ADMINISTRATIVE APPEALS

If your initial claim for ERISA disability benefits is denied, plans often allow for at least one administrative appeal.  The deadline for filing an administrative appeal for your ERISA disability benefits will be disclosed in the letter denying your initial claim.  Moreover, it is usually necessary to exhaust the administrative appeal process in your ERISA plan before you can file a lawsuit for disability benefits.  

Generally, only information or documents that are provided through the administrative appeal will be considered by a court if a lawsuit for benefits is ultimately filed.  Thus, it is crucial to ensure that all necessary information is submitted during the administrative appeal because there may likely not be a chance to provide further information in support of your disability claim if it becomes necessary to sue for benefits.

At Tact Law Firm, we can assist in preparing and submitting a compelling administrative appeal to overturn the denial of your initial claim for ERISA disability benefits.  This process includes:

• Assessing the denial letter to determine what reasoning the insurance company or administrator gave for denying benefits.
• Requesting and evaluating your entire claim file from the insurance company or administrator in order to understand what was provided in support of the claim and what actions the insurance company or administrator took in denying benefits. 
• Analyzing the medical documentation provided and determining what further medical records or reports need to be provided during the appeal. 
• Evaluating what further medical treatments or testing should be conducted to support the appeal. 
• Carefully analyzing any reports or opinions prepared by the insurance company or the administrator's hired medical examiners in order to determine which appropriate rebuttal reports should be prepared.
• Preparing a compelling and robust appeal letter that sets out the reasons why the denial of the initial claim for benefits was incorrect and why you are entitled to disability benefits under your ERISA plan.