Do I Need An ERISA Attorney? When It’s Time To Call The Experts

October 6, 2020 | J. Price McNamara
Do I Need An ERISA Attorney? When It’s Time To Call The Experts

The Employee Retirement Income Security Act (ERISA) was enacted as federal law in 1974. The Act provides protections and governs the benefits of individuals in the private sector. The law governs numerous benefits, including retirement accounts and long-term disability. An ERISA attorney is called, in most cases, when there are issues with long-term disability benefits.

What is ERISA?

ERISA law is designed to benefit employees by offering protections and rights. The law dictates the rights of each employee as well as insurance companies. If you're employed by one of the following, you're likely protected by this Act:
  • Employer with group disability insurance
  • Union
  • Employee group
The law protects employees from harmful industry practices and also protects the contributions made by employees. Employers that contribute to an employee's health or retirement plan are bound by ERISA rules. Employers are required to provide, in writing, information about each plan that the employee is eligible to participate in. When an employee is injured or ill, and they have to be on long-term disability, this is when an attorney that specializes in ERISA law can offer assistance.

When to Call an ERISA Attorney

The law is designed to protect employees, but it can be difficult to navigate the law on your own. An attorney who is familiar with the regulations is best suited to assist with:
  • Claims
  • Appeals
If you're attempting to go through a claim or appeal on your own, it's a risk that you shouldn't take on alone. The times when it's important to contact an attorney include:

Filing an Appeal

Filing an initial claim may seem like a straightforward process, but you likely have only one chance to file an appeal. When you file your appeal, you need to supply the following:
  • Medical documents and evidence
  • Vocational documentation
  • Witness evidence
ERISA limits your ability to continue submitting documentation to support your disability. You need to provide substantial documentation to address the obstacles that you face as a result of your disability. An attorney can help outline the life changes you'll face as a result of your disability and help collect the documentation to back these claims. Reports from specialists and doctors may need to be added to increase the chances of your claim or appeal being approved.

Claim Goes to Court

Insurance companies will fight back against claims to avoid paying them. The claim may go in front of the court. You have this one opportunity to win your claim, and it comes down to the legal team and documentation you can provide. The insurer's lawyers have a lot of your documentation in their possession. If you go into the appeal process unprepared, you may lose your only opportunity to receive the benefits you deserve. An attorney will:
  • Gather the documentation required to strengthen your claim
  • Defend your claim in court and paint a clear picture of your life after the disability
Going into the courtroom unprepared gives the insurer's argument a higher chance of convincing the court. You shouldn't leave your only appeal up to fate.

You Don't Know Your Rights Under ERISA Law

Our attorneys specialize in ERISA law. We know what rights and benefits are available to you under the law. These laws can have an impact on your claim, and it's important for an attorney to protect your rights. If you go into an appeal without a full understanding of your rights, you may lose rights you didn't know were available to you by law. Attorneys protect your rights and ensure that you're never caught off guard during the appeal process.

Changes or Amendments are Made

Attorneys can also work on plans to ensure that they adhere to ERISA regulations. Legal professionals will look over retirement plans to ensure that the plan is compliant and that there are no risks of compliance issues in the future. IRS requirements also dictate that qualified plans have new plan documents and tack-on amendments added every year or two to conform to new laws and regulations. Amendments may require the help of an attorney if eligibility requirements are changing or multiple employer plans are added. An attorney will draft and/or renew one of these plan documents to ensure that they meet the regulations put forth by ERISA. New plan documents are required every 5 to 6 years, and these too must be reviewed by an attorney. Plan and fiduciary issues are not always obvious to claimants who file for benefits. An attorney can help protect employees by helping them navigate the complex laws and regulations under ERISA, and determine where plan administrators or insurers have not followed the law when denying benefits. ERISA cases are complex. Whether you're filing a claim or appeal or need to file a lawsuit in court over an unfair claim denial, it's important to call an ERISA attorney as soon as possible. Contact us today for a Free Denial Review.
J. Price McNamara Author Image

J. Price McNamara


Losing my own brother, then my father and sister after long, disabling illnesses just a few months apart drove a career change for me. Before that experience, I never truly understood the place you’re in. I never understood the dramatic impact that receiving (or not receiving) the disability and life insurance benefits you paid for and counted on can have on your life especially when you need to focus on family and healing. What I experienced with my own family now drives the way I view my clients and my work, and I will never forget it!

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