Appeal after denial: Deadlines, Tactics and Common Mistakes

ERISA appeals are the only chance to add evidence — courts review the file as it stood at appeal. A do-it-yourself appeal that adds nothing locks in the denial.

This stage in the process

Claims are procedural contests as much as medical ones — every stage has a deadline, and the carrier’s file builds from your first words on the first call.

What actually moves the needle

ERISA appeals are the only chance to add evidence — courts review the file as it stood at appeal. A do-it-yourself appeal that adds nothing locks in the denial. The common thread across every stage: written records beat phone calls, and your own calendar beats the carrier’s reminders.

• Keep a claim journal: every call, date, name and promise.
• Send everything certified or through the carrier’s portal with confirmation.
• Escalate to a disability attorney at the first denial — not the second.

Mistakes at this stage

Over-volunteering activity levels, missing written deadlines while ‘waiting to hear back,’ and treating the adjuster as an ally. None of these lose claims by themselves; together they build the file the denial cites.

Appeal after denial: the deadline is 180 days from denial (erisa group plans) — calendar it the day the claim opens.