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what to do if your claim was denied

There are two steps to the appeal process

Whenever the Fund denies a claim for benefits (or other adverse benefit determination), in whole or in part, a member has the right to appeal the denial. You must go through the procedure below before starting any legal action.

Form One: A review by the Benefits Claim Appeals Committee (your initial appeal)

Form Two: If you disagree with the decision you received by the Benefits Claim Appeals Committee, you can request a review by the Trustee Appellate Review Committee

If your second and final appeal is denied, you have the right to bring a civil action pursuant to Section 502 of the Employee Retirement Income Security Act.

In order to prevent a delay, use the Appeal forms below and and either print and mail them back or use the Message Center.

  • 1

    Benefits Claim Appeals Committee - Form 1

    Complete and return this form within 180 days after you have been notified by the Fund of a benefit denial (or other adverse benefit determination).

    Your Appeal will usually be heard by the Benefits Claim Appeals Committee within 30 days after they receive the Appeal application. You may push back the 30 day limit giving the Fund additional time to research or for you to send more information.

    In order to prevent a delay, either print and mail the form back or use the Message Center.

    Download Appeal Form 1

    Appeal Form 1 

  • 2

    Trustee Appellate Review Committee - Form 2

    To appeal a benefit denial (or other Adverse benefit determination) to the Trustees, complete and return the form below within 180 days after you have been notified by the Benefits Claim Appeals Committee or Fund Staff of their decision.

    Usually your request for a review by the Trustee Appellate Review Committee will be heard within 90 days. It is very important to provide all the information needed to the Trustee Appellate Review Committee to make a decision on your claim. If you do not send all the necessary information, your claim will not be seen by the Trustee Appellate Review Committee.

    In order to prevent a delay, either print and mail the form back or use the Message Center.

    Download Appeal Form 2

    Appeal Form 2 

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