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Where to start when filing an ERISA disability claim

On Behalf of | Mar 11, 2022 | ERISA

Many of us learned at a young age that you should work hard when you’re young so you can retire early and enjoy the fruits of your labor when you’re older. It is oftentimes the case, however, that as we approach retirement age, we experience the challenges of illness or disability. Having a disability can impact our financial freedom in a way that might make retirement seem impossible.

Thankfully, there are legal protections in place to serve our best interests in the event that our employer or benefits plan sponsor fails to uphold their responsibilities should you have to file a disability claim. The Employee Retirement Income Security Act of 1974 (ERISA) sets rules, standards and enforcement provisions to protect the interests of people enrolled in employee benefits plans. It lays out the procedure for filing a claim, the timeline for a decision and the employee’s rights if the plan sponsor denies the claim.

How to start a claim 

If you have disability coverage through your employer, the plan sponsor is legally required to provide detailed information regarding your plan including the benefits process, what it covers, how to file a claim and what limitations might exist. This is called the Summary Plan Description.

The first step in filing a claim is to review your Summary Plan Description. You will want to review the qualifications and requirements to ensure that you meet the criteria. If you do not have this booklet or you cannot locate the list of requirements, you will want to contact your human resources representative, the benefits plan administrator or your employer to obtain this information.

Keep a record of everything

It is an unfortunate truth that private insurance companies would rather not pay you the benefits that you have earned and deserve access to. ERISA compels employers and benefits plan administrators to honor their legal obligations. It is wise to keep a record of all correspondence including phone calls, emails or letters. There are strict timelines and guidelines for the filing procedures, so you may want the support of legal counsel to avoid complications that could result in the denial of benefits.