What You Need to Know About ERISA & Long-Term Disability Insurance

by Sokolove Law

When you began working for your employer, you may have been impressed by certain benefits they offered, like access to long-term disability insurance. However, if you’re now in a position where you are trying to file a long-term disability claim, you may be encountering an acronym you’ve never heard before: ERISA.

What Is ERISA?

ERISA stands for the Employee Retirement Income Security Act of 1974. It is a federal law that sets minimum standards for pension and health plans provided by private-sector employers. It was originally meant to protect employee benefits and standardize the administration of employee benefit plans, which includes group life insurance plans, group health insurance plans, and group disability insurance plans.

However, there have been many amendments to the law over time and, in many ways, these changes may negatively impact people who have long-term disability insurance through an employer.

How Do You Know if ERISA Applies to Your Claim?

ERISA generally does not apply to people who are employed by the government, religious organizations (e.g. church), or schools.  Most other private-sector employees, who have long-term disability insurance through their employer, are covered by ERISA.

At first glance, it would appear that ERISA protects workers who are employed by private businesses. However, its strict regulations and complicated filing process make it easy for the average consumer to miss a deadline or make a mistake.

Under ERISA:

  • You are not entitled to a trial by jury if you believe you’ve been wrongfully denied benefits
  • You must appeal the insurance company’s decision through an administrative appeal process
  • You may only have 180 days to complete the appeal after the denial

If you fail to include all of the necessary information in your appeal, including the occupational, medical, legal or financial documentation that helps build your case, you may never be able to include this information in your record. One seemingly insignificant detail or document may prove to be essential to your claim. Minor errors can prevent a legitimately disabled person’s chance at receiving the benefits he or she deserves.

Contact Sokolove Law Now if Your Long-Term Disability Claim Was Denied

An experienced long-term disability lawyer can help you identify all of the necessary documentation and help ensure you’ve compiled a comprehensive appeal. You wouldn’t perform surgery on yourself – so why go through a complex appeal process without an attorney looking out for your best interest?

If you were injured and your long-term disability claim has been denied, don’t go through the appeal process alone, Sokolove Law may be able to help you recover your benefits. Contact us today for a free consultation.

What You Need to Know About ERISA & Long-Term Disability Insurance was last modified: December 28th, 2016 by Sokolove Law

4 Responses to “What You Need to Know About ERISA & Long-Term Disability Insurance”

  1. Jo Murphy

    Mine was with USDA/federal govt. I gave them which took 3 months to find the fax that an ALJ judge said I couldn’t do my past job which was with USDA and they never tried to find me an alternative. I told them I did send and appeals letter, but they said that never happened. I mean it took 3 months to find a fax how long will it take them to find a sent letter.

  2. I was denied about a year ago and appealed the decision. I was calling them and making sure that they received each and every document and anything that my doctors gave me to send them every time. Even if it was every day, I was in constant contact and first name basis with my disability case worker. After I sent everything I could possibly think that would be helpful in my case, I waited maybe a month and a half and called to see if anything was recently sent to me, then finally around the eighth week they sent me the letter saying that I am reinstated to receive my benefits again. Point is to make sure you are on top of everything you submit to them, I am with Cigna Disability and they are notorious for things not being sent to them, that they didn’t receive that certain document from your doctor etc, etc…If they do it to me again I will do the same thing every time and make sure they have that certain document in my file, within a few days, when I call them.

  3. I’m just wondering that since I have been denied once, about a year ago, for not having enough information from my doctors submitted. Then I won the appeal, now are my chances of being reviewed/denied again the same or are my chances less. I’m hoping they’ll just ease off since I’ve won the appeal…I’m dealing with Cigna Longterm Disability and I know they are really difficult to get anything from. They of course don’t want to pay out any benefits to anyone, but are they notorious for pushing 2nd denials on us?