What Are the Filing Deadlines for ERISA Disability Claims?

If you’ve been injured or disabled and you’re not able to work, you may have several options. You may be eligible for workers’ compensation, or you may qualify for the California State Disability Insurance program, which provides short-term disability benefits for up to a year to eligible injured workers.

If your employer provides long-term disability insurance coverage under a group plan – an ERISA plan – and you’ve been temporarily or permanently disabled, you should file a claim through the group plan. However, before you claim any disability benefits, discuss your circumstances with a California disability claims attorney at the McKennon Law Group.

Your attorney will review your case, determine your eligibility for various benefits, and recommend the best way to proceed – which may include filing a claim under the complicated ERISA guidelines. The Employee Retirement Income Security Act of 1974 – ERISA – is the federal law which governs the group insurance plans provided by many private employers.

Is There an ERISA Statute of Limitations?

While ERISA does not itself include a statute of limitations for participant benefit claims such as disability insurance claims, this doesn’t mean there is no deadline for ERISA claims. Instead, the deadline for filing an ERISA disability claim varies from state to state and usually depends on that state’s own comparable statutes of limitations.

In some cases, the courts have ruled that the terms and provisions of a particular insurance plan or policy may include a reasonable deadline for filing a claim. Of course, if you are temporarily or permanently disabled, and you can’t work, you should have an attorney acting on your behalf as quickly as possible. If you are not a participant in an ERISA plan, your other options for disability benefits will also entail deadlines.

After your disability claim is filed, ERISA requires the insurance company to approve or deny your claim within a “reasonable” period of time. Typically, a determination must be made within 45 days of receiving your claim, although this deadline may be extended by another 30 days if the company needs additional time to conduct and conclude its investigation of your claim.

How Much Time Do You Have to File an Appeal?

A disability claim may be rejected for a number of reasons. The insurance company may decide that you do not qualify, or the company simply may not have enough information to approve your claim. If your claim is denied, ERISA typically gives you 180 days to file an appeal. You’ll need to have an insurance attorney at the McKennon Law Group handle that appeal on your behalf.

In most cases, an insurance company must make an appeal decision within 60 days of receiving your appeal notice. If the company needs more time, you must be notified in writing. If your appeal is denied, you may or may not be required to file a second appeal before taking the insurance company to court. The terms and conditions of each plan or policy will determine what happens next.

Can You Sue the Insurance Company for Denying Your Disability Claim?

You may pursue a lawsuit against the insurance company only when you have exhausted the administrative appeals process. You’ll need to be advised and represented – through each step of the process – by the McKennon Law Group. We have seventy years of insurance claims experience, and for decades, we’ve successfully handled ERISA claims, appeals, and lawsuits for workers and their families throughout California.

Let us review your ERISA disability case at no cost and with no obligation. An ERISA claims attorney with the McKennon Law Group can provide personalized advice, effective representation, and recommend the best way to proceed with your claim. Call our law offices at (800) 682-4137, or reach out to us now by completing the contact form on this website.