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Long Term Disability Claims: Can You Represent Yourself?

UPDATED: August 5, 2019

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Can someone successfully represent themselves in a long term disability claim? The answer to that question will likely depend upon the stage of the claim itself. We asked Ron Dean, a California attorney who has been engaged in employee benefits litigation primarily on behalf of participants for over 30 years, to offer advice to those thinking about going the road alone. Here’s what he told us:

It’s ok most of the time at the initial claims level, but it’s especially difficult at the appeals level. They may be able to do it on their own if they follow simple rules and think of it, not just from what they know, but what they need the insurance company to know. So, if the ERISA (the Employee Retirement Income Security Act) claim is denied, then you get an appeal. You want an attorney involved in the final appeal process because one of the quirks of ERISA is that when you go to court, the only evidence you can submit to the court is evidence submitted during the claim and appeal process.

So, if you handle it on your own and you don’t get the right evidence in, an attorney isn’t going to be able to help you once you get to court because the record is closed and the evidence that was submitted is the only evidence allowed. I’ve seen a lot of cases lost, perfectly good cases, because the evidence wasn’t submitted during this administrative appeal.

Don’t leave anything to guess work

Dean’s recommendation to applicants is to do a great job on the original claim form. He says, “Don’t leave anything go to guesswork. Make sure all your evidence is in. Make sure that every doctor is on board; don’t leave until later anything that could be submitted now. That’s a very strong recommendation because you’re trying to get that claim paid without having to hire a lawyer. The last thing you want to have to do is hire a lawyer; but if you have to, you have to.”

If you’ve been denied valid long term care benefits, consult with an experienced ERISA attorney to discuss your situation and evaluate your options. Consultations are free, without obligation and strictly confidential.

Ron Dean
Contributing Author: Attorney Ron Dean Erisa Law Attorney

Ronald Dean has been engaged in employee benefits litigation primarily on behalf of participants for over 37 years. He is currently a member of the Board of Senior Editors of the ABA/BNA text, Employee Benefits Law, on the Advisory Board of BNA Pension and Benefits Reporter, and on the Advisory Board for ALI-ABA’s Employee Benefits Programs. He is a Fellow of the College of Labor and Employment Lawyers, a Charter Fellow of the American College of Employee Benefits Counsel, and a member of its Board of Directors from 2001 to 2007. He was named by the National Law Journal as one of the top forty benefits lawyers in the country, and by Southern California Super Lawyers as one of 12 Employee Benefits “Super” lawyers in Southern California. Mr. Dean was trial and appellate counsel in 15 published Ninth Circuit Court of Appeals opinions involving ERISA issues. He is a frequent lecturer for the American Bar Association's CLE programs as well as those of ALI-ABA, Glasser LegalWorks, the Law Education Institute and the Western Pension & Benefits Conference.

Article last updated or revieewed on August 5, 2019