Listen as John V. Tucker describes what you need to know about group long term disability plans.
If you have a long term disability plan, you need to know the differences between private plans and group disability plans. Many people don’t realize that the two plans are different. If you are going to make a claim under a group disability plan, then there are three things you need to know.
Group plans are covered under the federal law called ERISA. ERISA stands for Employee Retirement Income Security Act, and it varies drastically from state insurance laws. One of the biggest differences is that if your claim is denied under ERISA, then you have to file an appeal. The appeal will be sent back to the insurance company that denied you.
If you don’t file your appeal within 180 days, then you may lose the right to ever file a lawsuit because your claim will die after the 180 days. If do file an appeal, you will want to make sure that you have all of the evidence for your case in your insurance claim file because new evidence will not be allowed under ERISA.
Under ERISA, there are no testimonies, questioning of experts, or new medical records. All of your information has to be in your file during the claim and appeal.
Another important thing you need to know is that ERISA cases can be very difficult to handle alone. If you forget one thing, then there’s a good chance that you will lose. It helps to have an attorney who has experience with ERISA claims and knows the ins and out of ERISA guidelines. If you need to file a disability claim under your employer’s group disability plan, then you need an attorney. Watch the video to learn more.
If you have questions about group long term disability claims under ERISA law, I want you to call me at (866) 233-5044. I welcome your call.
Video TranscriptThe three most important things you need to know about your employer group long-term disability plan. I'm John Tucker, I'm a disability attorney and I represent people just like you all over the country and long term disability cases. Most people don't realize that group long-term disability plans are different than private disability insurance policies and I want to tell you three things that you must know if you're going to make a claim under your group disability plan.
First, group plans are covered by a federal law called ERISA, that stands for the Employee Retirement Income Security Act. ERISA is very different than state insurance law. One of the most significant differences is that you actually have to file an appeal if your claim is denied and that appeal goes right back to the same insurance company that just told me you weren't disabled. If you don't file that appeal and you have 180 days to do that, you're going to miss your right to ever file a lawsuit because your claim is going to die.
Second, if you file an appeal you have to make sure that all of the evidence you would ever want in your case is in that insurance companies claim file before the appeal is over. ERISA is very peculiar in that you have to have all of the evidence into the insurance company because a judge in a court will never consider any new evidence. You don't get the chance to testify in court and ERISA cases, your doctors can't come to court, you can't send new medical records, you can't hire experts to talk about why you can't work, it all has to be put together during your claim and your appeal.
Third, and this ties into what I just told you, you need an experienced ERISA attorney to help you with your appeal. Doing it by yourself works very rarely. You probably don't know all of the legal documents all of the legal arguments and the types of special evidence you need to prove your case to the insurance company or a court and if you leave something out probably going to lose. Find an attorney that understands ERISA, that knows ERISA and has handled more than one or two cases.
If you need to file a disability insurance case under your employer group plan or you need to file an appeal, call me at the number on your screen. I handle cases like yours every day and I'd be happy to talk with you about your client. I'm John Tucker. Thanks for watching.