Should I Consider an ERISA Appeal?

Need help with an ERISA appeal? Contact ERISA claims lawyer John Peace today!

If you were denied a benefit, you must decide whether you want to ask the plan to reconsider its denial, which is the nature of an appeal. However, you must decide whether it is worth your time to bring an appeal. Asking yourself these three questions can help you make that decision.

1. Am I able to appeal?

First, you need to identify whether ERISA allows you to bring an appeal. Plan participants and beneficiaries are able to appeal the denial of plan benefits. As mentioned before, plan participants have their names on the policy. A beneficiary might also be a plan participant but can sometimes be someone else.

For example, a plan participant could die and leave their retirement accounts to their spouse, who is now the beneficiary under the plan. Generally, beneficiaries can bring ERISA appeal just like plan participants, but you first need to nail down whether you have appeal rights in the first place.

2. Do I have the time to dedicate to my appeal?

Second, you need to decide whether you have the time necessary to dedicate to your appeal. The fact is that appeals are time-consuming and confusing. Many people—especially those who are suffering with illness or injury—are ill prepared to handle all of the confusing paperwork necessary for bringing an appeal. As a result, they might miss important deadlines and have their appeal denied for that reason alone.

At Peace Law Firm, we work closely with our clients to make sure that they bring an adequate appeal. Below are some of the steps we take after a client hires us:

  • We fully investigate the reason why you were denied. Many denials are illegitimate, but some might be valid.
  • We identify what supporting documentation is missing and come up with a way to obtain all that is necessary to support your claim.
  • We find necessary information so that you can bring an appeal. Often, in disability cases, we need to find more information that you are sufficiently disabled that you qualify for benefits under the terms of the plan. This means you might need to meet with a new doctor or undergo a new battery of tests.

3. How badly do I need the benefits?

Third, analyze how badly you need the benefits. If you choose not to bring an appeal, then you won’t get the benefits you applied for. It’s that simple. The appeal process is designed so that the plan administrator or others can take a fresh look at the benefits claim and decide whether to grant it.

Ultimately, whether you should appeal depends on whether you can support yourself without the benefits. If you have become disabled at work, then you probably need additional income, so bringing an appeal makes sense.

The Peace Law Firm is Here to Help

If you choose to go forward, you need to do so the right way. This often means hiring an experienced ERISA attorney who can help you put your best foot forward. Your attorney can help you determine whether it makes financial sense for a lawyer to help represent you in the appeal and your chances of success. Remember to ask an attorney how he or she bills and what costs you will be responsible for in the appeal. All billing arrangements should be agreed to by both parties and memorialized in a written statement.