The process of applying for disability benefits does not have to end with a claim denial. Both Social Security and employer disability coverage allow appeals, and private policies allow them as well. Claim denial doesn’t mean that a person isn’t disabled, or that benefits aren’t forthcoming. Less than a third of claims are approved on the first attempt, and disability coverage is governed by ERISA (the Employee Retirement Income Security Act). The ERISA law allows plan administrators to evaluate claims, creating a conflict of interest that can lead to unjust denials.
Appealing a Denial
If a person loses work because of disability, insurance benefits can be a way to protect the entire family. The law allows a Disability Lawyer in Brockton MA to appeal an initial denial, and the process can vary depending on the type of coverage (employer-sponsored, private or SSDI).
- Employer coverage: Under ERISA, a claim denial must be accompanied by an explanation. Claimants may also request free copies of records and documents used in the decision-making process. A lawyer will study the letter closely, noting any deadlines before work begins. In many cases, judges only consider factors that were brought in front of the insurer.
- SSDI: If a claim is denied, a person has the right to hire a Disability Lawyer in Brockton MA and file an appeal. There are four appeal levels, which must be taken in order. First, a claim goes before the state agency that initially denied it before it is heard by an administrative law judge. The claim then goes to the Appeals Council for review, before it goes to federal court.
- Private coverage: If a person buys their own coverage and a claim is denied, they should read the policy carefully. Some allow an initial appeal while others require additional documentation before a claim can be reconsidered. A disability attorney can help claimants read their policies and decide how to progress with the case. Visit here to get more information.
Call a Disability Attorney for a Free Case Review
Millions of people in America count on disability benefits to cover financial losses while they’re out of work. If a person’s claim is denied, they may need to hire a Disability Lawyer in Brockton MA, such as one from The Law Offices of Graham N. Wright, to achieve a fair outcome. If they’re not ready to move forward yet, the claimant can have their attorney review the claim and offer suggestions at no charge.
