The Employee Retirement Income Security Act (ERISA) was created in 1974 to create a minimum set of requirements for employee disability benefits and retirement plans. All employer-sponsored disability policies, as well as retirement policies, must adhere to federal ERISA regulations. While it may seem like this federal oversight is a good thing for workers to ensure that their retirement plans and short and long term disability benefits are up to standard, over the decades, ERISA has been modified by insurance companies to do just the opposite. Now, ERISA acts as a barrier between an injured worker and his or her disability benefits, allowing insurance companies to easily deny claims or stop paying benefits after a few months or years. To successfully file a claim or to fight back against a claim denial, you need the assistance of an experienced West County Energy Center ERISA lawyer.
As an employee of West County Energy Center, your employer-sponsored disability policy is covered by ERISA. The only types of entities that provide employer-sponsored disability that are not governed by ERISA include the following:
Other types of disability benefits that have nothing to do with ERISA include Disability and Supplemental Income through the Social Security Administration, workers’ compensation, and personal disability packages purchased by the employer outside of work.
According to the U.S. Department of Labor, an insurer has up to 90 days to make a decision once your ERISA claim has been filed. However, an insurer can notify you that an extension is needed to make the decision, and in that case, they can take up to 180 days to make a decision. For injured or sick workers that need their claim to be processed quickly, this waiting time can seem like an eternity. Then, after months of waiting, it is not uncommon to receive a denial letter in the mail. This letter must specifically explain why your claim was denied, and how to go about appealing. A denied claimant has 60 days to request an appeal. Then, the insurer has 60 more days to review your appeal, plus an additional 60 if they notify you that they need an extension. As such, filing a claim is a waiting game and a game that most insurers assume they can win.
If you have questions about filing an ERISA claim, or your claim has already been denied, a West County Energy Center attorney is here to help. Contact the Law Offices of J. Price McNamara today to set up a free consultation with one of our compassionate and experienced lawyers.
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