A Practical Guide to ERISA Long Term Disability Appeals

This CLE offers a comprehensive and practice-oriented examination of ERISA long term disability ("LTD") appeal strategies. Beginning with a review of the core rights and protections ERISA affords claimants, the program explains how these safeguards shape the appeals process and create opportunities to strengthen the administrative record. Attendees will explore  the most common reasons insurers deny LTD benefits and learn how to dissect a claim file to identify substantive and procedural weaknesses that can be leveraged during the appeal.

Building on foundational principles, the course provides practical instruction on how to develop targeted evidence, address insurer concerns, and craft persuasive appeal arguments. The program also focuses on the strategic use of the post-2018 Department of Labor claims-procedure regulations-particularly when insurers rely on new evidence, overlook critical medical findings, or fail to follow mandated procedures. Throughout the presentation, real case examples illustrate effective approaches for maximizing the chances of a benefit approval and preserving key issues for potential litigation. Led by attorneys Jennifer L. Hess and Ryan McIntyre, this course equips practitioners with the tools needed to navigate the ERISA LTD appeals process with confidence and precision.

Learning Objectives:

1. Explain the foundational ERISA rights and protections that govern LTD appeals and understand how these requirements influence the claim-review process

2. Identify common patterns and reasons for ERISA LTD denials, including medical, vocational, and procedural bases used by insurers

3. Analyze insurer claim files to uncover substantive gaps and procedural deficiencies, and evaluate opportunities to strengthen the administrative record

4. Develop and proactively build evidence that directly addresses insurer concerns and supports the claimant's functional limitations and credibility

5. Draft effective and strategically focused appeal letters that marshal medical and procedural arguments while preserving issues for potential litigation