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Appealing Denied Long-Term Disability Claims in Columbus

The appeals process for a denied long-term disability (LTD) claim in Columbus is a complex and lengthy one. Due to Federal ERISA laws, an applicant must fully exhaust all internal appeal processes at the insurance company before they can pursue a case in U.S. District Court.

This requirement places a great burden on applicants to not only work to ensure that their paperwork is correct, but also strains a person’s finances as they will be without work for this time-period. A distinguished long-term disability attorney can work with clients to appeal all denials of long-term disability insurance claims.  If you want more information about appealing denied long-term disability claims in Columbus, consult a skilled legal advocate today.

Beginning the Claims Process

The process of filing a long-term disability claim does not begin when a person is injured, but when they choose to enroll in the LTD insurance program. Many private and public employers provide this option to their workers as a deduction from their paycheck.

If an employee is not enrolled, they, of course, cannot claim benefits. The injury or illness itself that forms the core of the claim does not need to be work-related. It can also be either physical or mental.

The only qualifier is that the condition cannot have predated the workers’ enrollment in the program. This will be listed as a preexisting condition and form the grounds for a denial. Denials are also commonly issued due to a lack of medical evidence or for suspected fraud.

Long-Term Disability Claim Appeal Process

Regardless of the reason for a denial, the applicant retains the right to an appeal. Unfortunately, the effectiveness of this appeal has been lessened by the procedures outlined in the ERISA laws.

These laws state that insurance companies must have an appeals process in place for all denied claims. It also states that these appeal processes must be exhausted before the denial can be appealed in U.S. District Court.

Insurance Companies and Claim Denial

While appealing denied long-term disability claims in Columbus is a right, that does not mean that insurance companies are obligated to rule in the claimant’s favor. Every insurance company will have their own appeal procedures, but they all place the applicant in a position of a severe disadvantage.

Essentially, the insurance company is deciding whether or not they made a mistake. As one can imagine, this places the applicant in a tough spot as the insurance group is not likely to rule that they made a previous mistake.

Still, maintaining a strong record of medical treatment is extremely important during this stage as the entire file will form the core of any lawsuit in U.S. Court. Unfortunately, these appeals can take many months or even a year. During this time, the applicant is continuing to accrue medical costs without any source of income.

Lawsuits

Lawsuits filed in U.S. Court to reconsider an insurance company’s findings are determined solely on the evidence in the file. Applicants cannot appear in person, nor are attorneys allowed to speak in a hearing. The only evidence in the trial is that which is submitted with the complaint.

Therefore, it is extremely important that applicants continue with all medical treatment during the appeal process and submit this information to the insurance company.

Importance of an Attorney

Filing a claim for long-term disability benefits in Columbus is a lengthy and complicated process. Even if the claim is accepted in its first stage, benefits can never be issued for at least six months after leaving work.

With the long appeal process that most insurance companies use, it can take well over a year for a case to resolve. For this reason, it is extremely important for people to ensure that their application is as detailed and accurate as possible.

All future appeals and potential court hearings will rely on this information. If you want to know more about appealing denied long-term disability claims in Columbus, speak with a seasoned LTD attorney today.