• Menu
  • Skip to right header navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Before Header

Has your disability claim been wrongfully denied or terminated? Call us today for help!  (888) 321-8131

  • Facebook
  • Instagram
  • LinkedIn
  • Twitter
  • YouTube

OLF Ortiz Law Firm National Disability Attorneys

We appeal wrongful long term disability insurance and Social Security Disability denials.

  • ABOUT US
    • Our Team
    • Our Results
    • Areas We Serve
    • Core Values
  • PRACTICE AREAS
    • Administrative Appeals
    • Lawsuits
    • Lump Sum Settlement Offers
  • RESOURCES
    • Top 10 Mistakes That Will Destroy Your LTD Claim
    • Disability Insurance Appeal Guide
    • Physical RFC Form
    • Mental RFC Form
    • Lump Sum Disability Buyout Calculator
  • BLOG
    • Long Term Disability Denials and Appeals
    • Medical Eligibility for Long Term Disability Claims
    • Eligibility for Long Term Disability Claims
    • Your Chances of Getting Approved for Disability Benefits
    • Additional Parts Of A Claim That Do Not Happen in Every Case
  • Search
  • CONTACT

Mobile Menu

Schedule A Free Consultation Now!

(888) 321-8131

  • ABOUT US
    • Areas We Serve
    • Client Reviews and Video Testimonials
    • Our Team
      • Nick Ortiz
    • Our Office
    • Core Values
    • Referring Attorney Program
  • PRACTICE AREAS
    • Long Term Disability
      • Administrative Appeals
      • Lawsuits
      • Lump-Sum Buyout Offers
    • Social Security Disability Claims
      • Initial Applications
      • Request for Reconsideration
      • Hearing Before an Administrative Law Judge
    • Personal Injury Claims
  • DISABLING CONDITIONS
    • Long Term Disability
    • Social Security Disability
  • INSURANCE CARRIERS
    • Cigna
    • Guardian
    • Hartford
    • Lincoln Financial
    • Matrix Absence Management
    • MetLife
    • Mutual of Omaha
    • Northwestern Mutual
    • New York Life
    • Principal
    • Prudential
    • Reliance Standard
    • Standard
    • Unum
  • RESOURCES
    • Blog
    • Free Downloads
    • Lump Sum Disability Buyout Calculator
    • FAQ: Long Term Disability
    • FAQ: Social Security Disability
    • Abbreviations in Social Security Disability Claims
  • Search
  • CONTACT
  • Facebook
  • LinkedIn
  • Twitter
  • YouTube
You are here: Home / Long Term Disability Frequently Asked Questions / What Is ERISA and How Does It Effect My LTD Claim?

What Is ERISA and How Does It Effect My LTD Claim?

What Is ERISA?

The Employee Retirement Income Security Act (ERISA) is a federal law that sets minimum standards for most private employee benefit plans, including long-term disability (LTD) insurance. ERISA was enacted in 1974 to protect employees’ benefits by setting minimum standards for these plans. 

ERISA requires employers and insurance companies to provide clear information about benefits and ensure that plan administrators act in the participants’ best interests. ERISA also establishes a process for participants to file claims and appeals if they are denied benefits.  

https://www.youtube.com/watch?v=7u_1Fwxyjbw
ERISA Attorney Nick Ortiz answers the question, “What is an ERISA long term disability plan?”

If you have an LTD plan through your employer, it is likely governed by ERISA. ERISA’s rules and regulations can have a significant impact on your LTD claim, so it’s important to understand your rights. 

What is Long-Term Disability Insurance? 

Long term disability insurance replaces a percentage of your income if you are unable to work for an extended period of time as a result of your disability. LTD plans can be offered as a part of an employer’s benefits package, or they can be purchased individually. 

LTD policies typically have a waiting period of a few months before benefits begin and pay out a percentage of your income. Depending on the policy, benefits may last for a few years or until you reach retirement age. 

If you are unable to work, you will need to file a claim with your LTD insurance provider to receive benefits. The insurance company will review your claim to determine if you meet the policy’s definition of disability and are eligible for benefits. 

How ERISA Affects Your Long-Term Disability Claim 

If you have an ERISA LTD plan, you must follow specific rules and regulations when filing or appealing your claim. Here are a few key things to keep in mind: 

  1. ERISA requires plan administrators to provide you with clear and complete information about your benefits. This includes the plan’s terms, your eligibility for benefits, and the procedures for filing and appealing claims. 
  1. ERISA provides you with the right to file a claim for benefits and to appeal a denial of benefits. You must follow the plan’s internal appeals process before you can file a lawsuit in court. 
  1. ERISA sets forth strict deadlines for filing claims and appeals. You typically have a limited number of days to file an initial claim and 60, 90 or 180 days to appeal a denial of benefits (depending on what your policy says). 
  1. ERISA requires plan administrators to act in the best interests of the plan’s participants rather than their own best interests. This means that they have to make decisions about your claim based on the evidence and the plan’s terms. 
  1. ERISA limits the damages you can recover if you win a lawsuit against your insurance company. You may only recover the benefits you were wrongfully denied, interest on those benefits, and attorneys’ fees. 

Navigating the ERISA Claims Process 

Filing an LTD claim under ERISA can be a complex and confusing process. Here are a few tips to help you navigate the claims process: 

  1. Read and understand your plan’s terms. Your plan document will outline the eligibility requirements for benefits, the definition of disability, and the procedures for filing and appealing claims. 
  1. Gather and submit all necessary documentation. Your claim will be reviewed based on the evidence you provide, so it’s important to submit all relevant medical records, employment records, and other supporting documentation. 
  1. Follow the plan’s appeals process. If your claim is denied, you must follow the plan’s internal appeals process before you can file a lawsuit in court. This typically involves submitting additional documentation and presenting your case to an independent reviewer. 
  1. Seek legal advice if necessary. If you are having difficulty with the claims process or believe that your insurance company is acting in bad faith, consult with an ERISA attorney. 
  1. Keep track of and adhere to all deadlines. ERISA has strict deadlines for claims and appeals, so keep track of these deadlines and submit your paperwork on time. 

What to Do if Your Claim is Denied 

If your LTD claim is denied, you have the right to appeal the decision through the plan’s internal appeals process. This typically involves submitting additional documentation and presenting your case to an independent reviewer. 

If your claim is still denied after exhausting all of your administrative remedies, you may be able to file a lawsuit in court. However, ERISA limits the damages you can recover in a lawsuit, so it’s important to understand the potential risks and benefits of pursuing legal action. 

It’s also important to note that ERISA’s rules and regulations can vary depending on the specific plan and insurance company. You should carefully review your plan’s terms and consult with an attorney who specializes in ERISA claims to ensure that you understand your rights and options. 

In conclusion, ERISA is a federal law that governs most private employee benefit plans, including long-term disability insurance. ERISA’s rules and regulations can have a significant impact on your LTD claim, so it’s important to understand how the law affects your rights. If you have an LTD plan through your employer, be sure to read and understand your plan’s terms, gather and submit all necessary documentation, and follow the plan’s appeals process if your claim is denied.  

If you’re having difficulty with the claims process or believe that your insurance company is acting in bad faith, seek legal advice from an attorney who specializes in ERISA claims. Understanding your rights and how to navigate the claims process effectively will increase your chances of receiving the benefits you’re entitled to under your LTD plan. 

Request a Free Consultation 

If your ERISA disability claim has been denied or terminated, we can help. Call Ortiz Law Firm at (888) 321-8131 to schedule a free consultation with an experienced ERISA disability attorney. 

FacebookTweetPinLinkedInPrintEmail

Primary Sidebar

Top Ten Mistakes That Will Destroy Your Long Term Disability Claim

View All Long Term Disability Insurance Resources

No doubt that without Nick Ortiz and his Firm we could have never succeeded. All the gratitude and thanks we have for your efforts and talents. This was a blessing.

Robert White

View All Reviews and Testimonials

Complete This CONFIDENTIAL Form or Call (866) 480-3440 for a FREE Case Evaluation

0 of 350
GET HELP NOW

Learn More About Long Term Disability

  • Areas We Serve
  • Frequently Asked Questions
  • Denials and Appeals
  • Your Chances of Getting Approved
  • Medical Eligibility
  • Additional Parts That Do Not Happen in Every Case
  • Medical Conditions That May Qualify
  • Long Term Disability Insurance Carriers
  • Occupations That May Qualify
  • LTD Federal Court Case Summaries
https://www.youtube.com/watch?v=3EHrRKBKsok

Footer

Location

ORTIZ LAW FIRM
(888) 321-8131

316 S Baylen St
Ste 590
Pensacola, FL 32502
Monday - Thursday: 9:00 AM - 5:00 PM Friday: 9:00 AM - 2:00 PM
Saturday - Sunday: Closed

Our Team

  • Nick Ortiz
  • Jessica Ortiz
  • Dawn Keller
  • Tory Nelson

Practice Areas

  • Long Term Disability Insurance and ERISA Disability Insurance Claims
  • Social Security Disability Claims
  • Personal Injury Claims
  • Facebook
  • LinkedIn
  • Twitter
  • YouTube

Site Footer

©2020 Ortiz Law Firm, All Rights Reserved. Reproduced with Permission | Disclaimer | Privacy Policy

Share this ArticleLike this article? Email it to a friend!

Email sent!