If your employer-provided long-term disability insurance company denies your claim for monthly benefits following an administrative appeal, you have the right to sue the company in federal court. However, there may be a time limit within which you have to file this lawsuit. The rules in this area are governed by provisions called statutes of limitations. While the Employee Retirement Income Security Act of 1974 (ERISA) does not contain a statute of limitations itself, state laws may impose their own binding limitations. Additionally, disability insurance policies may contain clauses that impos ..read more

Filing for monthly benefits from an employer-sponsored (ERISA) long-term disability insurance policy can often be a complex and difficult process. One of the first requirements you’ll face is the submission of “proof of loss” documents to your long-term disability insurer. As the name suggests, proof of loss is the information you provide to your insurance company that proves you have an illness or injury and that it rises to the level of disability, as set out in your policy. In practice, though, there can be differences between given policies and insurance companies when it comes to what act ..read more

It’s not uncommon for long-term disability insurance companies to reject initial disability claims on employer-sponsored policies. There are countless reasons why an insurer might delay or deny your group disability claim; however, there are certain rules they must adhere to when they do. When you file for monthly benefits on an ERISA disability insurance plan and your insurance company responds by granting you anything less than the full amount you sought, this is known as an adverse benefit determination. It’s important to understand the parameters of these determinations so you can lodge a ..read more

If your long-term disability insurance coverage is a benefit you receive from your employer, it likely falls under the jurisdiction of the Employee Retirement Income Security Act of 1974 (ERISA). This highly complex body of federal legislation makes life very difficult for disability insurance claimants in a host of ways, including through its imposition of mandatory claim-ending deadlines. So, what are the most important ERISA disability deadlines to be aware of? The Summary Plan Description (SPD) ERISA requires employers providing long-term disability insurance to give their covered workers ..read more

The Employee Retirement Income Security Act of 1974 (ERISA) is a body of federal legislation that governs a wide range of employer-sponsored benefits for workers. This includes long-term disability insurance coverage you get as a perk of employment. There is a distinct appeals procedure when it comes to employer-provided long-term disability insurance plans (also known as ERISA policies). One of the rules here is that your insurance company must provide a “full and fair review” of your claim and appeal before you can file suit against the insurance company in federal court. So, what does a ful ..read more

Basic disability monthly benefits are the same under most individual or group long-term disability insurance plans—that is, you should receive income-replacement payments if you are sick or injured and rendered either totally or partially disabled. Each individual or group long-term disability insurer will draft specific contractual language that will govern your claim. While it is great to have coverage, insurance policies are not always drafted with your best interest in mind. You do not want to take a financial hit after an injury or prolonged sickness limits you from working. Let ..read more

We previously discussed the requirements and timeline for litigating an individual long-term disability (LTD) insurance or group ERISA claim. We know the basic prerequisites for filing, why you must not file too soon and how a disability lawyer can really help. Now we can review the statute of limitations on ERISA claims and the consequences of filing an ERISA lawsuit too late. Statute of Limitations Let’s proceed with the same scenario where a back injury renders you unable to do the important duties of your occupation. You need your LTD insurance benefits, and you file a legitimate, thorough ..read more

Congress passed the Employee Retirement Income Security Act (ERISA) in 1974 to help regulate retirement plans that employers offer to their workers. It was a well-intentioned law that was expanded to cover health, disability, and other insurance plans. ERISA now sets minimum standards that your retirement and other insurance plans must meet to provide workers with adequate protection, but it also makes employees subject to onerous requirements. When workers file claims, the sick or injured often meet swift and unreasonable denials by their own disability insurers because they failed to dot tha ..read more

You expect that your insurance and retirement plans will be there to support you if and when disability strikes. Unfortunately, that’s not always the case. Nevertheless, you do have protection under the Employee Retirement Income Security Act (ERISA). ERISA sets minimum standards that your retirement and other insurance plans must meet to provide you with adequate protection. When you file a claim, you expect that your plan will provide for you if you need it. But claimants often meet swift unreasonable denials. As soon as possible after you receive a group disability denial, you need to speak ..read more

ER Technicians have historically been in high demand due to many hospitals and healthcare providers reaching maximum capacity. This need has intensified amid the COVID-19 pandemic, and as previously discussed, ER Techs have consequently been at higher risk for disabling injuries and illness since their presence is required to support nurses and doctors. Should an injury or illness prevent an ER Tech from working, here are some basic tips for filing short-term and long-term disability claims while the United States is battling rising COVID-19 cases. Tip 1: Know What Type Of Disability Coverage ..read more