No Real Trial...
Did you know that in ERISA disability cases there are no real trials? That’s right, NO TRIAL. Once the insurance company denies your disability claim and your appeal is over, you get a chance to file a lawsuit. However, this suit isn’t tried before a jury of your peers. You cannot bring in witnesses to testify about how disabled you are. You cannot tell the Judge how your illness or injury prevents you from working. Not even your doctor can come in and testify on your behalf.
When you file a lawsuit in an ERISA disability case, a Judge will decide your case. The only evidence he will review is what is already in the claim file when the insurance company denied your claim. That includes the notes they took when they talk with you on the phone, their medical review, as well as their secret surveillance that they may have taken of you.
What does that mean for your case? You must win your case BEFORE it gets to trial. That is why your appeal is the most vital part of your case. Since you can’t add evidence to the claim file once your claim is denied, your appeal is your last chance to get all the evidence in the claim file that you would want the Judge to see. That is when you send in medical records, statements from your doctors, affidavits from family or friends, the diary you’ve kept “to tell the Judge when you get to trial,” the picture of your injury or deformity, or videotape of inability to function.
Since that is your last chance to solidify your claim, it is vital that you do not blow it. Although this may sound self-serving, I recommend that you consult with an experienced ERISA attorney immediately upon receipt of your first denial letter from the insurance company.