The Employee Retirement Income Security Act of 1974, also known as ERISA, is a federal law that sets standards that must be followed by the private industry for health and retirement benefits. ERISA does not require employers to have a plan in place but does require those who have a plan to meet specific minimum standards.
ERISA laws cover health, retirement, and other welfare benefit plans such as life and disability. ERISA ensures that the individuals who manage the plans must meet specific standards of conduct, as well as give detailed reporting to the government and certain disclosures to their participants. Provisions in the plan also aim to ensure that the funds in the plan are protected and the participants who meet qualifications receive appropriate benefits.
Since ERISA laws are federal laws, employee benefit plans are governed by them. This means that any disputes you have with your insurer will be handled in federal court and not by a local or state court.
If you have been injured or are sick and are unable to work, you can file a claim for either short or long-term disability benefits. Although the process seems easy enough, it can be much more difficult than it seems. In most situations, you will begin the initial application through your human resources office.
After filing the first application, you will likely be contacted by the disability benefits insurer. They may appear to be very friendly and nice and claim that they are there to guide you through the process, but do not be fooled. They are not your friend and they are not on your side. This claim agent is a representative of the insurance company and that company does not want to pay you benefits. Rather, they want to make you comfortable so that you will give them information that may help minimize or defeat your claim.
If they determine that you get benefits, your claim is still not over. An ERISA claim manager will likely review your claim every six to 12 months, and you will be required to cooperate and provide any information that is requested, such as medical records. Failure to cooperate will likely result in your benefits getting denied.
If you are attempting to file an ERISA claim, or your ERISA claim has been denied for short-term or long-term disability benefits, you need to consult with an experienced ERISA attorney as soon as possible. There are legal options available to help fight for the benefits that you deserve, and an attorney can help advise you of what those options may be. The attorneys at the Law Offices of J. Price McNamara have years of experience helping their clients with ERISA claims and we can help you, too. Contact our office today to schedule a consultation at one of our conveniently located offices. We will strive to get you the benefits that you are entitled to as quickly as possible.
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