Been denied long-term disability by Reliance Standard? You’re not alone. Reliance Standard long-term disability insurance benefit denials are common. We’ll explain why claims get denied and how to appeal and strengthen your case.
Quick Facts
Reliance Standard denies long term disability claims for lack of medical evidence or pre-existing conditions so knowing these reasons is key to your appeal.
Act fast after a denial—file an appeal within the timeframes and consider hiring a disability lawyer to help you through the process.
Get all your medical records and expert opinions together to build your case as this will help you win a denial.
Reliance Standard Long-Term Disability Denials
Reliance Standard has a reputation for denying long-term disability claims more often than approving them. They put profits over claimants so denials are common and can be very frustrating and unfair. Reliance Standard disability denies claims for seemingly random reasons which can put claimants in tough financial and emotional situations. This is where our highly experienced long-
Knowing why Reliance Standard denies is key to your appeal. Understanding common tactics and reasons for denials will help you prepare better for the appeal process and increase your chances of winning. Here are some of the reasons why claims get denied.
Reasons for Denial
Reliance Standard denies claims because there is no medical evidence. If your medical records don’t prove your disability Reliance Standard will use this as a reason to deny your claim. They also deny claims for pre-existing conditions and usually include exclusions for these conditions from the start.
Reliance Standard looks for reasons to deny claims so they use tactics to discourage you from appealing after an initial denial and give up. Especially in cases where details are unclear they will push you into legal action.
ERISA and Disability Claims
Disability claims under ERISA (Employee Retirement Income Security Act) which usually applies to long term disability insurance provided by employers tend to favor the insurance company. This makes the appeal process tougher for individuals trying to get their benefits because these rules advantage the insurance company when there’s a dispute.
As part of the claims process most ERISA plans require you to also apply for Social Security Disability Insurance (SSDI). Employer sponsored plans may be cheaper than individual long term disability insurance but they come with strict rules that can make things tough during the appeal process if you’re trying to get your benefits.
What to Do After a Reliance Standard Long-Term Disability Denial
Getting a denial letter from Reliance Standard is discouraging but you must act fast. File an appeal within the timeframes or you’ll miss the deadline and risk losing the appeal. After a denial the internal appeals process with the insurance company begins. Having a lawyer from the start will help you navigate these deadlines and expected objections and give you a better chance of winning.
Winning the denial involves several steps. Review the denial letter, get your medical records and consider hiring a disability lawyer to help you with your appeal.
Review Your Denial Letter
The denial letter from Reliance Standard is your roadmap to understanding why they denied your claim. You must review this denial letter thoroughly so you can address and fix these issues within your appeal process.
Fighting Reliance Standard’s big obstacles can be tough especially with their tactics to reduce claims payments. A thorough review of the denial letter will help you build a stronger appeal by knowing what corrections or additional information is needed.
At BenGlassLaw, our highly experienced and highly rated team will review denial letters and give you personalized feedback on what your next steps should be. This is 100% free and confidential!
Get Your Medical Records
A winning disability claim is built on solid medical evidence. You must get all your medical records, with emphasis on test results like MRIs or CT scans that support your claim. Including custom residual functional capacity forms can be a game changer.
Getting additional opinions from medical and vocational experts can help strengthen your appeal. Building a strong administrative record at this stage is crucial because this will be the foundation of your case throughout the internal appeals and any future legal actions.
Get an Experienced Disability Lawyer
A disability lawyer who handles long-term disability cases can help you with your appeal and often get better results. With knowledge of ERISA and Reliance Standard’s tactics a lawyer gives you an advantage. Many of these lawyers offer contingency fee arrangements – they only get paid if you win your claim so you don’t have to worry about upfront costs.
Fighting the appeals process alone can be tough when up against the insurance company’s legal team. Getting advice from an ERISA lawyer gives you important help and increases your chances of winning in the long term disability appeals process.
Appeal Process
Building a strong appeal is critical to reversing a denial and to build your administrative record before considering further legal action. Having a long-term disability lawyer can be very helpful in building an effective appeal making sure all the necessary evidence is included and presented properly. They know what evidence to look for and how ERISA rules apply.
When building your appeal make sure to follow policy definitions, provide additional evidence and avoid surveillance traps that can hurt your long term disability claim.
Policy Definitions
To be eligible for disability benefits you must show you can’t do the essential tasks of your regular job. This is required in the first 24 months. Reliance Standard denies claims because they don’t meet their policy’s definition of disabled especially within this initial period.
After that 2 year mark the standards change and you must show you can’t do any occupational duties to remain eligible for benefits. Vocational experts will evaluate your work capacity and quantify your level of disability. Medical doctor records are crucial in documenting the exact restrictions caused by your injury or health condition.
Additional Evidence
Adding new medical and vocational evidence can help your appeal. Medical expert opinions can support your case and counter the insurance company’s arguments.
These experts will provide opinions and testimony based on your medical history and current health status. Their expert evaluations including an independent medical examination will often be key to supporting your claim and any work restrictions you have.
Surveillance Traps
Be careful with your social media and public activities because they will be monitored during the appeal process. Reliance Standard may use surveillance tactics to gather information that can be used against you.
To minimize risks be sure to lock down your social media and don’t post anything that can be misinterpreted.
Appeal Process
After you submit your appeal to Reliance Standard there is a 45 day review period. During this time they will review the evidence and documentation you submitted with your appeal.
To navigate the appeal process with Reliance Standard you need to understand it’s internal and external reviews. Here are the details below.
Internal Appeal Process
You have 180 days to file an administrative appeal after a claim is denied according to ERISA. If you need to provide additional information after your disability insurance claim is denied you must do so within this time frame. Once you file your appeal Reliance Standard will review it and they have 45 days to do so.
Make sure to include all relevant evidence and documentation when you file your initial administrative appeal. This is critical because if you don’t you may be hurt later on. Reliance Standard may use external medical reviewers during their review process.
Make sure to send any communication or documents to the address listed in your denial letter from Reliance Standard if it’s different from the standard submission channels.
External Review and Litigation
You must complete the insurance company’s internal appeal process before you can go to court. If that doesn’t work then you may need to file a federal lawsuit to contest the denial.
Understanding the process and potential outcomes of going to court will help you make informed decisions moving forward. Talking to an attorney will give you more clarity and guidance throughout this process.
How to Win Your Reliance Standard Disability Appeal
Fighting Reliance Standard during the disability claim appeal process can seem like David vs Goliath. Using smart legal strategies will help your chances of winning. You need to address any excerpts from medical records that have been misinterpreted or taken out of context early on in the claims process with Reliance Standard.
To strengthen your case get experts in medical and vocational fields on your side. Below are some tips to help you navigate the process of appealing a disability claim.
Medical Experts
Medical professionals are key to validating disability claims through their professional opinion and expertise. Their testimony matches your medical records and health status and counters the insurance company’s arguments.
The detailed exams and statements from these medical professionals will greatly impact your appeal. Their comprehensive exams will dispute the insurance company’s allegations and support your disability claim.
Vocational Experts
Vocational experts are important for disability claims because they give an independent assessment of an individual’s ability to work. They look at how a person’s medical condition affects their ability to get a job and provide detailed reports and expert witness testimony that challenges the insurance company’s view of your work capacity.
Using vocational experts in your appeal process will help strengthen your case. Their analysis and statements will be a strong counter to the insurance company’s denial and increase the chances of reversing the disability benefits denial.
Administrative Record
During the appeal process you need to build a robust administrative record. Under ERISA rules evidence not included in the administrative record will not be admissible in court later on. So you need to get all the information in from the start including medical records and statements.
Having a comprehensive and organized administrative record allows a federal judge to review your case and see if the insurance company made an error. The more detail and depth of this documentation the better your chances of winning.
Results and Next Steps
If you win your appeal you may get benefits with back pay. If you win your appeal Reliance Standard will have to pay back owed benefits plus interest. This will give you financial relief and get you back on your feet.
Even if your appeal is denied there are still options for you. You can file a lawsuit in federal court against the denial and pursue judicial remedies. Knowing these outcomes and next steps will help you make informed decisions.
Benefits Paid
Winning your appeal means the insurance company will pay you back benefits and interest. This is especially helpful if there’s been a long gap in your benefits, it’s a big financial relief. The insurance company will also pay any past due amounts plus interest so you’ll be made whole for your disability benefits.
This result will validate your long-term disability claim and reinstate your long term disability benefits. This will give you financial peace of mind and emotional relief during this difficult time.
Denial and Litigation Options
If your appeal is denied again you can pursue justice by filing a lawsuit in federal court. This will involve disputing Reliance Standard’s decision through a long and arduous legal process.
Considering the possibility of further denial and litigation is why you need a disability attorney like our team at BenGlassLaw. Such an expert can help you through this tough time, navigate the legal maze and increase your chances of winning.
Conclusion
Fighting a Reliance Standard long-term disability denial can be tough but knowing why you were denied, what ERISA is and what to do after denial can give you the upper hand. Reviewing your denial letter, getting all your medical records and considering a lawyer are important steps in preparing your appeal.
Using medical and vocational experts, building an administrative record and knowing the appeals process will help you win. Whether you win your appeal or need to file a lawsuit being informed and prepared is key to getting your long-term disability benefits.
How BenGlassLaw Can Help With Your Reliance Standard Long-Term Disability Denial
Fighting a Reliance Standard disability denial is tough but knowing the process and your rights can give you the upper hand. From reviewing the denial letter and getting strong medical evidence to filing an appeal and getting an experienced lawyer each step is important to get the benefits you deserve.
Remember you don’t have to do this alone. Our team at BenGlassLaw can guide you through the appeals process no matter where you are in the US. Stay proactive, informed and persistent.
Contact our team today for a free, zero obligation consultation to learn how we can help you.
