What You Need To Know About Filing An ERISA Claim While You’re Employed

Should I File An ERISA Disability Claim If I Am Still Working?

You can file an ERISA disability claim while you are still working. However, you may not always want to.

Most disability plans require “an inability to perform the duties of your occupation” before benefits become payable. Therefore, you might be hard-pressed to prove that you cannot perform the duties of your occupation if you are still working.

What Tactics Will Insurance Companies Use To Deny My ERISA Disability Claim?

Insurance companies use a variety of tactics to improperly deny ERISA disability claims. For instance, surveillance is a tool often used by insurance companies to deny a disability claim.

However, you should beware of this tactic. While you might think that it shouldn’t matter whether an insurer conducts surveillance, it can be quite problematic for them to use this information against you.

You may think that you’re doing nothing wrong, only to be improperly “flagged” or denied for something completely innocent.

And you should keep in mind that… More and more companies are using electronic surveillance. Being tagged in an innocent post on Facebook by a friend or a family member might be just what an insurance company needs to deny your claim.

Why Would My ERISA Disability Claim Have Been Denied?

ERISA disability claims are denied for a variety of reasons. Most often, the carrier will claim that you did not meet the criteria of payments for benefits under a plan. Once it’s decided, they’ll send you a letter with the exact reasoning behind the denial.

If My ERISA Disability Claim Is Denied, Do I File An Appeal Or Do I File A Claim Against The Insurance Company Immediately?

Under ERISA regulations, you must exhaust your administrative remedies before filing a lawsuit.

That means you must file your administrative appeal and comply with any other requirements needed before filing a lawsuit, or else risk having your lawsuit dismissed.

Do I Need To Hire AN ERISA Attorney For My Appeal Or Can I File One On My Own?

While you can file your own appeal, your best course would be to hire an attorney who is well versed in ERISA law.

Most ERISA cases are decided based on the record in the claim filed. Since your record is closed at the conclusion of your appeal, your appeal is often the most important part of your claim.

An appeal is your last chance to highlight evidence that you may want the court to see. Overall, hiring a lawyer to file an appeal might be the best thing you can do for your ERISA disability case.

How Long Do I Have To File My ERISA Claim Or Lawsuit?

Your claim will be governed by the statute of limitations, which is the length of time that you have to file your lawsuit.

Most insurance policies will list your statute of limitations in the policy itself. If the policy does not state the statute of limitations, then the statute of limitations for your state’s contract law will apply.

How Might State Social Security Benefits Or Workers Comp Benefits Impact An ERISA Claim?

Most ERISA policies allow for an offset of other sources of income such as social security and workers’ comp benefits.

An “offset” means the insurance carrier will deduct the payments you receive from those sources from the amount they pay you, and pay you the difference.

How Much Can I Recover From An Insurance Company If I Win My ERISA Appeal?

If you win your appeal, you can recover your retroactive benefits and your rights to future benefits as long as you continue to meet the requirements of your policy.

For more information on Filing An ERISA Claim While Employed In FL, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (352) 577-7746 today.