Fair, & Prepared
Employers often provide employees with retirement benefits and disability insurance. Sometimes disputes develop over eligibility, or the amount of pension benefits to which a present or former employee may be entitled. When an employee is no longer able to work due to a medical condition, there can be a dispute over whether the employee meets the definition of “disability” in the employer’s insurance disability plan. Pension and Disability insurance disputes under Employer Sponsored Plans are subject to a complicated federal law, The Employee Retirement Income Security Act (ERISA). ERISA applies to all benefits secured through private employer employee benefit plans. ERISA outlines the rights and responsibilities of employers, employees, beneficiaries, pension funds and insurance companies.
ERISA provides certain rights if a claim for benefits is denied, including a requirement that the reason for denial be in writing and in a manner you can understand. There is also a requirement that a participant be given a reasonable opportunity for a review of the decision and that a participant has a right to a copy of the pension or disability plan upon request. In addition, once administrative appeals are exhausted, only federal courts have jurisdiction over a lawsuit. If an administrative appeal is not successful and a federal lawsuit is necessary, it is critical to understand that a federal court may not be able to review any materials other than the employer’s pension file or the insurance company disability file and the contents of any administrative appeals.
Filing a claim and obtaining the pension or disability benefits to which you are entitled can be complicated. Therefore, it is critical that you know as much as possible about ERISA and all of its requirements as early as possible.
If you have a potential dispute over a pension or a disability claim, it is critical that you be prepared and protect yourself to have the best possible chance of prevailing. You should have a clear direction and successful approach. Consultation with a qualified attorney at the earliest possible stage in the process is critical to maximize your chance of success.
We have successfully represented ERISA Pension and Disability Clients. Call us today at 267-470-4742 or contact us online to discuss your legal options