ERISA LAW BLOG

This is a question I get asked quite often by clients of mine who are State of South Carolina employees.  When a long term disability claim is denied for a State of South Carolina employee, there are two levels of appeal.  The first level of appeal is to Standard Insurance Company.  If Standard denies the first appeal, the second level of appeal is to PEBA (Public Employee Benefit Authority). It is not uncommon for Standard and/or PEBA to take months or even years to reach an appeal decision on a denied long term disability claim.  My clients become quite frustrated, particularly when they receive letters assuring them that an appeal decision will be made “within 45 days.”  Unfortunately, the South Carolina Administrative Procedures Act, the law which governs State of South Carolina employee benefit claims, does not contain a provision outlining any time frame guidelines within which an appeal decision must be reached by Standard/PEBA.  Therefore, Standard and/or PEBA can, quite literally, take years to reach a decision on appeal.  Another complicating factor is that when a denied claim is appealed to PEBA, a claimant has to wait for the committee to review the claim before PEBA will issue a decision.  The committee only meets once or twice a year, which further extends the time for a claimant to receive a decision.  As a result, it is very common for my clients to be approved for Social Security Disability and/or South Carolina Retirement System Disability Retirement benefits before receiving a final decision on the long term disability appeal.  The long term disability appeal process for a State of South Carolina claimant is very much a “hurry up and wait” scenario.  I move the appeals as fast as I can from my end, however, I cannot proceed forward to the next step in the appeal/litigation process until Standard and/or PEBA completes their appeal review.

If you have a denied State of South Carolina claim, please do not hesitate to contact me (M. Leila Louzri) at 864-242-6200 or llouzri@fosterfoster.com, and I am happy to discuss your potential case with you.

Read more about Do I Need An Attorney To Appeal the Denial of My Disability Benefits?