Employers often provide their workers with a variety of different benefits. Long-term disability benefits are a popular inclusion in many benefits packages, even though few workers ever need to utilize them. Therefore, there is often quite a bit of confusion about someone’s rights when they need to file a long-term disability benefits claim. If someone has a policy provided by their employer, then the Employee Retirement Income Security Act of 1974 (ERISA) applies.
ERISA establishes numerous legal protections for those with employer-sponsored long-term disability benefits, including the right to an appeal. As a result, an employee with ERISA long-term disability coverage who can’t work has protection if an insurance company denies their claim.
Unfavorable decisions aren’t always permanent
Those who carry private insurance policies are often at the mercy of corporate practices regarding their rights when making a claim. Those who don’t understand their policies or who don’t have the patience to pursue the matter in civil court could end up denied the benefits they deserve.
Insurance companies would prefer to receive premiums without paying out substantial benefits. Long-term disability benefits can cost businesses tens of thousands of dollars, possibly even more. The companies are usually keen to both deny claims whenever possible and minimize how much they pay on each individual claim.
Thankfully, an initial denial doesn’t automatically leave someone without coverage. Anyone with an ERISA policy has the right to an appeal and to retain a lawyer to assist them during that process. Those already struggling with a disabling medical condition may have a difficult time advocating for themselves during the insurance application process and appeals process.
Seeking informed legal guidance can make a big difference for those who need the support provided by an ERISA long-term disability claim and who either want to guard against the need for an appeal or who need to appeal a denial successfully.