What Do You Do If Your ERISA Claim Is Denied?
If your long-term disability claim was denied under an employer-provided plan, you are not alone — and the denial does not mean the insurance company is right.
Under the Employee Retirement Income Security Act (ERISA), insurers control the claims process, choose the medical reviewers, and often rely on paper reviews instead of treating physicians. That system is tilted against claimants from the start.
Why ERISA Disability Claims Are Denied
Insurance companies commonly deny claims by arguing:
-
Your medical evidence is “insufficient”
-
You can perform “sedentary work” despite your condition
-
Your doctors’ opinions are “subjective”
-
Surveillance or file reviews contradict your treating physicians
These tactics are routine — and they are intentional.
Why the Appeal Is the Most Important Stage
ERISA does not allow you to present new evidence later in most cases.
That means the administrative appeal is your last real chance to build the record.
Once the appeal window closes:
-
No new medical records
-
No new expert opinions
-
No vocational evidence
If the record is weak at the appeal stage, the case is often lost before it reaches court.
How an ERISA Attorney Levels the Playing Field
An experienced ERISA attorney focuses on:
-
Identifying missing medical and vocational evidence
-
Exposing flawed insurer medical reviews
-
Submitting objective testing where appropriate
-
Locking insurers into the administrative record
This is not a standard insurance claim — and treating it like one is a mistake.
Deadlines Matter
Most ERISA plans allow 180 days to appeal a denial.
Miss that deadline and your claim may be barred permanently.
Talk to an ERISA Disability Attorney Before You Appeal
Insurance companies expect claimants to appeal on their own. They rely on it.
If your disability benefits were denied, speak with an attorney who handles ERISA claims regularly — not a general practitioner.
📞 Contact Stennett & Casino for a free consultation before you submit your appeal.