What Is ERISA?

We established Roberts Disability Law, P.C. to help clients prove their entitlement to employer-provided benefits. We understand the importance of these benefits to provide compensation our clients need to pay for their basic life needs. We also understand ERISA’s complex rules and regulations. By remaining on the front line of developments in ERISA, we provide our clients throughout the San Francisco Bay Area with the quality representation they need to get through challenging situations.

ERISA Basics

ERISA stands for the Employee Retirement Income Security Act of 1974. This law covers claims related to most employer-provided pension, severance, and health and welfare benefit plans. Common health and welfare benefit plans include those providing disability, life, accidental death, and dismemberment benefits. Large employers may “self-fund” these benefit plans, but the plan benefits are usually paid with insurance policy funds. ERISA typically applies to benefit plans established by private sector employers and does not apply to plans offered by a church or government entity.

How Does ERISA Impact My Benefits Claim?

When ERISA governs your claim for benefits, it preempts all other state laws. In other words, the only rights and remedies that you are entitled to receive are those that the courts have determined are available under ERISA.  Although this area of the law is always changing, the rights and remedies available to the average ERISA plan participant are generally limited. Under ERISA, insurance carriers or benefit plan administrators decide whether you meet the requirements for benefits based on the terms set forth in the insurance policy or benefit plan document. If the company denies your claim, you cannot file a lawsuit until you have exhausted your administrative remedies. This means that you have to submit a request for review (or appeal) to the administrator in order to get it to overturn the claim denial. Only when the carrier has issued a “final denial” can you file a lawsuit for benefits. And a court is typically limited to the claims record that exists at the time of the final denial. It is important for you to have the representation of a knowledgeable ERISA attorney at the time the carrier first denies your claim.

Why Choose Roberts Disability Law, P.C.?

We at Roberts Disability Law, P.C. always prioritize our clients’ best interests. We take the time to learn all of your case details to develop the best strategy for getting your benefit claim paid. Because of our experience and knowledge of ERISA, we know how to get disability insurance carriers to pay claims and to build the best record for litigation if it becomes necessary. We stay up to date on all of the latest ERISA trends by reviewing all of the recent decisions issued across the country, as well as speak and frequently write on matters impacting our clients.

We frequently achieve successful results against many ERISA plan administrators. Our client-centered approach has led to many positive results for our clients, as well as victories in both federal district court and in the U.S. Circuit Court of Appeals.


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We know how to get your insurance claim paid. Call today at:
(510) 230-2090

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