Nurses and healthcare workers give everything to care for others, so facing a long-term disability claim denial can feel especially unfair. Long shifts, infectious disease exposure, lifting injuries, and ongoing workplace stress can lead to long periods where healthcare workers are unable to work.
What Type of Appeals Can Be Filed?
Navigating the appeal after a denied long-term disability claim as a nurse or healthcare worker can feel overwhelming, but understanding your options is the first step forward.
Administrative Appeal with the Insurance Company
This is typically the first kind of appeal employees must pursue. It involves a written request for a new review by the insurance carrier’s internal appeals department. For employer-sponsored (ERISA) policies, this is mandatory before going to court. You will be able to submit new or stronger medical documentation, employment records, and letters from treating providers addressing specific abilities and healthcare job responsibilities.
Second-Level or Voluntary Company Review
If the first appeal fails, some disability policies offer a second tier of company review (sometimes called a “voluntary appeal”). This provides another chance to address lingering concerns, correct any documentation that is missing, and include additional statements, such as workplace incident reports or occupational assessments.
Legal (External) Appeal or Litigation
For many, especially those whose initial administrative appeals have failed, the next step after exhausting internal reviews is taking the case to court. This process may be available for both private long-term disability plans and ERISA policies. A federal court may review the insurance company’s decision and determine whether it complied with the policy terms and applicable law.
A law firm experienced with disability denials for healthcare professionals can ensure all available options are pursued.
Why Having an Attorney Can Make a Difference For Nurses and Healthcare Workers With Denied Disability Claims
A disability claim denial can threaten your ability to support your family and take care of your health. Lawyers can be essential in the appeals process:
- Insurance companies do not always understand what nurses and healthcare workers do. An attorney can clearly point out how your injury affects daily tasks.
- Denials often happen because the insurance reviewer doesn’t grasp how challenging the job is physically, mentally, and emotionally. A lawyer knows what proof you need to back up your claim.
- Missed deadlines or unclear paperwork can ruin your chance for appeal, but an attorney can help you meet every requirement on time.
Ultimately, working with an attorney means having someone on your side who takes your job seriously and fights to get you the benefits you deserve.
Schedule a Free Consultation With Julie Rice Law To Discuss Your Long-Term Disability Denial
If you’ve had your disability claim rejected, don’t be discouraged; successfully overturning these denials is possible when you have the right help. We’ll look in detail at why your claim was denied and what we can do to build the strongest appeal possible. If you are a nurse or healthcare professional and your benefits have been denied, talk to us today about your options. Call Julie Rice Law and schedule a free consultation.