Simple Overview of the Claims Process

Long Term Disability benefit plans offered by employers are employee benefits, just like health insurance. They are almost always subject to ERISA, a federal statute regulating nearly all employee benefits.  Attorneys Low and Canata represent short and long term disability claimants in applying for benefits, appealing denials and terminations and litigating claims in federal court.  Here's what you need to know and what we do. 

Applying for benefits

Most people assume that if they become disabled they simply apply for and receive benefits under their employer's disability policy.  In practice, the information they provide is crucial to obtaining benefits.  Attorneys Low and Canata work with claimants and their health care providers to deliver the proper information for successful initial determinations.

APPEALS

Claimants who receive adverse determinations must methodically attack the reasons given for the denial, while providing whatever additional medicals and other information are necessary to substantiate that they are disabled under the terms of the policy. They must file a timely appeal.  They will not have a right to a trial if they lose their appeal.  

Attorneys Low and Canata thoroughly investigate claims, prepare strong evidence, refute reasons for adverse determinations and submit powerful appeals on behalf of every single client.

FEDERAL COURT REVIEW

Claimants who receive final adverse determinations must file suit in federal court to challenge the decision.  Claimants do not have a right to a trial.  Instead, a federal judge will review the record that the insurer compiled during the appeal, and often must 'give deference' to the insurer. 

Attorneys Low and Canata represent clients understanding that they may have to seek federal review.  From the time they meet their clients, they set their cases up to expose unreasonable actions and decisions by insurers.  They are preparing for success in federal court from the time they begin working with their clients.

Want to dig a little deeper into the claims litigation process? Click the link below: