How We Handle Your Long Term Disability Benefits Appeal

We have discussed what we do up to the point in time which your Administrative Appeal has been submitted to the insurance company. Now we share how we can help with your Long Term Disability benefits appeal in Orlando.

The first thought is, why am I appealing to the insurance company if they already denied it? The best answer to this question is that these claims are required to go through this administrative process before a lawsuit can be filed to enforce the insurance company’s obligation. Here is how our attorneys can help you with your Long Term Disability benefits appeal in Orlando.

Regulations And Time

The federal regulations which require the appeal allow the insurance 45 days to respond to the Administrative Appeal. However, the regulations also allow an additional 45 days which the insurance company can claim for any or no reason. In addition, at any time the insurance company requests that the claimant provide documentation, these time periods are “tolled,” meaning that whatever period of time it takes to respond to the inquiry is added to the 90 days they already have. It is not unusual to get these requests shortly before the expiration of the 90 day period for your Long Term Disability benefits appeal in Orlando.

How Do The Insurance Companies Get In The Way?

Often, the insurance companies will ask the claimant to secure documents from third parties and try to count the delay toward tolling.  This is not correct as tolling only applies to delays supposedly created by the claimant. We press the insurance companies throughout the appeal process in order to ensure our clients’ appeals are handled in as timely a manner as possible.

The insurance company is ultimately required to render a “benefits determination,” either favorable (hopefully!) or adverse. In another blog, we discuss what to expect after the benefits determination is rendered. If there are any questions you have about your Short Term Disability or Long Term Disability claim, contact our firm and we can set a conference. This conference is usually free of charge and you are not under any obligation to hire me nor would you feel any pressure from me to do so.

Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida. We focus exclusively on claims for Short Term Disability or Long Term Disability benefits.