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The effects of ERISA on disability claims

If you have a job in a private or publicly traded company, and insurance programs supplied by your employer, then you should be familiar with the Employee Retirement Income Security Act, more commonly known by the acronym ERISA. This act was put in place to help regulate the benefits offered by private employers. 

What benefits does ERISA cover for employees?

ERISA may cover several types of pension, welfare and benefit plans. The coverage may be different based on your employer’s plan. Some of the types of benefits covered include:

  • 401k plans
  • Disability benefit plans
  • Health benefit plans
  • Long-term care plans
  • Fringe benefits

What you may not know about ERISA is that if you have disability coverage through your employer’s group plan, then it could be greatly impacted by ERISA.

ERISA impacts disability claims in the following ways:

  • The disability plan of your employer may add extra guidelines to follow. You will need to ask your employer to distribute all documentation to you.
  • ERISA places extra strict deadlines on when you can file a claim or an appeal. These can be harmful if you do not know the deadlines, or don’t act quickly. They can also be helpful, as the administrator must look at your claim within the designated timeframe.
  • Disability claims that are governed by ERISA are covered by federal law. In these cases, you may not be able to seek damages for pain and suffering or bad faith. The review of your claim by the federal court might be limited to evidence given by the disability plan at the time of their final determination.

If your ERISA covers your long-term or short-term disability plan, you will want to make sure all documents, timelines and necessary information are in place when you make a claim. You will want to have all possible information submitted in your claim or appeal. You may want to take the time to understand what ERISA is, how your employer’s plan works and how ERISA impacts different types of claims.

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