ERISA is an acronym for the Employee Retirement Income Security Act, and ERISA is a federal law originally designed to protect workers from the possibility of bankrupt pension plans. Additionally, ERISA included provisions regarding disability and long-term disability. One of the most important distinctions of ERISA, compared to long-term disability plans, is that ERISA only really applies when you receive a plan offered by private employers (not churches or government organizations).
If you’re unsure of how ERISA affects your long term disability (LTD) case, and you’ve suffered a disability that prevents you from working, make sure to call Houston LTD benefits attorney William Herren as soon as possible. Whether you’re in the beginning stages of preparing your claim, or you’ve received a benefits claim denial and you need to appeal the decision, we at Herren Law boast the resources and legal know-how to give you a strong, thorough representation. We work on a contingency basis, which means that we won’t accept a fee unless you win your case with us by your side. To speak with Houston attorney William Herren, call Herren Law today at (713) 682-8194.
In the meantime, you can learn more about ERISA and LTD claims below.
Understanding Long Term Disability and ERISA
As mentioned above, ERISA applies to employer-provided insurance policies. If you have purchased long term disability insurance directly from an insurer (rather than receiving it as an employee benefit), then ERISA probably doesn’t apply. In this case, the laws regarding your insurance plan will most likely come from the State.
Although the original idea for ERISA was to protect workers, it is now known as an extremely pro-insurance law. This is why you need to understand ERISA and your long term disability plan, as you need to be prepared for the claim process and how ERISA affects your disability benefits claim. For example, ERISA claims can be very drawn out. Before you’re able to file a federal lawsuit regarding your benefits claim, you will need to exhaust any and all processes with the insurer; this means that you will need to go through the in-house appeal process with your insurance carrier before filing a lawsuit with ERISA.
Furthermore, the time to appeal in ERISA cases is limited. After receiving a claim denial, you have only 180 days to appeal; after filing the appeal, your insurers will have up to 90 days to make a decision. This means that you’ll be in a “limbo” for up to 270 days, all while you’re disabled and unable to work and bring in an income.
How ERISA Affects a Claim for Long Term Disability Benefits
For employees of private companies, ERISA will probably apply to your long term disability case. Keep in mind that ERISA statutes are long-winded and incredibly complex, and how ERISA will affect your disability case depends on the unique circumstances of your disability claim and other factors. Nonetheless, with decades of experience as a Houston disability benefits attorney, we at Herren Law have witnessed a few ways that ERISA affects long term disability cases. Below, we’ve included just a few of these ways:
- Following a denial of benefits, ERISA requires that the disability insurance plan must provide the claimant with copies of documents, records, and any other information that is relevant to the claim.
- If a claimant fails to appeal within ERISA’s guidelines (180 days), then the claimant forfeits his/her rights to appeal or file a lawsuit later on.
- ERISA requires that the insurance company must make an appeal determination within 90 days of receiving the appeal.
- Some disability benefits plans require two appeals, but ERISA specifically states that plans cannot require a claimant to file more than two appeals before filing a civil lawsuit.
- After exhausting the appeal process, a claimant may file a civil lawsuit, but due to ERISA, the claimant must file in federal courts.
- ERISA preempts state laws, which means that disability claims under ERISA cannot include bad faith damages as well as damages for pain and suffering.
- The federal court’s review will ordinarily be limited to evidence available at the time of the final determination. Limited discovery is allowed in some ERISA claims.
Contact Houston LTD Attorney William Herren Today
Despite the long and complex regulations set forth by ERISA, some of the most important pieces of information include the appeal process as well as the deadline for appeal. With years of experience dealing with long term disability claims and ERISA cases, we at Herren Law have the in-depth legal knowledge and litigation strategies that you need to put forward a strong and comprehensive case. For a free, no-obligation consultation with our Houston-based firm, call long term disability attorney William Herren today at (713) 682-8194.