When you work for a company in Wisconsin that offers disability insurance, you should understand what you would need to do if you’re temporarily or permanently disabled. ERISA, or the Employee Retirement Income Security Act of 1974, is a federal law affecting disability benefits and retirement plans. This law has a lot of rules that you as the claimant must follow if you don’t want your claim to be denied.
What to expect with ERISA disability benefits
Employers who offer long-term disability benefits to their employees must provide information about what is and is not covered in the plan, directions on how to file a claim, and an outline of how an employee can file a claim if they’re denied. When an employee files a claim, the insurance company has 45 days to make a decision. If they decide to deny the claim, they must also provide the reasoning for their decision in writing. If the claimant disagrees with the denial, they can file a lawsuit claiming that the insurance company intentionally denied their claim.
Filing an appeal to your denied claim
Before you file a lawsuit, you also can file an appeal. During this process, someone not part of the original decision will look at your claim and appeal to determine whether they think your original claim was denied in error. Additionally, you should be aware that you have 180 days to file an appeal. With some insurance plans, you might be able to appeal up to two times before you have to file a lawsuit.
If you think you might be at risk of long-term injury, understanding your disability insurance is crucial. And if you have a disability claim that has been denied, be sure to contact Alan C. Olson & Associates to learn more about how we can help you get the long-term disability benefits you need.