ERISA Administrative Appeals Are Mandatory Before Filing a Lawsuit

kansas city long-term disability lawyer appeal denialIf your long-term disability policy is governed by Employee Retirement Income Security Act of 1974 (“ERISA”), you need to understand that ERISA claims are different.  Under ERISA, there are certain things you must do before you are entitled to file a lawsuit to recover benefits that were wrongfully denied or terminated.  

You can learn more about all these differences by downloading our free ERISA disability guide, Danger: Proceed At Your Own Risk.  

One key difference is this: before filing a lawsuit in court, ERISA requires you to exhaust all "administrative remedies."  This means you must file an administrative appeal with the insurance company before pursuing your case in court.  

Our exerpienced long-term disability attorney is one of the very few nationwide who is trained in the law that governs these policies called ERISA.  Call our office today at 816-203-0143, or use our contact page or web chat, to get the help you need.  We're here for you, and on your side!

ERISA Gives Insurance Companies Broad Discretion to Deny Claims

The administrative appeal process gives the insurance company the opportunity to take another look at your ERISA benefits claim and to reach a different decision if it 'believes' the facts warrant it.  ERISA also gives broad (although not unlimited) discretion to the insurance company in reaching a decision on whether to deny or terminate benefits.  In other words, they're not your friend.

ERISA Long Term Disability Appeals Are Complicated

The administrative appeals process is an important opportunity for you to provide all supporting documentation and evidence for your claim. It is critical that all the required information is gathered and submitted that supports your disability claim, and to address any inaccuracies. You will not be able to submit anything further after the appeals process has ended.  ERISA bars you from adding new information beyond the claims file later.

If a lawsuit is filed prior to filing an administrative appeal on an ERISA disability benefits claim, two things are very likely to happen.  

  • First, the court will dismiss your claim based on the failure to follow the requirements of ERISA.  
  • Second, by the time your case is dismissed, the deadline to file an administrative appeal may have passed.  

Remember, you only have 180 days from the date of denial to file an administrative appeal.  These deadlines are firm.  If the appeal is not pursued within this timeframe, you will lose your right to file a lawsuit or recover any benefits - even if you have a valid claim that should otherwise be paid under the law.


Contact Our Experienced ERISA Long-Term Disability Attorney

long term disability guide to appeals from our lawyer Kansas CityERISA claims and appeals have strict rules and procedures, and are complex.  The stakes are high in these cases, and no one should try to go it alone.  If you want to learn more about why, you can also instantly download our free long-term disability guide, Danger: Proceed at Your Own Risk This guide lays out the steps in ERISA appeals.

Consult with our attorney today, who is one of the very few attorneys nationwide experienced in ERISA.  Our long-term disability attorney will review your denial letter for free, and provide a strategy for moving forward.  We can help answer your questions, protect your right to appeal, and have the right strategy in place to get your benefits reinstated.

If you have questions about your long-term disability case, call us at 816-203-0143, or contact us through our contact form or web chat, and get the help you need, and deserve.  We're here for you, and on your side!


Kevin J. McManus
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Kevin McManus is an accident injury and disability lawyer in Kansas City, MO, and Overland Park, KS