If you have applied for long-term disability benefits, you may experience a denial. When you receive notice from the insurance company that your claim has been denied, the clock starts ticking down for you to file an appeal.
If you miss a deadline, you could forfeit your right to appeal the decision and not be able to bring a lawsuit in court. There have been many challenges to strict deadlines over the years, but courts generally rule in favor of the insurance companies in most cases.
Note: If you miss your appeal deadline, you should not presume your case is over. You should promptly consult a long-term disability attorney to clarify whether the standard 180-day deadline applies to your situation.
How Do Deadlines Affect You?
The administrative appeals process is mandatory for ERISA long-term disability claims. You must exhaust your appeals before you can appeal your case to the Federal Court. Under ERISA, you usually have 180 days from receiving notice of the denial or termination of your claim to file an appeal. However, every long-term disability plan is different, and deadlines may vary.
Keep in mind that even if you are on day 182 or so and your policy requires an appeal within 180 days, you may have some “wiggle room” if your denial letter says something like “you must file an appeal within 180 days of the date you receive this letter.” As mail can take approximately five days to arrive from the date on the letter, you may have 185 days to file an appeal.
Example: Fortier v. Hartford Life & Accident Insurance Company
In this case, Mrs. Fortier received disability benefits from Hartford, her long-term disability company. She received a letter in September that her benefits would be terminated in November (two months later). She believed that her 180-day time clock started in November when her benefits were terminated, but actually, her 180-day time clock started in September when she received the notice. She did not send her appeal letter until two months after her 180-day window had closed. Ultimately, the First Court of Appeals ruled against her, citing that the law states the deadline starts when claimants receive notice.
Good Excuses For Missing Your Appeal Deadline
So, what is a good excuse for missing a deadline? Ultimately, nothing. If you miss your appeal deadlines, likely, you will not be allowed to pursue your claim further. You will also not be allowed to add additional documents to your claim to help strengthen your case. Obtaining and submitting all your supporting documents on time is critical to a successful claim.
Working With a Long-Term Disability Attorney
The appeals process is critical to the success of your claim. Navigating this process can be difficult, but having a skilled disability lawyer can help you secure the benefits you deserve. Professional assistance can often spell the difference between the success or failure of your appeal.
A proficient long-term disability lawyer will ensure you meet crucial deadlines, collect the necessary documentation, support you during interviews, and offer invaluable advice to enhance the likelihood of your claim’s acceptance. There are no attorney fees unless we win your claim and no upfront costs to get started.
The Ortiz Law Firm has a strong track record of successfully representing clients nationwide in their disability claims. We offer a free case evaluation to speak with a long-term disability attorney. We are here to address any questions you may have about your claim. To learn more about how we can help with your appeal, please call us at (888) 321- 8131.
