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LTD Claim Denials Lead to Complicated Appeals Process

Being unable to work because of an illness or injury is something many in California do not like to consider. However, those with foresight plan for that possibility by adding long-term disability to the insurance benefits they obtain through their employers. Because these policies are often offered as part of an employee benefits package, they are usually subject to ERISA (the Employee Retirement Income Security Act), which governs most employee benefits litigation. ERISA and the associated Department of Labor regulations also govern the process of administratively appealing the denial of a claim for disability benefits which is normally required prior to a lawsuit being filed.

After planning ahead and purchasing LTD insurance, it can be discouraging if the insurer denies the claim. At that point, the claimant is likely suffering physically, emotionally and financially, and challenging the denial can be a struggle. Nevertheless, ERISA requires that the claimant administratively appeal the denial to the insurance company or plan administrator prior to bringing a lawsuit to seek the benefits at issue in state or federal court.

The reasons for denial of a claim for benefits vary but it is not uncommon for the insurance company to base its denial upon an error on the claimant’s application or the alleged failure to provide enough medical support for one’s claim. This is why many people wisely seek the assistance of an attorney from the very beginning of the claims process.

When faced with a long term disability claim denial, a claimant in California should be prepared for a difficult battle if he or she intends to appeal, and if necessary, proceed with filing a lawsuit.

An attorney who has experience with disability law and ERISA governed disability plans will often provide you with the best chance for a successful outcome. This will allow a claimant to focus on his or her health and recovery, rather than fighting with an insurance company.

Client Reviews
Just when I thought there was no hope to recover my LTD benefits, I found attorney Constantin Roboostoff. With his expertise, I was able to recover all of my back long term disability benefits. Other attorneys wouldn’t take my case because it wasn’t cut and dry. Mr. Roboostoff took the challenge and did an incredible job. Not only did he get my current disability benefits going, he also recovered all my back benefits. He was a true blessing and I would recommend him whole heartedly. CW
It was my pleasure to make contact with Scott Kalkin three years ago after other lawyers had turned me away and told me I would not succeed in my lawsuit. Thanks to Scott's thoroughness, dedication, and diligence, my lawsuit WAS successful and he saw me through to the end, which included putting legal pressure on the insurance company which had invested so much time, personnel, and money, in not paying me what was due. RB
As soon as I met with Scott, I could tell he was knowledgeable, resourceful, experienced, highly professional, and would be dedicated to getting me fair treatment. Scott has handled all interactions with my insurance company ever since. Being able to rely on him to represent me has been a huge relief for a chronically ill person. SO