ERISA Law and Lawyers - FAQ

What does ERISA stand for?

The Employee Retirement Income Security Act of 1974.

When would I need an ERISA lawyer specialized in this area of the law?

If you have a legal conflict involving any benefits under an employee benefit plan, you need an ERISA attorney. The most common cases involve disability benefits, health benefits, pension benefits, and life insurance benefits.

Does ERISA apply if I work for a government agency?

ERISA regulations do not apply to any government employees at any level - local, state, or federal.

Does ERISA apply if I work for a non-profit employer?

ERISA governs most disability plans sponsored by non-profits, with the exception of churches and certain other religious institutions.

What has been the impact of ERISA on the regulation of disability insurance plans?

The unintended impact of the ERISA law has been to facilitate the denial of legitimate long term disability claims by insurance companies. ERISA makes the insurance company judge and jury of its own disability claims, and puts a large burden on the claimant throughout the process. ERISA also removes the threat of damage awards in court proceedings that the insurance company has to consider when the case is governed by state law. In spite of these hurdles, disabled individuals can still prevail when their claim is contested.

Can the terms of my disability plan be modified by the insurance company or my employer?

Since your group disability plan is based on a contractual relationship between your employer and your disability insurance company, they can modify the plan at any time. Any modifications made after you file your claim, or after your claim has been approved, may or may not impact your claim. Certain types of post-claim modifications are routinely enforced in court, e.g., implementing discretionary review. Other types of post-claim modifications have generally not been permitted, e.g., changing the definition of disability. Surprisingly, some courts have permitted insurers to retroactively impose maximum benefit limitations (e.g., 24 months) on existing claims.

Why is it hard to find an experienced ERISA lawyer?

ERISA law is very complex because it involves elements of trust law, contract law, and disability law. Even though it is a Federal law, there is a significant variation in how it is applies within different jurisdictions. Since the law prohibits punitive damages, ERISA attorneys cannot obtain the large jury verdicts available in more high-profile areas of law practice.