Wednesday, May 23, 2012

How to Deal with Denial of Long Term Disability Benefits

When appealing a denial of long-term disability benefits, it is important to act fast to develop the information to rebut the reasons the insurer gave to deny the claim.  The relevant period for determining disability is the “elimination period,” which is usually the 180 days after you become disabled.  If you wait too long to do the testing you need for your appeal, the insurer can disregarding the information on grounds that while it may show that you are disabled at the time of the testing, it does not show that you were disabled during the elimination period.    This was demonstrated in the case of Kellyv. Reliance Std. Life Ins. Co., 2011 U.S. Dist. LEXIS 147133 (D.N.J. Dec. 21, 2011), where the court disregarded the claimant’s cardiac condition in determining if he was disabled because he first received treatment for the condition after the elimination period, even though the condition contributed to his disability during the elimination period.  The case illustrates why it is important to talk to an attorney early in the appeal process so we can develop a comprehensive and timely plan to maximize your chance to get disability benefits.  Other information on appealing disability benefit denials under ERISA and for private plans is on the Employment Law section of our website.