Disability Insurance
Denied or Ended Benefits
A denial or a stopped payment can leave you worried about income and unsure how to respond. Stansberry Kinsley’s disability insurance lawyers help people across Alabama review these decisions and prepare appeals when an employer plan is governed by ERISA.
How long do I have?
For a disability claim covered by ERISA, the appeal rules generally allow at least 180 days after you receive a denial or a decision to stop benefits. That period does not settle every possible deadline, including a deadline for later legal action. We can review the letter and plan together to explain the timing that applies.
Start with your policy or plan and the latest letter you received. You do not need every record before asking for a case review.
Your situation
What to understand first.
What is ERISA?
ERISA is a federal law that governs many employee benefit plans, including many disability plans offered through work. It sets requirements for claims and appeals. Individual insurance policies and some employer arrangements follow different rules, so the coverage needs to be identified before choosing a response.
What should an appeal address?
The appeal should respond to the reasons given in the decision. That may mean explaining a work duty, supplying missing medical information or addressing how the insurer applied a plan term. A review of the claim documents helps make those questions clearer.
The ERISA disability-claim rules provide access, on request and without charge, to relevant claim records. We can discuss those records and what additional explanation or evidence may be needed.
What to keep
Start with the information you have.
Keep available records together. This is a starting list, not a requirement to gather everything before getting in touch.
- The decision letter: Save it with the envelope or email and note the date it arrived.
- The policy or plan: The plan documents or policy, and the summary plan description if you have it.
- The claim file: Ask for a copy of the records the insurer or plan relied on, and keep the request and the reply.
- New medical information: Treatment, tests and statements from your doctors since the decision.
- Everything you send: Copies of appeal letters and attachments, with proof of when they were sent.
Ask about timing early.
Insurance and plan letters state the dates that apply to you, and appeal windows can be short. Keep each letter, note when it arrived, and ask for a prompt review of the dates in it.
Common questions
A few answers before you begin.
The next step
What happens next.
A case review is a place to begin understanding the questions your claim raises.
Tell us where your claim stands.
Start with your policy or plan, the stage your claim has reached, and the questions you want answered.
Review the available information.
Discuss the letters, forms and medical information already supplied, and anything the insurer or plan has asked for.
Understand the next step.
Ask what further information may be needed and which next steps may be appropriate for your circumstances.
What will it cost?
A Free Case Review costs nothing. Many disability insurance cases use a contingency fee, which means the attorney’s fee is a percentage of any recovery. Before you decide whether to hire us, we’ll explain the proposed fee, any payment due upfront and how case expenses would be handled. Depending on the agreement, you may be responsible for some expenses even if no attorney’s fee is owed.
Talk with us
Bring the decision letter and any benefit documents you have. Request a Free Case Review or call 844-327-5529.
Related reading: Denied Benefits and Appeals · Understanding ERISA: Your Guide to Private Retirement and Health Plans · What’s the Difference Between ERISA and Individual Disability Insurance? · Why Was My ERISA Disability Claim Denied?.
You can start with the questions you have.