The three things to do in the first week after a denial: find your real deadline, request your full claim file, and start your evidence.
What the 180-day figure actually is, why it is a floor and not a fixed answer, and why it is not the deadline to sue.
The regulation says the 180 days runs from receipt of the denial notice. Here is why that gap matters and how to document your receipt date.
What a compliant denial letter must tell you, the one extra date the appeal denial has to carry, and the questions to ask if either is missing.
You are entitled to a free copy of everything relevant to your claim, including material the plan did not rely on. Here is how to ask for it.
Your plan's claims procedures must identify every medical or vocational expert whose advice it obtained, whether or not it relied on their opinion.
The internal appeal is generally the last real chance to build your record. Here is what belongs in it.
Why courts reviewing an ERISA denial often will not look at evidence you did not submit during the internal appeal.
The regulation's neutral-reviewer rule is not the same thing as your plan's own IME clause. Here is the difference.
The regulation requires a different, non-subordinate reviewer, and a separate medical consultant for medical-judgment denials.
45 days, extendable twice by 30 days each, with notice to you before each extension starts.
45 days from each request for review, extendable once by up to 45 more. A plan with two appeal levels runs a separate clock for each.
A narrow exception. If a plan fails to follow the claims procedures the regulation requires, you may be treated as having exhausted your appeal already.
Disability claims use a strict-adherence standard, with one narrow good-faith exception for minor errors.
Most, but not all, employer group LTD plans are governed by ERISA. Here is the fork, and why it matters before you rely on anything else on this site.
Federal, state, county, city and public-school employer disability plans are generally exempt from ERISA.
A disability plan run by a church or a qualifying church-affiliated organization is generally exempt from ERISA unless the organization elected coverage.
A disability policy you bought yourself, outside of work, is generally not an ERISA plan at all.
Whether a court decides your case fresh, or only checks whether the plan was reasonable, depends on one clause in your plan document.
A single sentence in your plan document that decides whether a court reviews your denial fresh or only for reasonableness.
Not legally required, but the appeal is technical and generally your only real chance to build the record.
Your options depend on your plan's process, the record you built, and the date your right to sue expires, which your denial notice has to give you.
Generally yes, once your internal appeal is exhausted. The lawsuit is narrower than a general civil case, and your plan may set its own filing deadline.
Six mistakes, each one a direct consequence of a rule explained elsewhere on this site rather than a guess about what tends to happen.
Four independent law firms that state, on their own websites, that they handle ERISA long-term disability appeals across most or all of the country.
The 180-day appeal floor is written into a paragraph aimed at group health plans. Here is the cross-reference that pulls a disability claim into it.
Narrower than it sounds. The penalty attaches to disclosure duties ERISA imposes, not your claim file; the figure is not independently verified.
The claim-file rule is not limited to what the plan actually relied on. Here is the regulation's own four-part definition of what counts as relevant.
Government and church plans are not the only coverage ERISA leaves out. A plan solely complying with workers' comp or state disability law is exempt too.
Beyond government, church, and workers' comp plans, ERISA Title I also exempts foreign plans for nonresident aliens and unfunded excess benefit plans.
The federal appeal-decision deadline applies whether your plan offers one internal appeal or two. Here is what that structural choice changes.
Every deadline this site describes fits into one sequence. Here is the whole claim lifecycle in one place, with the regulation behind each step.
The ERISA process is the same for every insurer. How it applies when Unum denied your LTD claim, plus one verified chapter of Unum's regulatory history.
A working checklist of the records, plan documents and statements to gather before you file your ERISA long-term disability appeal.
Two separate systems, a plan-specific offset clause, and why many claimants end up pursuing both benefits at once.
The ERISA process is the same for every insurer. How it applies when Prudential denied your LTD claim, and the guides that cover every step.
Whether you got LTD coverage through your job or bought it yourself changes the appeal deadline, the exhaustion rule, and the standard of review. It does not simply erase state insurance law for an insured group plan.