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Long Term Disability / Life /
Accidental Death / ERISA

Our past years of representing insurance companies taught us a thing or two about how they work behind the scenes. Let our experience work for you.

ERISA Disability Application Process in Louisiana

ERISA creates specific procedures that insurance companies are required to follow whenever a person makes a claim, and furthermore limits access for workers to federal courts. However, long before you need to think about these provisions in the law, you must first file a claim with your insurance company.

Every insurance company in Louisiana maintains their own specialized procedures regarding applications for ERISA benefits. Still, there are some common factors that you can look for to potentially give yourself an advantage in the ERISA disability application process in Louisiana.


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Receiving a bill should never be the first step in getting help. Our firm knows that when dealing with an ERISA, long term disability or insurance claim, what you need is answers, and we are here to provide them free of charge.

Our firm welcomes telephone calls or the opportunity to visit with you in person to answer any questions you may have. We also provide FREE comprehensive case reviews. There is no obligation to hire us as your ERISA attorney.

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Too much is at stake to guess about the best approach and strategy for fighting your denied insurance claim — years and years of financial security.

After spending years representing insurance companies, we don’t guess. We know their playbook and how they work behind the scenes. Using that knowledge, we’ve developed our own Clear Advantage Process for fighting claims.

It’s personally satisfying to use what I’ve learned as an insurance company insider, now for the good — helping families reverse unfair denials of insurance benefits they paid for, need and deserve.


About J. Price McNamara

Price McNamara began his law practice in 1990 representing insurance companies.

In 1995, Mr. McNamara founded McNamara Law Offices, where he represents people across the U.S. who are wrongfully denied long-term disability insurance, life insurance, and accidental death insurance benefits, with special focus on ERISA claims and lawsuits.

His is a member of the Louisiana and Texas Bars, with office locations by appointment only in Baton Rouge, Metairie, and Houston. He lives in Baton Rouge, Louisiana with his wife and their three children.

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How to File an ERISA Claim

Every insurance company has their own procedures to file a claim. However, ERISA requires these insurance companies to provide their customers with a Summary Plan Description, or SPD. The SPD provides information about what benefits the plan provides, as well as how a potential recipient could file a claim for those benefits.

In general, an application for benefits will ask for information concerning:

  • How the injury or illness came about
  • What medical treatment the applicant is seeking
  • When the applicant is expected to make an improvement, if at all
  • How the condition affects the applicant’s ability to do their job


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Baton Rouge Office

10455 Jefferson Hwy,
Suite 2B
Baton Rouge, LA 70809
Phone: (225) 201-8311
Fax: (225) 201-8313
(By Appointment)

New Orleans Office

4141 Veterans Memorial Blvd.
Suite 212
Metairie, LA 70002
Phone: (504) 458-8455
Fax: (225) 201-8313
(By Appointment)

Houston Office

363 N Sam Houston Pkwy E
Ste 1100 PMB, #114
Houston, TX 77060
Phone: (713) 439-0339
Fax: (225) 201-8313
(By Appointment)

A successful application should state that the injury or illness did not occur while at work, as that scenario would make it a workers’ compensation claim. It should also state that the condition has been ongoing for a number of months and is expected to last for many months into the future. All this information must be verified by a licensed doctor or therapist.

When is it Appropriate to File an ERISA Claim?

All long term disability plans have a built-in waiting period for people wishing to make a claim. This waiting period is designed to filter out conditions that result in a quick recovery. This waiting period varies on a plan by plan basis, but generally lasts for around three to six months.

A potential applicant cannot file a claim during this time, but they should be visiting with their doctor to receive treatment and obtain that doctor’s professional opinion as to the extent of the condition. Many people are protected by short-term disability plans that can provide income during this waiting period. Potential applicants should consult with their plan’s SPD to identify the proper waiting period.

Initial Insurer Decisions on Claims

ERISA strictly controls when an insurance company must make a decision after a worker files a claim. The law states that most claims must be decided within 45 days after receipt by the insurance company. In special situations, the company can apply for a 30-day extension.

After this time passes, the insurance company must either begin to issue benefits or provide the worker with a detailed letter explaining the reason for the denial. This letter should also contain instructions on how to file an appeal.

The ERISA Disability Application Process in Louisiana Can be Complex

Anyone who wishes to take advantage of their employer’s long term disability program must follow strict rules. These rules are in place to prevent fraudulent claims and to ensure that insurance companies have all the information they need to make informed decisions.

This process includes making doctor visits, gathering relevant information, and filing the application after completing a waiting period. An attorney could help you understand the ERISA disability application process in Louisiana. They could also assist if you already filed an application and received a denial. Call today to see what options may be available to you.

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