What Is ERISA?
Were your ERISA disability benefits denied in California? An attorney can help.
Most of the life, health and disability policies issued through employers in the United States are governed by the Employee Retirement Income Security Act of 1974 (“ERISA”), a federal statute that protects employee benefits by imposing minimum standards on employers/ERISA administrators.
ERISA requires plans to provide participants with plan information including important information about plan features and funding; provides fiduciary responsibilities for those who manage and control plan assets; requires plans to establish a grievance and appeals process for participants to get benefits from their plans; and gives participants the right to sue for benefits and breaches of fiduciary duty.
ERISA involves a complex area of law that can be difficult for many people to understand. For that reason, some employers and insurance companies take advantage of disabled workers and improperly deny their claims. If you are interested in receiving ERISA benefits but aren’t sure if you’re eligible, or filed for ERISA benefits and your claim was wrongfully denied, a California ERISA attorney can help you.
Who Is Eligible For ERISA Benefits?
Those who are approved for social security benefits or private benefits may be rejected under ERISA. Not all candidates are eligible, and the full list of eligibility requirements is exhaustive.
ERISA applies to private-sector companies that offer pension plans to employees. Regardless of how your employer has structured his or her business (limited liability corporation, S-corporation, C-corporation, or other) it is covered by ERISA as long as it is a private entity. ERISA was enacted to ensure that the benefits an employee has been promised, that are part of their retirement or severance package, are provided as they were originally intended to be.
Why Was My ERISA Disability Claim Denied?
Many people believe they are eligible for ERISA benefits, but are still denied. It can be difficult to understand without the insight of a lawyer. Disability claims that would ordinarily be approved under private disability or social security disability are often rejected in the ERISA system. The following list are common reasons why claimants have been denied ERISA benefits:
- Failure to provide medical documentation or evidence that proves your disability
- Incomplete information or errors in the claim information
- Failure to meet filing deadlines
- Pre-existing medical conditions
- Self-reported symptoms (not properly documented with medical professionals)
- Out of scope treatment (medical care not authorized or out of protocol)
- Contradicting evidence from social media or private investigators
- Employability in a different occupation
- Specific exclusions from your individual policy
These are still more reasons why an ERISA disability claim can be denied in California. This process can be exhaustive, and can be a lot for an individual to handle without the help of a qualified attorney. If your ERISA claim was denied in California, waste no time and contact a lawyer as soon as you can.
Can I Appeal A Denied ERISA Claim?
Was your ERISA disability claim denied in California? There’s still hope. One of the most helpful aspects of working with an ERISA attorney is that they can help you appeal your wrongfully denied claim and resubmit a stronger application. If you believe that your ERISA disability claim was wrongfully denied, an attorney will advise you whether or not appealing the decision is the right course of action to take, depending on the specifics of your situation.
If your attorney advises that you submit an appeal, they will walk you through this process and ensure that every important deadline is met. Your attorney will then help you strengthen your claim. This is often done by fixing any errors, adding any supporting documentation such as medical information, and will make sure all fields are complete with the strongest information possible to prove your right to these benefits.
ERISA involves mandatory administrative appeals and strict deadlines, so it is imperative that you know your rights and swiftly hire an ERISA attorney. If you do not follow the proper appeal procedures, you could lose your right to sue your employer and/or the insurance company that administers the claim.
Schedule A Free Consultation With An ERISA Lawyer If Your Disability Claim Was Denied
If you or a loved one have become disabled, getting the benefits you deserve is crucial. Contact McKennon Law Group PC with any initial questions you have about ERISA benefits, even if you’ve been denied.
We offer an initial consultation for any California resident in need of guidance regarding ERISA disability claims. Your initial case evaluation with McKennon Law Group PC is free of charge, and comes at no risk or obligation to you.