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Greenville ERISA Lawyer

Greenville ERISA Lawyer

Here is a startling fact: 25% of all workers will, at some point during their careers, experience a disabling accident, injury, or illness. Employees who have an Employee Retirement Income Security Act of 1974 (ERISA) disability benefit plans often struggle to understand the complicated regulations governing the benefits and employees’ access to them. That is why enlisting the assistance of a local ERISA attorney can be an essential step in obtaining the benefits you deserve following a disabling accident or illness.

Employer Responsibilities

Federal law requires employers to inform employees about the disability benefits to which they are entitled. This should include:

  • A comprehensive explanation of what is covered and what is excluded;
  • Instructions on how to file a claim following a disabling event;
  • A description of steps to take and statutes of limitations following claim denials.

What You Need to Know

Companies choose specific language in their contracts in order to define covered disabilities. Even if they approve your claim, you must undergo a waiting period before receiving long term disability benefits. Once you start getting this support, be aware that the money may be taxable.  At any rate, the benefits may be offered as an offset to Social Security Disability benefits and may be limited as to the length of time for eligibility.

Receiving a Denial

Within 45 days of filing a claim, employees must hear back from the insurance provider on their decision. If the claim is denied, a written explanation must be provided.  At this point, employees must decide whether to accept the determination or to fight back.

Appealing the Denial

At the Law Offices of J. Price McNamara, our legal team handles these situations every day. We understand that from the perspective of the insurance provider, limiting payouts makes great financial sense. They may be looking for any reason to deny you the coverage you need, including challenging a physician’s report, denying that your medical problem is eligible for coverage, or disputing the documentation submitted. They may try to narrowly define terms of your contract in order to give them cover in the denial process. We know precisely how to proceed to fight for the benefits you need and deserve:

  • We analyze the medical and work-history documentation provided to support your claim, and supplement it as needed;
  • We contact necessary entities to explore the reasons behind the denial;
  • We orchestrate negotiations with plan administrators to compel payment of needed benefits;
  • When all else fails, we pursue legal action to obtain benefits on your behalf.

Following a Disability

If you are part of the unlucky one-fourth of Americans who have experienced a short or long term disability, we believe you are entitled to support. At the Law Offices of J. Price McNamara, we will intervene when bad-faith insurers balk at providing the benefits you deserve.  Contact us today in Greenville for a consultation about your case.

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