If you have long term disability insurance through your employer, then the plan is likely subject to compliance with ERISA. ERISA, or the Employment Retirement Income Security Act of 1974, is a federal law that sets standards for many employer-provided benefits. Your long-term disability insurance plan may be subject to an array of ERISA compliance issues, and you likely have questions. Learn more from CJ Henry Law Firm, PLLC today.
It’s important to determine whether or not your long term disability policy is governed by ERISA. While most employer sponsored plans are covered, others are not. If you work for a government entity (federal, state, or local), Indian tribal entities, or a church, your plan is not likely to be covered by ERISA.
Many of the benefits plans offered by employers fall under ERISA, including:
CJ Henry Law Firm, PLLC has experience with an array of ERISA plans, in particular long-term disability policies.
The details of your long term disability policy will determine the standards required to approve or deny your claim. Some common issues that come up include:
ERISA is a constantly changing law. Thus, your disability insurance policy must comply with the law as it changes. Rules and processes for adjudication, denials, and appeals are modified on a regular basis. It is the responsibility of the long term insurance company to know about these changes and comply. However, they may violate ERISA if no one calls them on their illegal practices.
Some updated ERISA practices include the following:
Many long-term disability claims are denied initially. Your first step should be to seek out a knowledgeable attorney who can evaluate your denial documents and help you make a decision about your next best steps.
If you need to obtain additional medical evidence for the LTD insurance company, then you may need a new doctor or a specialist. You should continue seeing all of your providers so that your medical records are ongoing and show the severity of your condition. If you stop going to the doctor, the LTD Company may assume you are well or no longer need to be considered disabled.
We have worked with thousands of clients facing ERISA compliance issues in LTD claims. Call us today.