Avoiding Denial for Disability Benefits Under ERISA

The Employment Retirement Income Security Act of 1974 is designed for the benefit of those who cannot work anymore due to disabilities or to old age. Well, the security they should be providing is all-encompassing, but the thing about ERISA is its high denial rate for applicants trying to get benefits.

But it is wrong to assume that the high denial rate are mere whims. The denial rate of ERISA is for it to protect itself from unnecessary release of money for applicants who are actually disqualified to claim the benefit. ERISA simply prioritizes those whose conditions are clear-cut qualified to acquire their benefits for support.

Although, it is possible that ERISA inspectors merely overlook some of the conditions, or sometimes downgrade the written documentation of those who submit their claims. It is important for claimants to have the will and the patience to appeal their almost-always denied initial claims, especially if they think that they really deserve the benefits.

But before marching into the ERISA office, sputtering about inequality and lack of democracy and the ineptitude of the government because of the repeated denial of your ERISA claim, you'd better do the following first:

Have a Claims Reviewer or a Lawyer Criticize Your Claim

• Find out and advise you specifically why your claim has been denied.
• Specify the provision which the claim-denial is grounded.
• Advice what additional documents or material is needed to strengthen your claim.
• Inform you on what to do to have your initial claim reviewed.

Criticize Your Own Claim

Criticizing your own claim and your own health status will give you a solid idea on how the evaluator of your ERISA claim might have thought while rejecting your claim. Do not assume anything, and be critical, and by doing that you will be able to see the holes in your claim and cover it.

Choose Your Own Lawyer

For obvious reasons, it is better for you to work with a lawyer whom you trust to assist you in forwarding the best of your interests in the ERISA claim. Avoid working with lawyers provided by the insurance company itself.

Ask Your Doctor to File a Complete Report

Filing a complete report to give to the insurance company is better than filling up the essentially scarce space allotted for explaining the condition in insurance company forms.

There are stories and stories of rejected disability claims all because of some petty disqualification that, in fact, simply fails to see the actual need of an individual to claim the said benefits. ERISA evaluators are inherently positioned to find as much loophole as possible with the kind of disability you have presented, so preparation is really needed for application of both the first claim and the appeal to save more time and money.