With jobs and benefits in flux with the changing landscape in New Jersey and across the nation, being protected for the future is one of the biggest concerns that people will have. The potential for suffering an injury that leaves a worker disabled and unable to work is always a lingering worry. Knowing how the Employee Retirement Income Security Act of 1974 – also called ERISA – protects workers in these circumstances can alleviate many of those concerns. However, it is not unusual for problems to arise and legal help will be necessary. Having a grasp on ERISA when there is a dispute is key.
Although the genesis of ERISA was for retirement plans, there are health plan protections in the law. When private employers offer disability insurance to workers, ERISA is a protective measure. ERISA impacts employer-based disability insurance. If the worker has private disability insurance, that is not relevant under ERISA. With ERISA, employers give employees certain information regarding their disability benefits.
ERISA’s regulations oversee the plan and the way in which workers will get their benefits. The employer must provide the employees with information regarding the benefits. Within that information must be: what is covered and what is not covered; how a claim must be filed if there is a disabling issue; and how to appeal should there be a denial of benefits. After the claim has been filed, there is a 45-day time limit in which the insurer will decide to approve or deny it. If it is necessary, it can be extended for another 30 days.
Should there be a denial, the employee must be given written notice as to why. There are ERISA-based deadlines to appeal. There will be a deadline for the appeal to be approved or denied. The final step for an employee is to file a lawsuit. A judge will decide after assessing the record. Since ERISA is such an integral part of the benefits workers get in certain jobs, it is vital to understand it and what can be done should any issue arise. A law firm that specializes in these essential employee benefits can help with a case related to ERISA.
