ERISA - Disability Appeals - When Do You Get a Lawyer?

So your employer's long term disability plan documents says this:

ERISA requires that you go through the Company's administrative review process prior to pursuing any legal action challenging our claim administration. Submit your appeal to us within 180 days."

We've had clients tell us that they thought this meant they couldn't (or shouldn't) use an attorney during the appeal process.

Here's what the plan documents should say:

Get a lawyer to do your appeal. What we know but you don't is that if you have to litigate your case later the only thing your lawyer is going to be able to use are the documents, reports, evidence and arguments that were in your appeal. Our claims adjusters are trained to not only deny claims but to "bullet-proof" the claim file so that even if you get a GREAT lawyer later, he/she doesn't have any ammunition to use.

 

Its all in my free book.

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