How to Navigate the ERISA Claims Process for Disability Insurance

The ERISA claims process for disability insurance sounds complicated but does not have to be. Learning more about how this process works may help simplify the overall process. Exploring the steps involved may help you better navigate the overall process of starting your ERISA disability benefits. Talk to a Philadelphia ERISA claims lawyer for further guidance.

How to Navigate ERISA Claims

The ERISA disability claims process involves multiple steps. One of the first steps is to assess whether you have a condition that would significantly hinder work performance. You might be able to figure this out on your own or consult with a medical professional to determine this.

Once you realize your medical condition or disability may impact work performance, the next step is to look over your Summary Plan Description. This is usually provided by an employer who provides ERISA benefits. The Summary Plan Description should detail the plan benefits, how to file a claim, and the limitations of the plan.

Read through this plan to see whether you meet the plan requirements to qualify for ERISA benefits. If there are no instructions for where to file your claim, then you might be able to write a letter instead. This letter will be used to notify your employer that you are filing an ERISA claim. You can give the letter to your Human Resources manager or employer.

The next phase is the waiting period. In most cases, a decision about your claim must be made within 45 days. Deadlines can be extended another 30 days depending on various reasons, like needing more time to review your claim. You must be notified about these extensions and about the outcome.

Be Wary of Tactics to Deny Your Benefits

Some employers may use tactics to deny ERISA benefits to save the company money. Knowing about the ERISA rules set in place can help you know when an employer might be using these tactics against you. For one, the process of reviewing your ERISA claim must be objective and based on fact, not bias. There cannot be a conflict of interest.

Denials must provide you with information like why your claim was denied and what criteria were used to determine this. You must be provided this information in a timely manner, along with the opportunity to defend your claim with evidence and testimony. Not only that, but you must be provided the opportunity to go through an appeals process.

Do not panic if your initial claim is denied. Consider contacting a Philadelphia disability lawyer to explore your options for filing an appeal. An experienced lawyer can help you take steps to defend your claim and increase your chances of receiving disability benefits under an ERISA plan.

Contact Edelstein & Nelson for Legal Help

Figuring out the complex ERISA claims process can be stressful. Feel free to speak with a Philadelphia ERISA claims attorney about your options for disability benefits. Start by calling Edelstein & Nelson today at (800) 300-0909 for a consultation today. Our experienced team of lawyers is ready to help you explore ways to increase your chances of receiving the ERISA disability benefits you need.