Colleagues, I am now accepting ERISA claims.

ERISA INFO

If you received a disability claim denial letter from anyone besides workers’ compensation or the Social Security Administration, you may have an ERISA claim.

What is an ERISA claim?
ERISA claims are for individuals who have claims for disability benefits with an insurance company or their former employer. This is NOT a claim involving social security disability cases. Rather, employees are often offered group disability and life insurance. Employees generally choose to enroll in the insurance, or their employer enrolls them. Additionally, union members will have such benefits through their union.

When do I have an ERISA claim?
When an employee or union member becomes disabled (i.e., unable to work), s/he files a claim for short term disability, after which the claim is transitioned to long term disability. Generally, insurance companies do not dispute short-term claims that have merit. When that disabled individual transfers to long-term disability, however, the claims are strongly contested and often denied.When a disability claim is denied, an appeal can be made on that decision to the insurance company and, if not successful, an ERISA claim can be made to pursue litigation on behalf of the insured. Because these benefits are employer sponsored benefits, the claims are generally governed by ERISA (Employe Retirement Income Security Act), which is a speciality type of legal practice.

What’s an example of an ERISA claim?
Here’s an example claim: The manager at Kroger is enrolled in Kroger’s group benefits plan. As a part of that plan, Kroger offers long-term disability coverage, which is insured by Company X Insurance. One day the manager develops Multiple Sclerosis and is unable to work. He files a claim for long-term disability benefits with Company X, pursuant to Kroger’s plan. Because Company X fully insures the claim and makes the benefit decisions, Kroger is no longer involved. Company X denies Manager’s claim. His claim is governed by ERISA and he is required to file an appeal to Company X to contest the denial. An ERISA Lawyer will handle those appeals as they are complex filings that are critical to set up the insurance file for litigation (if necessary). If the appeal is denied (whether brought by the attorney or the manager himself), the next step is to file an ERISA claim for benefits action is Federal District Court.