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Disability Benefits and Rights Under ERISA

Our ERISA Lawyers Explain Your Rights

Our disability attorneys understand the difficulties faced by individuals who are unable to work, either temporarily or long-term. If you have an illness or injury that prevents you from working, then it is important to understand your rights. Employees who are enrolled in a disability insurance plan offered by a private employer and find that they cannot work due to an illness or injury have certain rights under a decades-old federal law. The Employee Retirement Income Security Act of 1974 (ERISA) is a comprehensive federal law that governs multiple types of insurance and retirement policies offered by private employers.

Signed into law by former President Gerald Ford, ERISA made the federal government primarily responsible for regulating these policies instead of the states. Life insurance and disability insurance fall under ERISA’s umbrella. Employees working for private companies have certain rights when using and collecting from employer-offered policies, such as disability insurance. Your employer must disclose your rights under a disability benefit program and provide information on how the policies work. An employer cannot fire you to prevent you from collecting benefits. Disability insurance providers must also abide by ERISA’s regulations.

Sadly, employees can run into problems when their employers refuse to abide by ERISA’s guidelines or when insurance providers unfairly deny claims. Employees may lose access to benefits that cover them and their families. If you have a disability from a disease, illness or injury and cannot presently work, then losing access to these benefits could lead to a catastrophic financial situation. Fortunately, employees have rights under the law and can file appeals or even lawsuits.

The nationally recognized ERISA lawyers at Tucker Law Group can help if your employer’s disability insurance provider unfairly denied your claim. We have extensive experience with cases involving ERISA violations against every major disability insurance company. Our team of ERISA attorneys helps policyholders across the nation battle the disability insurance companies in federal court.

Employer Requirements and ERISA Violations for Disability Insurance

ERISA provides employees with a number of protections that make it easier to get information on your disability benefits and how to file or appeal claims. Under ERISA your employer must:

  • Provide you with information on your eligibility for benefits
  • Give you information on how and when to file a claim for benefits
  • Provide you with information on the appeals process for accessing denied benefits
  • Notify you of any significant changes to your benefits
  • Provide you with information on the features of your benefit plans and how the plans are financed
  • Give you information on which health conditions the plan covers

Your employer may violate your rights under ERISA if they do not abide by the rules listed above. Under ERISA, your employer may be guilty of violating your rights if they:

  • Fail to provide you with important information about your benefit programs, such as changes in the terms
  • Deny access to benefits you are eligible for
  • Fire you or demote you for attempting to access your benefits
  • Deny benefits or provide lesser coverage to certain workers, such as older or pregnant employees

You can file a complaint against your employer for violating your rights under ERISA. Depending on the circumstances, your employer could face civil or criminal penalties. You could also recover benefits, and interest on those benefits, denied by your employer.

ERISA Disability Claims

Insurance companies who provide disability benefits can sometimes run afoul of ERISA regulations. For instance, an insurance carrier must provide you with their reason for denying a claim in writing. Additionally, your provider must make a decision on whether to accept or deny your claim within a certain period of time. There are also time limits for making a decision after you file an appeal.

If you followed the guidelines, your disability is eligible, and your claim was unfairly denied, then you may still have options to recover your benefits. Additionally, you may be able to file a lawsuit if you appeal your case and still receive a denial. ERISA disability claim lawsuits are overseen by a federal judge. You and your attorney would need to argue that the provider erred in denying you benefits. The judge presiding over the case will review the documentation on file with the insurance provider. Documentation can include doctor’s visits, claims, appeals and letters from employers.

However, there are cases where you can recover your benefits by showing that a conflict of interest led to your denial. This would make the process of recovering benefits more likely and easier. Our ERISA attorneys are experienced with uncovering the deceptive techniques every major insurance company uses to deny disability insurance benefits.

Do I Need an ERISA Lawyer?

Disability insurance claims and lawsuits are difficult to litigate. However, an attorney with experience handling ERISA claims can help recover evidence, file paperwork, and argue your case before a federal judge. Depending on the unique circumstances of your case, it may be possible to recover disability insurance benefits from your employer’s insurer.

Tucker Law Group can review your situation and help you determine which legal options are available for recovering your benefits. Our attorneys are nationally recognized for their ERISA expertise in helping individuals wronged by insurance companies.

If you have questions about your rights under ERISA or your options for filing a lawsuit, then we encourage you to call us for a free consultation. You can schedule a consultation with us by dialing (866) 233-5044 or by using the contact form on our website.