Understanding the Impact of ERISA on Disability Claims

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Disability Insurance Policies in Philadelphia

The Employee Retirement Income Security Act of 1974 (more commonly known as ERISA) is the federal labor law that governs many long-term disability group plans. ERISA policies are far different from individual policies, and applying for ERISA long-term disability benefits can be extremely confusing and challenging for many people.

ERISA regulates most benefits in these cases, and Edelstein Martin & Nelson, LLP has years of experience handling these types of claims for clients all over Pennsylvania. If you or your loved one needs assistance with any long-term disability claim, you will want to call (215) 858-8440 to schedule a free consultation.

Important Aspects of ERISA Long-Term Disability Claims

It is important to understand that an employer’s insurance company, not the employer, decides whether a person’s disability is compensable. In many cases, insurers will seek extraordinary evidence of such disabilities.

Numerous complications can arise in these types of cases. Some of the most common issues in ERISA long-term disability claims include, but are not limited to:

  • Defining Disability — The definition of what constitutes a disability can vary by plan. Certain policies have very narrow definitions, while others may be broader. An experienced attorney can assist you in proving your disability when the requirements are more rigid.
  • Waiting Period — Most long-term disability plans involve elimination periods in which people are ineligible to receive any benefits. Depending on the policy, this period may be 30, 90, 180, or some other specified number of days. In most cases, people must exhaust all short-term disability benefits before seeking long-term disability benefits.
  • Tax Considerations — Certain policies may involve taxable benefits, while other plans may provide benefits that are tax-free.
  • Social Security Disability Insurance (SSDI) Applications — Many providers of long-term disability benefits will require people to also apply for SSDI benefits because the SSDI benefits can be offset against possible long-term disability benefits.
  • Percentage of Salary — When a person is approved for long-term disability benefits, the amount awarded is based on the person’s salary. In most cases, the individual will receive roughly 60 percent of his or her salary.
  • Duration of Benefits — A plan should also establish how long a person can receive long-term disability benefits for. In some cases, benefits are provided for a specific number of years. In other cases, the benefits may last until the individual reaches a certain age.

It is important for people to keep in mind that insurers are always looking for reasons to deny long-term disability claims. One of thDisability Insurance Policies in Philadelphiae most common reasons for denial of claims concerns a person’s failure to follow doctor’s orders. In other cases, insurance companies may conduct undercover surveillance of claimants. You will want to make sure that you are working with an experienced attorney so you can avoid some of the most common mistakes that lead to claims being denied.

Find a Long-Term Disability Insurance Attorney in Pennsylvania

Do you or your loved one have an ERISA long-term disability claim in Pennsylvania? Contact Edelstein Martin & Nelson, LLP as soon as possible.

Our firm has recovered more than $90 million for our clients. Our lawyers can provide a complete evaluation of your case as soon as you call (215) 858-8440 or contact us online to schedule a free consultation.