There are two primary types of long-term disability plans: individual long term disability plans and plans that are governed through the Employee Retirement Income Security Act, or ERISA. While both types of plans can provide disability benefits to those out of work for a long period of time due to a disability, the plans are very different. An ERISA long-term disability lawyer can help you navigate these differences.
Applying for long-term disability benefits is a complicated process. Without an ERISA lawyer, the insurance company can take advantage of you. ERISA long term disability cases are particularly difficult because of the specific rules you must follow.
What is ERISA?
ERISA is a federal law that provides protection to employees. One of the major protections surrounds employer-provided long term disability insurance. When an insurance company denies a claim for long term disability benefits, ERISA allows you to sue in federal court.
ERISA long-term disability benefits replace lost wages that a person cannot collect due to his or her disability. The law provides for certain minimum protections in these LTD plans. For example, the plans must provide for an appeal. The time limit on the appeal must be at least 180 days. The plan must also notify you of your right to sue in Federal District Court.
Finally, the amount you can receive for disability benefits under ERISA can differ depending upon the plan. The plan typically provides for benefits at 50 to 75 percent of your wages before your disability occurred.
If you are hoping to pursue long-term disability benefits, it’s important that you follow the application instructions.
Applying for Long-term Disability Benefits Under ERISA
In order to qualify for ERISA long-term disability benefits, you must apply for benefits. The application process is lengthy and complicated. Many ERISA long-term disability claims are denied.
If you want to apply for ERISA long-term disability benefits, the first thing that you should do is request a copy of your insurance policy. Fortunately, ERISA protects your right to do under the law. The policy acts as the rule book. Once you know the rules, you will know how to approach your case.
The policy will also govern specific timelines for your case. For example, how long must you work with the employer to be covered? How long must you be out of work to qualify? It will also explain how much and how long you would be paid.
You also will need plenty of medical evidence to support your disability. If you do not have the right evidence, your claim will be denied.
Appealing a Denial of Long-term Disability Benefits Under ERISA
ERISA long-term disability claims can be denied for a number of reasons. You might not be eligible under the plan. Sometimes the insurance company needs more information about your claim. We like to be involved from the beginning to make sure that your application is complete. But if you receive a denial, you need to pay attention to the timelines.
Normally, you have 180 days to file an appeal of an ERISA long-term disability claim. The denial will tell you why you were denied and what information you’d need to supply. You will need to provide all necessary information to the person specified in the denial notice before the end of the 180-day period.
Keep in mind, this may be the last opportunity to add evidence to your case. If you are denied on appeal, you may be permitted to file a claim in the Federal District Court, but we generally cannot add any additional evidence at that stage. That’s why having a top LTD lawyer is so important.
Sometimes, you will have an opportunity for a second appeal before filing an action in District Court, but this is not guaranteed.
Hiring an ERISA Long-Term Disability Lawyer
If you are applying for long-term disability benefits or are considering pursuing an ERISA disability dispute for your denied long-term disability benefits, an attorney can help. An ERISA disability lawyer can guide you through the process of filing your claim and filling out your application, provide you with more information about the type of documentation you will need to file your claim and will give you insight regarding what types of long-term disability benefits to which you may be entitled.