ERISA Benefit Denials
ERISA is a set of federal regulations that set minimum standards for many voluntarily established benefit plans in private industry. These standards are intended to protect the employees who are enrolled in these plans – but it often does not turn out as intended.
ERISA requires multiple protections to be established, including, but not limited to:
- Having claims procedures which contain administrative processes and safeguards designed to ensure and to verify that benefit determinations are made in accordance with governing plan documents and that, where appropriate, the policy provisions have been applied consistently with respect to similarly situated.
- When denying or terminating a claim for LTD benefits, provide a description of the additional material or information to perfect the claim or an explanation of why such material or information is necessary and why in order to support the claim for disability benefits.
- Consider the comments and documents submitted in support an appeal of the denial or termination of benefits.
- Provide all relevant records and materials in its possession regarding the claim.
- During the appeal review, provide to claimant all reports generated in the process of the review, along with adequate time for the claimant to respond before making a decision.
- The right to sue for declaratory relief in Federal Court once all administrative appeals have been denied.
Have Questions? Speak to a Long Term Disability Lawyer –
Receiving the benefit you deserve due to an injury or illness can be difficult. Our ERISA attorney is ready to help you obtain your rightful disability benefits. At the ERISA Law Center, we understand the difficulties you are facing, and we are prepared to fight for you to ensure that you receive your long term disability benefits.