Most employers offer employees health insurance and other critical coverage that comprise benefit packages. This employer-sponsored coverage can vary significantly from job to job, and there used to be little oversight in place to keep employers honest. As such, the federal government implements laws, including ERISA, that are designed to protect employees from wrongdoing in relation to employee benefits. 

If you are an employee whose benefit claim has been denied, don’t wait to discuss the matter with an experienced attorney at a reputable ERISA law firm near you. 

Your Rights under ERISA

ERISA stands for the Employee Retirement Income Security Act, and it oversees benefits, such as disability coverage and other extras that lie outside the scope of legal requirements for employers.

Employers are not required to provide benefits packages, but many do in an effort to attract and keep valuable employees who help them grow their businesses. Those companies that afford their employees benefits as part of their pay package face careful rules and regulations under ERISA. These include:

• Requirements regarding minimum eligibility for employees
• Requirements regarding benefits funding
• Requirements regarding employee vesting
• Requirements regarding the disclosure of information

The benefit plans offered by employers must be administered by trustees – who, in turn, are overseen by ERISA’s broad reach. 

Benefits Commonly Covered by ERISA

ERISA typically covers specific private benefits offered by employers, such as the following:

• Long-term disability that is covered via contractual insurance 
• Medical care add-ons like surgical care and mental health care
• Retirement plans
• Assistance with childcare
• Legal services
• Severance packages 

When a claim related to a benefit supplied by your employer is denied, an ERISA attorney can help.

Your Appeal

If your benefits claim is denied, you can file an ERISA claim appeal, which is critical to your ability to gain the benefit you’re owed. The basic steps involved include all the following:

• Your ERISA attorney will write an appeal letter that includes the details relevant to your claim denial.
• The letter will carefully outline the evidence in support of your claim. 
• Your attorney will use their legal skill, insight, and powers of persuasion to encourage the insurance company to overturn your claim denial and will request that those benefits originally promised to you by your employer be granted.

If your initial appeal proves unsuccessful, you can move forward by filing a federal lawsuit that asks the court to find the denial of your claim arbitrary and capricious. In essence, this means determining that the denial was unfair to you, and your attorney will request that, in response, the court award benefits you’re owed along with your reasonable attorney fees.  

Turn to a Reputable ERISA Law Firm Near You

The trusted ERISA attorneys at Roberts Disability Law, P.C., in San Francisco, recognize how financially damaging denied benefit claims can be for employees and dedicate their practice to fiercely advocating for advantageous resolutions. We’re on your side, so please don’t wait to contact us for more information today.