If you’re denied long term disability insurance benefits by the insurance company, you may be eligible to appeal your long term disability case to federal court. Litigation is the process of taking legal action or filing a lawsuit to protect your legal rights.
Unlike an individual disability policy that is governed by state law, federal courts have jurisdiction over all ERISA long term disability cases. Policyholders whose benefits have been denied or terminated do not have the right to a jury trial in ERISA cases. The federal judge alone will make the decision in an ERISA long term disability lawsuit.
Note: A lawsuit can be extremely time-consuming. That is why it is critical that the disability attorney you choose to represent you does everything possible to resolve your case during the internal administrative appeal process without having to depend on a federal court for a fast resolution of your claim.
How to Appeal Your Long Term Disability Case to Federal Court
Most civil cases are started by one party (the party suing, called the “plaintiff”) filing a “complaint” with the court. A “complaint” is a document that describes what the plaintiff wants (money or some other type of relief) and why they believe they are entitled to that relief. It also identifies the “defendant” (the party being sued). The court will also issue a “summons”, which notifies the defendant that they are being sued. The complaint and summons must both be “served”, or personally delivered by a process server, to the defendant
Once the Complaint is processed by the Clerk of the Court and a summons is issued, we will have a process server deliver it to the defendant. The defendant has 20 days from the date that they are served in which to file a response to the Complaint, which will usually be an Answer to the Complaint or a Motion to Dismiss. Assuming the defendant chooses to Answer the Complaint (in which they will most likely deny everything that we allege in the Complaint), the next step is to hold a Parties Planning Meeting.
At the Parties Planning Meeting, the attorneys for all the parties will get together to discuss how much time will be needed to perform discovery in the case and various other procedural deadlines. Based on the discussion at the Parties Planning Meeting, we will submit a report to the court, who will then issue a “Scheduling Order” which sets forth important procedural dates, such as when witnesses need to be disclosed, when discovery ends, and when the case should be ready for trial. In federal court, the short deadlines that the court imposes in which to finish discovery force everything to move along rather quickly. It does take several months, however.
When Can You Sue?
In an ERISA disability claim, a lawsuit cannot be filed until all of the claimant’s administrative remedies have been exhausted. Most LTD policies governed by ERISA require at least one appeal directly with the insurance company or plan administrator before a lawsuit can be filed.
How Does the Judge Make a Decision?
In ERISA cases, the court uses one of two standards of review to evaluate your disability claim: either the de-novo review standard or the arbitrary and capricious standard, also known as the “abuse of discretion” standard. The judge decides which standard to apply based on the wording of the policy in question.
Legal Representation in Long Term Disability Insurance Lawsuits
Although based in Florida, the Ortiz Law Firm represents claimants across the United States. If your LTD claim has been wrongfully denied, delayed or terminated and you’d like to speak to an experienced long term disability insurance attorney contact us at (888) 321-8131 to schedule a consultation. We can help you evaluate your claim to determine if you will be able to access long term disability benefits and how to move forward with the process.