Unlike some states, Illinois law requires that federal courts apply a de novo standard of review in long-term disability (LTD) claims if the coverage was issued or offered in Illinois. Judges can weigh all the evidence in your claim and do not have to defer to the insurance company’s past decisions. However, that doesn’t mean that your appeal will be easy.
If an insurance company has denied your long-term disability (LTD) benefits in Illinois, you need to understand how the courts will assess your legal and factual arguments. To learn the essentials, keep reading this article. To find out how these laws apply to your insurance claims, contact Bryant Legal Group.
What Is a Standard of Review?
Lawyers are obsessed with standards of review, but most clients don’t understand the concept. A standard of review can deeply impact your chances of winning your lawsuit. These standards set the rules of the game and determine how much flexibility and discretion a judge has when reviewing a case.
There are two possible standards of review in long-term disability claims.
- De novo: The judge approaches the case with fresh eyes, and weighs all of the available evidence. De novo means “from the beginning” in Latin.
- Abuse of discretion: The judge gives some deference to the insurance company’s decision and will only overturn a denial of benefits if the company’s decision violates the law, is irrational, or is completely unsupported by the evidence.
Insurance companies prefer the abuse of discretion standard since judges are more likely to uphold a denial of benefits. To make sure this lenient standard of review gets applied, most insurance companies insert special “discretionary clauses” into their plans.
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Thankfully, while some states still permit these clauses, Illinois made discretionary clauses in insurance plans illegal in 2005. Federal courts upheld this law in 2015. Today, almost all insurance disputes in Illinois involve a de novo standard of review.
What Do Standards of Review Mean for My LTD Claim?
Today, thanks to the de novo standard of review, you have a better chance of winning your LTD appeal in Illinois than you did in the past. Judges in cases where the Illinois law applies now have broad powers to review long-term disability claims and can freely consider all of the evidence available to them. If the insurance company’s decision is inconsistent with the law or the evidence, the judge can grant your disability insurance benefits.
However, that doesn’t mean your long-term disability appeal will be successful. ERISA, the federal law that governs employer-sponsored benefits, may apply to your claim. This law sets strict limitations and procedures on employer-sponsored LTD claims. That’s why it’s in your best interest to consult an experienced LTD lawyer at Bryant Legal Group if you have an LTD claim in Illinois.
For decades, our team has helped people with disabilities get their disability insurance benefits. When you work with Bryant Legal Group, we will:
- Explain in plain language the complex array of laws and regulations that impact LTD claims
- Interpret your disability insurance plan documents and apply them to your situation
- Collect evidence, including medical records and expert opinions, that can strengthen your legal claims
- Help you navigate all the levels of the ERISA appeal process
- Meet the tight filing deadlines and other procedures associated with an LTD claim
We take a client-centered approach, building strategies that focus on both your long-term and short-term goals.
RELATED: When Should I Speak With a Disability Insurance Lawyer?
Can I Submit New Evidence During a Long-Term Disability Lawsuit?
Even though Illinois adopted a more lenient standard of review, it doesn’t mean judges have access to all your information and documents. Instead, your ability to submit new evidence will depend on whether your appeal involves an ERISA or private disability plan.
- Employer-sponsored (ERISA): Your only chance to submit evidence is during the insurance company appeal process. The judge will only consider evidence that was available to the insurer at that time.
- Private: You can submit admissible evidence and information throughout the claim, as long as you follow Illinois’ rules of evidence.
If you’re unsure whether you have an ERISA or private LTD plan, it’s a good idea to consult an attorney. We can help you understand the exact procedures that apply to your long-term disability claim and then build a compelling record of evidence that clearly explains your situation and your eligibility for benefits.
Bryant Legal Group: Trusted Illinois Disability Insurance Lawyers
We were at the forefront of the fight for de novo review in LTD claims. Today, we continue to stand up to insurance companies using a sophisticated and practical approach to ERISA and private long-term disability insurance appeals. Bryant Legal Group is based in Chicago but serves all of Illinois.
To schedule a consultation with one of our experienced attorneys, either fill out our online contact form or call us at (312) 561-3010.