For Disability Claims and Appeals, Timing is Everything
Tuesday, August 20th, 2013
If you are considering filing a claim for disability benefits or have been denied long term disability insurance benefits and are considering what to do with the stomach-churning letter that you received denying your claim, know that time is not on your side.
There are strict time limits at practically every step of the claim process, and no consideration for the poor state of health or emotional state of the claimant. No matter how heartwarming or amusing their commercials may be, insurance companies are not social service agencies. There are set limits of time for claimants to file a claim, to respond to queries for additional information when a claim has been filed, and zero flexibility to appeal a denial of claim.
If it seems unfair that to impose strict time limits on people who are so ill that they cannot work, that too is not of concern to the disability insurance company. While the person you speak with on the telephone may seem caring and concerned, remember that they are working from a carefully scripted playbook and are extremely well trained to demonstrate compassion while informing you that you will not be receiving a check this month, or for that matter, any month at all.
The complexity of the long term disability insurance claim is problematic for claimants, regardless of their level of education or pay grade. These are sophisticated contracts governed by federal law. Even our fellow attorneys, unless they are disability attorneys familiar with the processes and procedures of LTD law, fall into the same traps as anyone else. The time limitations are just one of many challenges that claimants face.
Here are some of the critical deadlines to be aware of when it comes to disability insurance claims:
Generally speaking, a disability claim must be filed within 30 days of the disability beginning. This varies from insurance policy to policy, so it is important to read the contract carefully – or have an experienced attorney review it for you.
If the insurance company asks for additional information, the request may have a specific date by which information must be received. Check the policy.
If the claim is denied outright, you have 60 days to file an appeal. This information should be in your contract, but it may not be easily found. The deadlines for filing an appeal are governed by ERISA, the federal law that controls many aspects of employee benefits. Often, language concerning dates and time frames can be very confusing to the layperson. If you do not respond within 60 days, you risk permanently losing the right to fight the denial.
Selecting and retaining an experienced and well-credentialed Long Term Disability Insurance Lawyer is a critical step for claimants. An experienced practitioner will take on the worries and the details of a disability insurance battle, whether that means helping you to file a claim, making sure your doctor understands the key role of medical reports, navigating through the complex process of appealing a denial, or, if necessary, taking your case to court.