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Maneuvering Through The Tricky Laws Surrounding ERISA Disability Claims: How A Lawyer Can Help

Government agencies often make laws more difficult to understand and follow than is really necessary. Anyone who has ever filed their federal taxes has experienced this confusion. If you are attempting to file a disability claim but are trying to file it with the government instead of through your private insurance provider, you may end up with a similar headache. This is due to the fact that ERISA (Employee Retirement Income Security Act) has some tricky laws to maneuver around and through. A lawyer can help and explain to you in the following ways exactly what this means for ERISA disability claims.

Private vs. Public Disability Insurance

The biggest difference you will encounter when you are trying to file a disability claim is reconciling your disability insurance with government agencies. If your employer has included disability insurance in your pension plan or your benefits package, then ERISA states that you have to file a disability claim with your employer's disability insurance first. Your employer's disability insurance is considered (in most states) "public" insurance because most of the people in the company you work for are offered this insurance and accept it as part of their benefits. You are required to use this insurance first when you want to protect your current income or your retirement income from being siphoned off for medical bills related to your claim.

The laws do not apply to privately-owned disability insurance, which is what you would have if you purchase your own disability insurance rather than take the plan offered by an employer. Many self-employed individuals purchase their own disability coverage, and they are not required by ERISA to abide by the same guidelines, laws and rules. However, privately-owned disability insurance also means that your claims could take much longer to get an answer, in which case you would need a lawyer's help to speed up the process and sue the insurance provider if necessary. (You cannot sue any ERISA-regulated insurance provider unless your claims have been repeatedly denied and there is substantial evidence to support your case.)

Choosing to Be Highly Regulated or Not Regulated At All

The second conundrum many people face when they want to file a disability claim is that private disability insurance is not nearly as highly regulated as public disability insurance from an employer. Less regulation means that you have more ability to sue and obtain your full benefits under your private plan, but more regulation means that you are almost guaranteed a quick and virtually painless answer or benefits check because of the tight grip ERISA regulations have on employee-sponsored plans. Your lawyer can help you decide which type works best for you and then help you enroll by reading over your contracts and explaining anything that does not make sense.