ERISA and Long Term Disability

The Employee Retirement Income Security Act, or ERISA, is a Federal law that was made to protect employees’ rights to their benefits. In the case that an employee has become disabled and is unable to work, they may be qualified for long term disability benefits under the ERISA plan, which is usually included by the employer as an employee benefit. ERISA does not apply for disability insurance plans that have been purchased individually.

When ERISA applies to an employee’s plan, it controls almost all aspects of that plan and also how the employee obtains its benefits. It requires the employer to provide their employee with information regarding their disability benefits, which include:

  • What is and what is not covered in the plan, explained in detail.
  • Steps on how to file a claim if the employee becomes disabled.
  • An outline of the appeal process in case the claim is denied.

After the employer files a claim, ERISA gives a time limit to the insurance provider to decide whether to accept or deny the claim. If the claim is denied, then they must give an explanation as to why.

Employees must remember to follow the requirements of ERISA very carefully so as not to risk the claim being denied. In addition, no steps must be skipped during the disability benefits claim process because this can result in future claims in court not being allowed to proceed.

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