Recently, our office has heard from many clients that claims representative have directed them to appeal the denial of Short- and Long-Term Disability benefits in a short, direct statement. Some clients have come to us after having written to their insurance carrier only stating, “I appeal,” at the direction of the representative assigned to their claim.
This may be the most damaging step you can take on your long term disability benefits claim.
When appealing your long term disability claim, it is important to detail your medical, disabling condition as well as possible. This includes requesting and submitting the entirety of your medical records evidencing your disabling conditions and any other contributing conditions. In addition to the medical records, you most probably need questionnaires and statements from your treating physicians. These opinions and the appeal itself should outline in detail your medical records, conditions, the manner of your reduced functionality, and how that functionality affects your ability to work in your or any position.
The important takeaway here is that once the appeal portion of your claim has been exhausted, evidence of your disability is closed for purposes of initiating litigation. The information proffered by you during the appeal process and that gathered by the insurance carrier is the entirety of the evidence which would be collected in the event of the need for a lawsuit.
For the above reasons, it is entirely unethical for a claims representative to recommend to unrepresented claimants that all they need to do is to state that ‘they appeal’ in written form.
If you have any questions about your short term disability or long term disability claim, please give Herbert M. Hill, P.A. a call and we would be glad to answer any questions you may have. We are available at 407-839-0005 or, toll free, 844-454-59995, If you would like, after discussing your case, we can set a conference. In most circumstances, that conference would be free of charge but in no circumstance would you be 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. While the vast majority of cases handled are for disability insurance benefits, areas of practice include employee benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (“ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.