidence that supports your limitations.
- Citing federal case law and Department of Labor regulations that protect your rights.
By controlling the quality of the administrative record, your attorney builds the foundation for success both during the appeal and, if necessary, in federal court.
We Protect Your Rights from the Start
At Disability Insurance Law Group, our attorneys know how insurers operate and how to hold them accountable under ERISA. We prepare comprehensive appeal packages that include medical records, expert testimony, and detailed legal arguments to maximize your chances of success.
Whether your claim was denied for alleged insufficient evidence, pre-existing conditions, or vague definitions of disability, we can help you fight back.
Get Legal Help Before You File Your Appeal
If your disability claim has been denied under an ERISA-governed plan, time is limited. The decisions you make in the next few weeks can determine whether you ever receive your benefits.
Contact Disability Insurance Law Group today at 954-989-9000 or reach out online to schedule a free consultation. Our nationwide ERISA attorneys can review your denial letter, explain your appeal rights, and guide you through every step of the process.