ERISA LTD Lawsuit
People working for benefits from their employer are often insured against loss of income if they become disabled. Short and long-term disability benefits are available through your employer’s long-term disability insurance plan. While it may be hard to navigate by yourself, certain procedures are in place to ensure you get the benefits you deserve. An attorney will be immensely helpful throughout your effort to get disability benefits.
What is ERISA?
ERISA is an acronym that stands for Employee Retirement Income Security Act of 1974. The act aims to create minimum standards for most private pension and healthcare plans, including many long and short-term disability insurance policies. When someone experiences a loss in income from a disability, they are likely eligible to invoke their employer’s insurance policy through their benefits package. If you need long-term disability through your employer, write to Human Resources for the policy information. Review it yourself or with a lawyer to understand how it applies to you.
ERISA sets the standards for what an employer must provide regarding disability insurance policies. The act requires that employers share the following information with anyone that is covered under their policies:
- Summary of benefits
- How to file a claim
- Appealing a claim
- Rights when filing a claim
When is ERISA Invoked?
A certain timeline of events must be followed when someone applies for some form of disability benefits. In terms of both short and long-term disability under an employer’s insurance policy, there is a 45-day period after applying for an administrator to accept or reject a claim. The insurance company can get an additional 30 days as an extension if needed.
You can appeal the decision for up to 180 days if your claim is denied. Consider contacting an attorney at this time because they can make the rest of the process a lot easier. It may seem like you can handle this step of the process by yourself, and you probably could, but there are certain things to remember that an attorney will know to pay attention to later. The lawyer will know what the rest of the case could look like and any issues that could arise with your claim, and greatly increase your chance of succeeding on a later appeal.
Once you’ve sent your appeal, the insurance company has 45 days to respond. They could be awarded an additional 45 days to answer your appeal in special circumstances. You will likely have to go through all of the possible appeal steps set up by the insurance company before you can bring a lawsuit to court under ERISA. Make sure to exhaust any and all possible appeals on an administrative level before trying to file a lawsuit. An attorney will be extremely valuable at this point.
What Does ERISA Litigation Look Like?
Once you have conferred with an attorney to discuss filing a lawsuit under ERISA, you will begin suing your employer and/or the insurance company. If your appeal to the insurance company was denied, the next step is to contact an attorney who can help you bring an ERISA lawsuit. Thankfully, many civil lawsuits are settled out of court. Your lawyer will facilitate settlement negotiations between you and the entity you’re suing, but you will have the final say on whether an offer is accepted or not. The company will likely try to settle the case out of court to save on time and cost associated with litigation, yet they may try to lowball the settlement initially. If you feel an offer is unacceptable, your attorney will help you bring the case to court. Remember that the case can be settled at any step in the process, not just at the beginning or when the judge decides.
The case will likely be in the federal court system if it makes it to court. This is because many state laws pertaining to employer pension and healthcare are preempted by federal law under ERISA. This means that federal law will be followed instead of state law, so it will be shifted to review by a federal judge. When a claimant seeks damages in the lawsuit, they are usually able to be awarded the amount outlined in the policy, but they are not able to recover punitive damages or money for pain and suffering. A lawyer will be your advocate in court and set up a winning case. For example, an attorney will know that discovery in these cases is generally restricted to documentation that was put in the administrative record. This means you probably won’t be able to bring in new information beyond what you’ve already set forward to prove your case.
Contact Us Today!
For many people, applying for disability benefits can be the difference between struggling to afford life and the ability to support yourself and/or your family. Long-term disability can be a tricky process without help, especially when considering the interplay of federal law and the complexities of rules of evidence. With the help of a lawyer, you could settle with the insurance company to get your disability benefits or succeed in court to get the money you deserve. Contact us when filing an appeal to increase your chances of receiving your benefits today!