If you sustain an injury or an illness that leaves you with a disability, you may not be able to work and care for yourself and your loved ones. Subject to the nature of your disability, you may be eligible for financial restitution through your employer-funded Employee Retirement Income Security Act (ERISA) program.
Unfortunately, it is not uncommon for an insurance company to deny a disability claim. If your disability claim is denied, you’ll need to understand what led to this outcome so you can figure out your next step. These are three common mistakes that can lead to a long-term disability claims refusal.
If you miss important deadlines
Time is of the essence when dealing with any legal matter. As far as ERISA claims are concerned, there are specific timelines within which you need to file your claim and/or provide information regarding your disability to the insurance company. Otherwise, you’ll risk a rejection.
Lack of sufficient evidence
Evidence is at the core of any disability benefits claim. Thus, it is important that you provide sufficient evidence to prove that your disability is impacting your ability to work. Simply accompanying your claim form with general diagnosis documentation may not be enough. You’ll likely need to provide comprehensive documentation that includes your treatment plan and records.
Ignoring your treatment plan
If the insurance company learns that you are not taking your treatment plan seriously (say, skipping your doctor appointments or simply failing to follow through with the recommended treatment regime), it will ask questions. You need to follow through with your treatment plan to the letter or risk an assumption that you are making your condition worse via your own negligence (or that you’re not truly unwell).
Protecting your rights
The process of filing for ERISA disability claims can be quite complex, especially when you have health issues to deal with. Learning more about ERISA disability laws with the assistance of a legal professional can help you to protect your rights and interests while pursuing the benefits you are genuinely entitled to.