Frequently Asked Questions

LTD coverage is often offered as part of an employee benefits package through your employer. You can also purchase a private policy directly from an insurance provider. Review your benefits booklet or reach out to your HR department to confirm coverage.

Insurance companies deny claims for many reasons, including:

• Lack of sufficient medical evidence
• Claiming a pre-existing condition exclusion
• Missing deadlines
• Stating your condition doesn’t meet the policy’s definition of disability
• Surveillance suggesting you are not disabled

If your claim is denied, it’s important to review the denial letter carefully and begin the appeals process immediately.

If your claim is denied, follow these steps:

• Carefully examine the denial letter to identify the specific reasons behind the decision.
• Gather additional medical evidence or documentation.
• File your appeal within the specified deadline (usually 180 days under ERISA plans).
• Consult an experienced disability attorney to strengthen your case during the appeals process.

Under ERISA (Employee Retirement Income Security Act), you have 180 days from the date of the denial letter to file your appeal. This is a critical window to compile and submit all necessary evidence to support your claim.

To increase your chances of success, include the following in your appeal:

• Comprehensive medical records
• Statements from your treating physicians
• Vocational expert opinions
• Daily activity logs or visual evidence of your condition
• Test results showing objective functional limitations

Yes, insurers often wrongly categorize conditions like chronic pain, migraines, or mental health issues as subjective. However, with the right evidence, such as statements from specialists, diagnostic tests, or functional capacity exams, you can dispute this classification.

ERISA is a federal law that governs employee benefits plans offered by private employers, including LTD insurance. It sets strict deadlines and procedural rules for filing claims and appeals while giving plan participants the right to sue insurers for denied benefits.

ERISA grants you:

• The right to obtain copies of your full policy and claim file.
• An explanation of why your claim was denied.
• The opportunity to submit evidence during an appeal.
• The right to litigate the denial in federal court if your appeal is rejected.

No, ERISA applies only to plans offered by private employers. Policies purchased independently or provided by government employers are handled under state law or other regulations.

The appeals process involves strict deadlines and technical requirements for evidence submission. An experienced attorney ensures that:

• Deadlines are met.
• Comprehensive evidence is gathered.
• Legal arguments are framed effectively for appeal or litigation, increasing your chances of success.

At Bartolic Law, we are dedicated to guiding our clients through the world of ERISA and LTD appeals. Our team has experience handling a range of disability claims, including those involving employer-provided plans governed by ERISA. We understand how important it is to secure your benefits and will work tirelessly to ensure that you receive the best possible outcome in your case. With us on your side, you can trust that your appeal or litigation process will be handled with care.