Our California ERISA Lawyers Are Here to 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.
However, because ERISA involves a complex area of law, employers and insurance companies often take advantage of the employees to improperly deny claims. If your claim is denied, you can seek the help of experienced ERISA and pension attorneys to appeal the decision and sue for policy benefits, attorneys’ fees and interest due on the unpaid ERISA benefits.
If your ERISA claim was denied, you should consider consulting with an insurance litigation attorney and appealing the decision immediately. 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.
Furthermore, an ERISA appeal is your last chance to submit supporting documentation and create a strong case for litigation. The attorneys at McKennon Law Group PC in California, have decades of experience handling ERISA cases. We can litigate your ERISA claim or help prepare your appeal and ensure that all relevant medical and vocational information is provided to the insurance company.
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.
If Your ERISA Disability Claim is Denied
If you participate in a group insurance plan offered by your private-sector employer, it is almost certainly an ERISA plan, which means the plan is governed by the Employee Retirement Income Security Act of 1974. Claims for ERISA insurance benefits can be exceedingly complicated and detailed. There is no room for error when you file an ERISA claim.
Have an ERISA claims attorney at the McKennon Law Group help you file an ERISA insurance claim if you are covered by your employer’s group insurance plan, you become disabled, you cannot work, and you need to receive disability benefits. Your attorney can ensure that, at least on your end, there are no mistakes or misunderstandings that could delay the approval of your disability claim or result in the claim’s denial.
What Does an ERISA Disability Claim Require?
Insurance companies closely scrutinize every claim. A claim for ERISA disability benefits must include your own employee statement, an employer statement, and an Attending Physician’s Statement. Your ERISA disability benefits claim must also include a full disclosure of your income and assets.
If you provide any inaccurate information to the insurance company, your disability claim could be rejected, and appealing the denial of an ERISA claim is a costly and time-consuming process. It’s better to submit a complete and accurate claim with an attorney’s help at the start, avoid the need for an appeal, and receive your disability benefits as quickly as possible.
What Will a Lawyer Do on Your Behalf?
If you filed a claim on your own for ERISA disability benefits and that claim has been denied, the insurance company must sent you a letter of denial that includes specific details about why your claim was denied and about how you can file an appeal. When a McKennon Law Group attorney handles your appeal, that attorney will:
1. review your claim, your denial letter, and any related evidence or documents
2. determine what the insurance company believes is missing from your claim
3. ensure that sufficient medical evidence is presented in support of your claim
4. try to have the denial of your claim reversed on appeal
When Should You Appeal the Denial of Your Claim?
You typically have at least 180 days to file an appeal, although some plans may establish longer deadlines. Either way, there is no reason to delay. If you are disabled and can’t work, your debts may be mounting, and you need to have the denial of your ERISA claim reversed as quickly as possible.
For more than seventy years, the attorneys at the McKennon Law Group have advised California consumers who are involved in disputes with insurance companies. We have effectively advised and represented hundreds of clients, and we know how to resolve the most complicated disputes involving ERISA claims and other insurance benefits.
Contact a California ERISA Lawyer Now
The ERISA attorneys at McKennon Law Group PC understand how this federal law can protect you. For more information, please see our ERISA FAQs. We help clients throughout California and nationwide. For a free initial consultation, please contact an experienced ERISA attorney by filling out this free consultation form or by calling 1-800-682-4137.