Long Term Disability Insurance Policies come in a variety of types and are governed by different laws. Often times these cases are referred to as ERISA cases because the Employee Retirement Income Security Act of 1974 governs the case.
No matter which type of long term disability policy is involved, the stakes are high and the issues are complex. Difficult questions related to federal preemption versus the states’ rights to regulate insurance policies sold within their borders exist. There are also complicated offsets between social security benefits and workers’ compensation benefits that must be addressed.
Most importantly, ERISA cases are generally tried based on the evidence before the insurance plan claims administrator when the decision to approve or deny was made. Accordingly, claimants cannot add evidence after the final decision to deny the claim has been rendered. This means that claimants should hire an attorney early so the record in their case can be properly developed.
If you have a LTD plan and have been denied check the deadline to appeal. Most plans allow for at least one appeal within 180 days of denial. Beware, that six months goes by quick, call early.