Multiple realities exist in California ERISA long-term disability cases, as repeatedly evidenced by varied outcomes in claim matters.
Some claimants see their protracted disabling conditions responded to in a timely, comprehensive and problem-free fashion by plan administrators and plan-funding insurance companies.
Conversely, others experience far different outcomes. Some claimants are challenged from the outset. Other claims are initially approved yet subsequently denied, and many claimants experience complex and convoluted processes en route to denial, necessitating the need to appeal.
The latter scenario is what preceded a claimant's lawsuit recently filed in federal court in California.
Reportedly, that individual suffered a debilitating back injury several years ago while working for the Federal Express Corporation. His claim filed last month in the U.S. District Court for the Central District of California states that his benefit plan administrators and insurer (Aetna) are unlawfully denying him LTD benefits. He additionally contends that he has never been provided with any reasonable explanation to support the denial.
We note on our website at the long-established Bay Area law firm of Roboostoff & Kalkin just how common such a fact pattern is. Many individuals across California suffer frustration and financial challenges in the wake of claim delays and denials.
Our proven legal team urges those individuals to immediately request their entire claims file if they are confronting obstacles in securing the contractual benefits to which they are entitled. A proven LTD attorney can help them with this, as well as ensuring that all ERISA requirements are followed during the appeals process.
Many claimants understandably wonder whether they must sue their employer, as well as the insurance company, to collect disability benefits. At least in California, this is not usually necessary.
It is usually the case that a claimant will file suit only against a benefit plan and its insurer. That is what unfolded in the case spotlighted above.
Disability denial is obviously a core concern for any sick or injured individual who cannot work. Any questions or concerns should be immediately brought to a seasoned disability attorney with a demonstrated record of strong client advocacy in LTD matters.