Philadelphia Long-Term Disability (ERISA) Attorney
Every day, people across the Philly region are in car accidents, take unexpected falls, or are diagnosed with illnesses that keep them from being able to work for extended periods of time. While there are laws created specifically to protect employees’ jobs and income when tragedy strikes, the process of getting approval for benefits is not always clear-cut.
If you are looking to file a claim for benefits due to an accident or illness, your claim has been denied or wrongfully terminated, or you need advice on recovering disability benefits for yourself or a close family member, let Young Marr & Associates help you. We have more than 25 years of experience working with long-term disability clients in Pennsylvania. Call us today at (215) 515-9254 to schedule a free consultation on your ERISA disability case.
What is Long-Term Disability Insurance?
Disability insurance is a benefit generally found in an employer’s benefits package. Long-term disability insurance covers a portion of an employee’s income, normally up to 70%, if the employee is injured or becomes seriously ill and cannot work. These employer-provided policies are different from workers’ compensation, Social Security Disability Insurance, and private plans. Instead, these plans are paid for by your employer as part of your benefits, alongside things like a 401(k) or pension plan.
If you are hurt outside of work, workers’ compensation does not cover you, which is why many employers offer long-term disability as well. These plans usually cover a wide range of disabilities, including severe injuries and long-term illnesses like cancer, heart failure, and other conditions that will keep you from returning to work.
What is ERISA and How Does it Affect Disability Cases?
Many financial plans offered by your employer, such as pensions and 401(k)s, are governed by rules under the Employee Retirement Income Security Act of 1974 (ERISA). This law provides rules and regulations for your employer and any insurance companies or benefits providers they work with. Some rules require your employer to give you notice and information about changes they make to your policy, while others dictate what decisions an employer can and cannot make regarding your plans.
When you file for long-term disability payments through your employer-provided plan, ERISA’s rules help dictate procedures for denials and appeals, as well as rules for how the insurance company should handle your claim. The law does not require your employer to provide long-term disability insurance coverage – but if they do provide this coverage, they must follow the rules.
ERISA only covers plans provided by your employer. This means ERISA does not cover private long-term insurance policies. That means that if you pay out of pocket for your own long-term disability insurance, ERISA does not cover that plan – though other laws may still allow you to file claims against those private providers. ERISA also has exceptions for plans provided by government employers and many church employers, meaning those insurance plans are not covered under ERISA.
If you are having trouble getting your benefits under your employer-provided long-term disability plan, speak to a lawyer about filing an ERISA disability claim.
When Can I File an ERISA Disability Claim in Philadelphia?
Before filing an ERISA claim for your disability case, you must ensure that you meet a few requirements. First, your plan must be covered by ERISA. If you pay for your plan yourself, ERISA may not cover your claim, and you should speak with an attorney about other potential claims. Second, you must ensure that you meet the insurance company’s definition of “disabled.” Different insurance policies differently define which illnesses or injuries qualify for coverage and what causes of injury lead to denials. Speak to an attorney if you have any questions or concerns about whether you have coverage and whether your condition or injury qualifies for long-term disability coverage.
If your employer or their long-term disability provider refuses to accept your application, denies your coverage, or unjustly delays your coverage, talk to an attorney immediately about filing a claim. ERISA law provides requirements governing many of these issues, and any time an employer or insurance provider fails to follow the rules, they can open themselves to an ERISA claim.
aThese claims can help you get the compensation you are entitled to, but they may involve complex litigation. Our ERISA and long-term disability lawyers can help you file your claim and get the disability coverage you need.
Our Philadelphia Long Term Disability Attorneys Can Help
If you call our law offices, one of our attorneys will walk you through the process of filing or appealing your claim step-by-step, help you to gather important documents and medical files to support your claim, file the necessary paperwork, and, if necessary, appeal a claim that has already been denied. Trying to face the uphill battle of gaining long-term disability benefits on your own can be detrimental to your case. Call Young Marr & Associates today at (215) 515-9254 for a free consultation on your disability claim.