Have You Heard of ERISA? It’s important to have familiarity with the Employment Retirement Security Act (ERISA) if you receive employee benefits through your employer. Established in 1974, ERISA sets minimum standards for private industry to protect individuals in employee benefit plans, including pension and welfare benefit plans. Welfare benefit plans may include benefits in …
Recently the Department of Labor (DOL) proposed some amendments to Section 503 of ERISA (Employee Retirement Income Security Act), to improve the current rules governing Long Term Disability claims and appeals. Joe sent his comments and recommendations to the DOL with the hope of improving the disability claims process for all of our clients. Here are …
Proposed Changes to Rules Governing ERISA Long Term Disability Claims Read More »
LONG TERM DISABILITY & THE UNDIAGNOSED CONDITION One of the most difficult cases in our long-term disability practice is the individual who does not have a diagnosis. It is very common in medicine for claimants to go longer than a year without receiving a proper diagnosis. This is not the fault of physicians, but …
Long Term Disability & the Undiagnosed Condition Read More »
ERISA “Full & Fair Review” & the Missing Pieces of the ADMINISTRATIVE RECORD One of the most important pieces in a long-term disability case is the “administrative record.” The administrative record is defined as: everything that the insurance company considered in the denial of your claim. It also includes any appeal that you might submit, …
Missing Pieces of the Administrative Record – Full & Fair Review under ERISA? Read More »
Under ERISA, one of the rights you have as a part of your disability benefits claim is the right to a “full and fair review” by the insurance company. In providing a “full and fair review” the insurance company cannot cut corners or rely on generalizations to evaluate your claim. Instead, the insurance company has …
INJURED VICTIMS SUFFER TWICE UNDER McCUTCHEN RULING Congress needs to fix resulting unfair outcomes under ERISA subrogation claims (Yes, the tail finally does wag the dog!) On April 16, 2013, the United States Supreme Court issued its long awaited decision in the case of U.S. Airways v. McCutchen, (No. 11-1285). The case involved a subrogation …
Injured Victims Suffer Twice Under McCutchen Ruling on ERISA Subrogation Claims Read More »
Most individuals become familiar with the phrase 502(a) lawsuit by receiving a letter from an insurance company denying access to their long-term disability benefits. The traditional language often used by long-term disability insurers advises clients that they have “exhausted their administrative remedies”, and now have the ability to file a lawsuit under Section 502(a) of …
Reinstating your Long Term Disability Benefit: The ERISA 502(a) Lawsuit Read More »
