Consider what you would do if your ERISA long term disability insurance appeal were denied. Would you hire an ERISA long term disability lawyer then to help with your lawsuit? If the answer is “yes,” you should absolutely hire a lawyer before filing your appeal.
There are several reasons to hire an ERISA attorney in Arkansas at the appeals stage, but most claimants are convinced by the appeal NOT being in the same category as the initial benefits claim. The appeal is an extension and foundation of the lawsuit. If you know that you would hire a lawyer for the lawsuit stage, go ahead and hire them now. They will build their entire case into the appeal because there is no opportunity to build a case after the appeal. ERISA restricts the lawsuit to the evidence and arguments presented in the appeal.
If you are not persuaded by the appeal-is-part-of-the-lawsuit argument, it should only be because you believe you would file and complete your possible lawsuit without an attorney. Some lawsuits can be successfully settled without a lawyer, but this is not that type of case.
ERISA regulations make a lawsuit concerning employer-offered disability insurance claims illogical and challenging in ways that other lawsuits are not. It is very, very hard to win one of these cases without an ERISA-experienced attorney.
In these cases, your lawyer will be a teacher, too. Because federal district court judges see such a variety of cases, your judge will not likely be well-versed in how he/she is supposed to rule on these types of cases. In fact, it is quite possible that your judge may not have presided over an ERISA disability case in a year or possibly even ever. Unfortunately, contrary to what most people would expect, you cannot expect the judge to parse the information correctly or to even know what questions to ask. That is why you need an ERISA lawyer in Arkansas to show the judge where to look and the standards by which to rule.
In addition to generally educating the judge about how ERISA disability cases should be judged, a lawyer will also write an appeal that educates the judge on exactly what the insurance company has done wrong in handling your particular claim. When filing an appeal, your lawyer will compile all evidence of your disability and make it as clear as possible to the insurance company that you deserve benefits. Additionally and most importantly, your lawyer will begin the case that the judge would see. Your lawyer will tell the insurance company how they have been unreasonable in the initial benefits denial. Your lawyer will point out all the evidence the insurance company failed to address and cite examples of how past courts have interpreted that kind of negligence. Your lawyer will dismantle any arguments the insurance company wrongly used to deny your benefits—such as cherry picking from video surveillance or using an inappropriate independent medical examiner. Your lawyer will argue in the appeal the same way he/she will argue in the courtroom, proving both that the insurance company was wrong (you, in fact, are disabled) and also unreasonable in the process, logic, and evidence they used to deny your claim.
Your lawyer will argue in the appeal as though they are arguing in court because the judge is ruling only on what happened up through the appeal. No further evidence may be introduced. The earlier in the appeal process your lawyer can prove that the insurance company was unreasonable, the stronger your case will be.
We fill the appeal with questions about the evidence the insurance company ignored in the initial benefits claim or examples of things they did that were “arbitrary and capricious” or not “reasoned and principled” to set them up. This type of appeal makes it painfully obvious that the insurance company did NOT perform a reasonable review of our client’s application when they deny benefits without answering all our questions. And when the judge cannot look at anything more than the evidence submitted through the appeal, this kind of blatant disregard for the appropriate claims process is very helpful in winning a case.
These are the reasons why starting to work with a lawyer at the appeals stage is so important. If you are looking for an experienced ERISA attorney in Arkansas, contact Krebs Law Firm. Call at 870-741-8100 to learn more today.