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When Does ERISA NOT Apply to LTD Claims?

In most cases, if you have long-term disability benefits available to you through a group insurance plan sponsored by your employer, ERISA is the federal law that governs the benefits process. However, if you purchase an LTD policy individually and not through your employer, then ERISA does not govern any clams that you make for benefits under the plan.

In other cases, employers may offer LTD insurance policies for their employees. If they are strictly voluntary and employees rather than the employers pay for all premiums, then ERISA does not apply to these plans. Employers may even permit payments by employees to be payroll-deducted or allow the insurance company to advertise its services to employees. Nonetheless, the employer may not be directly sponsoring the LTD plan, which makes ERISA inapplicable.

Another situation in which ERISA may not apply to long-term disability claims is the plans offered to local, state, or federal government employees. If individuals perform contract work for governmental units, they may need to clarify whether the LTD benefits plans available to them through the government are subject to ERISA. Church employers also may offer long-term disability benefits plans for employees that also may not be subject to ERISA.

Furthermore, some states, including California, require that employers provide disability benefits for their employees. Even those employers directly provide these plans, ERISA may not govern the plans, because ERISA does not apply to plans maintained by employers solely to comply with state disability laws.

Although ERISA does not apply to some long-term disability plans as described above, these plans still typically have some protections for the individuals who have LTD coverage under them. For instance, most policies have specific deadlines for filing claims and processes to appeal to the denial of benefits. If you must seek court intervention for being denied benefits by one of these plans, you may seek damages or remedies that are greater than what ERISA permits.

Bonnici Law Group provides client-focused representation throughout the ERISA claims process. We are here to consider the evidence in support of your ERISA long-term disability claim and evaluate your application. Next, we can develop the most effective strategy for fighting any denials of coverage that you may receive. Allow us to handle your legal needs while you focus on your physical and emotional health. Contact the ERISA long-term disability attorneys of Bonnici Law Group at 858-261-5454 or help@bonnicilawgroup.com.

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While taking an ambulance is a given when you're severely injured, should you take one if your injury isn’t that serious? While many people choose to skip the ambulance due to its high cost, is it really worth it? Will it affect your case? Keep on reading to find out.

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