Did the insurance company deny your ERISA long-term disability claim?
Insurance companies do not care if you can work or not. Instead, they only care about making a profit. That means collecting premiums, not paying claims.
If you received your denial letter, there is a lot of work to do in a short amount of time.
We will review your ERISA Disability denial letter for free. All you have to do is click the red button below, and upload your denial letter.
Upload your denial letter
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Give us two business days to review your denial letter and send us an email that you uploaded it.
Why Do They Deny Claims?
Insurance companies know that if they deny your Virginia long-term disability & ERISA claim, most people would have a difficult time getting all of the right paperwork ready to file a successful appeal. That is why they do it. I know, it is not fair.
When youâve been turned down by your long-term disability company, suffering from a disability that leaves you barely able to function in everyday life, call the law firm of Osterbind Law. We know how to sense when they’re bluffing and when they’re notâand we’ve won against claims denials from every major insurance company.
Has your Virginia long-term disability claim been denied?
Our ERISA lawyers will review your denial letter and give you a 30-60 minute Free Strategy Session. In that session, our lawyers will walk you through a strategy to win your long-term disability claim for FREE!
You need a winning strategy and you need it yesterday!
If they deny your claim and you do not successfully appeal, then the insurance company wins and they donât have to pay your claim.
They deny claims knowing that you are disabled. They know you are applying because you are physically unable to work. And yet they expect you to present an appeal as if none of that were true.
After your long-term disabilility claim is denied, you only have one appeal. That is why the stakes are so highâyou only get one shot.
And, your one shot has to be completed within 180 days of your denial letter.
So if you wait around, you may lose your case.
If long-term disability benefits are your only option to provide for your family, then you need to start thinking about your next steps now.
Unlike so many other cases in Virginia, ERISA long-term disability cases have short deadlines and require you to act quickly.
Has your Virginia long-term disability claim been denied?
Our ERISA lawyers will review your denial letter and give you a strategy to win your long-term disability claim for FREE!
You need a winning strategy and you need it yesterday. If they deny your claim and you do not successfully appeal, then the insurance company wins and they donât have to pay your claim.
They deny claims knowing that you are disabled. They know you are applying because you are physically unable to work. And yet they expect you to present an appeal as if none of that were true.
After your long-term disabilility claim is denied, you only have one appeal. That is why the stakes are so highâyou only get one shot.
And, your one shot has to be completed within 180 days of your denial letter.
So if you wait around, you may lose your case.
If long-term disability benefits are your only option to provide for your family, then you need to start thinking about your next steps now.
Unlike so many other cases in Virginia, ERISA long-term disability cases have short deadlines and require you to act quickly.
What is an ERISA Disability Policy?
ERISA stands for the Employee Retirement Income Security Act. It is a series of federal statutes that govern benefit plans that Employers offer to their employees. These statutes control health insurance, dental insurance, vision insurance, 401kâs, and short-term/long-term disability insurance.
The rules are strict and federal courts are unforgiving.
They do not give the claimant the benefit of the doubt; instead, the courts treat both sides the same.
Often to the claimant loses out because you did not have an ERISA lawyer helping you through the process.
If you are applying for long-term disability in Virginia, that usually means you have been diagnosed with a significant injury like:
- chronic fatigue syndrome,
- musculoskeletal problems such as a spinal injuries or a spinal condition,
- cardiovascular diseases like heart failure or coronary artery disease,
- stroke,
- cognitive impairments like a traumatic brain injury,
- respiratory diseases like asthma or COPD, or
- maybe even cancer.
These diagnoses are difficult. They require significant treatment and sometimes they require a significant amount of rest.
At this point, you can do three things:
The choice is yours. There is no wrong choice, but there are consequences to our choices.
DO NOTHING
If you are defeated, you could stay down. You could lose the right to pursue your claim at all in the future. By not doing anything or waiting too long, it will be too late to accomplish any degree of success.
HANDLE THE APPEAL ON YOUR OWN
You can work up your appeal on your own by filling out the insurance companies limited forms. And, hope for the best knowing that the insurance company has more resources and knowledge about how these claims are resolved. At the end of the day, this may cost you.
HIRE AN ERISA ATTORNEY
An Osterbind Law attorney can review your denial letter and recordsâfor freeâto tell you what your chances of success may be. Our attorneys have the specialized knowledge of the law and the practical aspect of these claim. They can tell you whether you can win or lose. Then, they will create a plan to win.
Why hiring Osterbind Law is the best option
When federal judges look at long-term disability claims in Virginia, they see inequality. Especially for people compared to the vast experience of the insurance companies. One federal judge said:
âThe Court also recognizes that ERISA claimants may not have the advantage of legal advice or favorable referrals before the administrative process is complete, placing such claimants at a distinct disadvantage if discovery is not permitted on judicial review. For ERISA claimants not able or aware enough to hire legal counsel before the administrative process is complete, they likely enter into judicial review facing a loaded deckâa deck loaded with the expert opinions of those hired by the plan administrator and, with the possible exception of a treating physician or two, lacking the opinions of vocational or medical experts hired by the claimant. Further, if the plan vests discretion with the plan administrator, as almost all do, such claimants also face the hurdle of a discretionary standard of review.â
Abromitis v. CNA, Reporter, 261 F. Supp. 2d 388 (F. Dist. Ct. W.D.N.C 2003).
This isnât just me saying it, this is a federal judge.
If you donât want to face a loaded deck, you need to start looking for an ERISA attorney.
1. The best time to consult a long term disability lawyer is right away.
What Judge Cogburn is saying here is that ERISA long-term disability claims in Virginia are different than almost every other case. In a personal injury case, you can file your lawsuit, send written questions to the other side that they are required to answer, order a deposition of the opposing party and any important witnesses, find new witnesses and present new evidence, and eventually, present your evidence to a judge or a jury. Unfortunately, with ERISA long-term disability cases, that is not true.
Your opportunity to present evidence is limited to the appeal process with the insurance company. That means the same company that is responsible for paying your claim is responsible for fully and fairly considering whether your disability meets the eligibility requirements under the plan. This structural conflict of interest sometimes weighs in your favor, if you know how to develop the case.
Ideally, you want an ERISA lawyer filing the notice of your disability and drafting the initial disability claim application. A lawyer can help you identify the areas where the insurance company is likely to object to your disability claim. Insurance companies will nitpick through your medical records and find statements like, âshe is doing wellâ and take those statements out of context. Addressing some of those statements is essential for winning your claim early. Your lawyer should prepare to preemptively address these problems.
Also, there are pretty strict deadlines to filing your long-term disability claim within and if you donât meet these deadlines, they can be treated like a statute of limitations. Having an ERISA lawyer helping you from the very beginning will eliminate many of these problems.
2. The second best time to consult an ERISA long term disability lawyer is after your long-term disability claim has been denied.
After you have submitted your long-term disability claim and the insurance company has denied it, you should consult an ERISA lawyer immediately.
At this point, your timeline is very limited and there is significant work to be done to overturn that initial decision. If you hire an ERISA lawyer to help you, he or she should start by gathering all of the relevant information necessary for your claim. That includes all of your medical records, all of your vocational records, and the entire claim file. This is typically your last chance to prove your claim by presenting new evidence.
Your ERISA lawyer should be able to discover exactly why the insurance company denied your claim. Many times, insurance companies give vague explanations for your denial that make no sense. If that is the case, a lawyer will be able to force them to be more specific so you can address every issue raised by the insurance company.
Your ERISA lawyer should also be able to get additional evidence to submit in support of your long-term disability claim. Often, the insurance company will deny your claim for lack of objective evidence. Your lawyer should know the types of tests, exams, or images that would provide the necessary objective evidence to prevail and work with your healthcare providers to get that information. Then, your lawyer should present that information in a compelling way to the insurance company.
Hiring an ERISA lawyer should make your life easier, not harder.
Call us at 434-515-2807.
Our ERISA attorneys offer free strategy sessions for all who ask us to review their claim. Whether you are thinking about applying for long-term disability benefits, or if youâve already been denied and you need to appeal, weâll sit down with you to discuss the merits of your claim and provide a strategy for going forward. We call these free strategy sessions. We donât pressure you to do something that you donât want to, but rather, weâll present you with all of your options and set out a strategy going forward. Give us a call or send us an email and weâll be happy to talk with you.
We also have several videos with answers to the most frequently asked questions that people have after their long-term disability claim was denied.
We represent claimants for long-term insurance disability claims against insurance companies who don’t want to pay.
Your employer pays for a long-term disability insurance policy as an employment benefit. These insurance companies gladly accept the premium payment from your employer but rarely do they want to pay a claim like this. If your benefit is $6,000 per month, that is $72,000 per year that the insurance company has to pay. You can see why they donât want to pay. We always quip that insurance companies are in the business of making profits not paying claims.
But your plan administrator owes a fiduciary duty to all plan beneficiaries, including you. That means that she has to act with your best interests in mind. However, when faced with your best interest versus paying a substantial claim, you can see why the insurance company would deny it.
They are required to give your claim full and fair consideration. If they donât, then your only recourse is to file a complaint in the federal district court. This stage becomes even more complicated and a lawyerâs ability to communicate in writing is essential.
