WHAT SHOULD YOU DO IF YOUR CLAIM FOR BENEFITS IS DENIED?
When you put in a claim for benefits, the last thing you want is a denial, but that is sometimes what you end up with. Whether you think you are looking at a wrongfully denied individual disability claim or not, it is important to know what to do next.
First of all, you need to know that you do have some protections under the laws in California. These come from the Employee Retirement Income Security Act, which is also known as ERISA. It was filed in 1974.
There are a few situations in which you will not be covered by this act. For example, if your plan is through a church, you may not get the same coverage that someone else would. However, millions of people do, so this is definitely worth looking into.
You do have the right to appeal the denial. Those who administer the plan are fully obligated to give you all of the information that you need to get this review, and they cannot keep it from you. The minimum amount of time that you are going to have to put in for the appeal is 60 days. There are some plans that give even more time than this, but you should at least have the two months in which to act.
Many times, the review itself will not take more than 60 days, so you simply have to wait to find out the verdict after submitting. If it looks like more time is going to be needed, a written notification has to be sent to you so that you know there is a delay.
Source: United States Department of Labor, “How To File A Claim For Your Benefits” Sep. 04, 2014