If your company has stopped paying your long term or short term disability benefits there are a few things you need to know? But really you only need to know one … CALL A LAWYER.
Contacting a lawyer to help preserve your rights is a very good idea. While some might find it easier and less stressful simply to ask the company or the holder of your disability policy to reconsider on their own, there are a lot of very good reasons you should consult the help of a lawyer right away. Let me explain.
For starters the cards are usually stacked against you. A lot of disability policies fall under the authority of ERISA. ERISA was not enacted by Congress to help workers and the people who become hurt and disabled. ERISA was enacted by Congress to make it more difficult for injured people to get the benefits they deserve. Instead of going to your local district or Circuit Court and filing a lawsuit against the company that has denied or cut you off, you have to go through a convoluted process where you are afforded fewer rights than you would have under Michigan Law.
ERISA pre-empts Michigan law and mandates that you have to file a lawsuit in Federal Court to get your benefits from a company that has wrongly cut you off or denied you your benefits.
However, that's just the beginning. In fact you don't even get to have a judge or jury review all the evidence in your case and come to an independent opinion as to how bad you are injured.
No . . . ERISA says that first you have to appeal your decision with the insurance company that has already denied you. And once they deny you're first Appeal you have to Appeal again; one more time asking the same insurance company which has already denied you twice to reconsider again. Only after you appeal the company's decision again and have exhausted your internal and pointless appeals do you get to go to Federal Court.
Once at Federal Court you don't get a the right to a jury trial, you don't get the right to ask the company for all the information that would be relevant to your claim, and you don't even get the right to submit more evidence or medical records proving your injury. In fact the federal judge only gets the right to look at the evidence that the company already has regarding your injury (the info that you submitted along the way before trial). Then the Judge has to start off giving deference to the Company. Then the Judge only gets to review the decision that company made to see whether it was arbitrary in capricious (extremely egregious and unsupported).
What does this all mean? It means that if you don't give all the documentation of your injury to your insurance company during your pointless internal appeals you likely won't ever get to, and you will have almost no chance of getting your
benefits. It also means that if you don't actually go through with all those pointless appeals you may never even get to sue in court because the law won't let you.
To get back to my original point, this is why you need to contact a lawyer. A good disability lawyer will help you supplement your medical records and craft the legal and factual arguments that the Company cannot simply ignore during your internal appeals with the Company. Then when you do get to Federal Court you will have a chance at getting the benefits you deserve.
The Company that has denied you has already figured that your average injured worker will not have a chance against the ERISA scheme, don't give them the upper hand.
Call The Clark Law Office today @
517-347-6900 for an experienced
disability lawyer today to secure your rights. Your phone call is
FREE! Call today for your free consultation.