As an employee, your employer may afford you private insurance, which often includes disability coverage, in addition to other benefits that are part of your payment package. Such coverage is private and tends to vary considerably from employer to employer, which means there is little oversight in relation to how coverage applies or even in relation to its duration. As such, the federal government implements a range of laws that are put in place to help protect the rights of employees like you. If your benefits claim has been denied, reach out for the professional legal guidance of an experienced ERISA lawyer near San Francisco today.

ERISA Defined

The term ERISA stands for the Employee Retirement Income Security Act, which guides the coverage lying outside that required by law – such as workers’ compensation – that employers supply their employees. There are no laws in place that require employers to offer employees benefit packages, but the companies that want to stay on top of their game and continue to recruit top talent generally do so. At this point, ERISA’s exacting rules and regulations apply. 

The specific requirements addressed by ERISA include the following:

• Requirements related to minimum eligibility
• Requirements related to vesting
• Requirements related to funding
• Requirements related to disclosure

These benefit plans are administered by trustees – who are governed by ERISA’s rules and regulations. 

Common Benefits

The kinds of private benefits offered by employers that ERISA generally covers include:

• Specific medical care, such as surgical and mental health coverage
• Long-term disability that is paid through contractual insurance
• Retirement plans
• Severance packages
• Legal services
• Childcare assistance

If you need to avail yourself of the coverage or benefits your employer provides, but your claim is denied, it’s time to consult with a formidable ERISA Lawyer. 

Appealing the Denial

Once a claim is denied, an appeal generally follows, and this appeal will guide everything that comes after, which makes it critical to the overall success of your claim. The steps forward include:

• Your ERISA lawyer will draft a cogent appeal letter. 
• The letter will succinctly outline a wide range of evidence relevant to your claim.
• Your lawyer will strongly encourage the court to overturn the denial of your claim and will request that the benefits to which you are entitled to be granted. 

If this initial effort proves unsuccessful, your lawyer will very likely advise you to move forward by filing a federal lawsuit requesting that the court find the original denial arbitrary and capricious – in pursuit of the benefits you’re owed along with reasonable attorney fees.  

Reach Out for the Skilled Legal Guidance of an Experienced ERISA Lawyer near San Francisco Today

The practiced ERISA lawyers at Roberts Disability Law, P.C. – proudly serving those in and around San Francisco – are unwaveringly committed to employing the full force of our impressive experience and skill in pursuit of claims resolutions that honor our clients’ rights and best interests. We are on your side and here to help, so please don’t put off contacting us for more information today.