Articles Posted in administrative appeals

In an ERISA case, at the center of any dispute over a claimant’s eligibility for long-term disability benefits is the administrative record. The administrative record is legalese for all the medical records, documents and other information obtained by, and submitted to, the plan administrator during the initial stages of the…

In an ERISA disability case, an insurance company cannot deny a claim without any explanations. Instead, under 29 U.S.C. §1133, it has to provide written notice of the “specific reasons” for the denial, and it must allow a “full and fair review” of any denial, i.e., an administrative appeal. An…