In the United States, most people depend on their jobs to provide them with a livelihood and sense of purpose. Unfortunately, accidents do happen and if a person suffers from an injury or illness that prevents them from working for a considerable amount of time, their employer-provided disability benefits should provide them with a steady income until they are able to work again.
Unfortunately, some workers will have their benefits claims denied by insurers, even when they meet the requirements. If you have been denied disability benefits, a Texas ERISA lawyer may be able to help you obtain them.
Before a person can understand ERISA, they must first understand long-term disability and the coverage it provides. Long-term disability is often provided at the expense of the employer and when a person sustains an injury that prevents them from working for an extended period, their disability benefits will provide them with financial support.
This support usually amounts to roughly 50 to 70 percent of the income of a worker but it can help them maintain their standard of living and pay medical expenses. Unlike workers’ compensation benefits, which are only provided when a person is injured on the job, long-term disability provides benefits when a person is injured outside the workplace. These benefits are usually administered after the short-term benefits of a person runs out, which is usually between 10 and 53 weeks after an injury occurs.
ERISA, officially known as the Employee Retirement Income Security Act, was enacted in 1974 to protect the rights of workers with pension and health plans. The Act also outlines regulations regarding private long-term disability coverage provided by employers, ensuring employees have access to the coverage they are promised if they are unable to work due to a disability or injury. ERISA requires employers to follow strict laws regarding:
If an employee is covered by an employer-provided disability plan, the employer is obligated to provide them with a brochure that outlines the features of the plan and what benefits are offered. They must also provide information regarding out-of-pocket costs for coverage.
Even with ERISA laws in effect, many insurance companies will attempt to deny workers the benefits they are legally obligated to provide. Insurance companies often attempt to calculate the amount of time it will take a worker to recover and return to work, but this calculation usually fails to take the illness or injury the worker is suffering from into consideration.
Understanding disability and ERISA laws can be remarkably difficult, especially in the face of a denial of benefits. However, as an employee who has been provided disability insurance by an employer, you have certain rights that must be honored by both employers and insurers and if your benefits have been denied, you have a right to appeal. Contact a Texas ERISA lawyer now to discuss your case.
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