3 ERISA disability claim myths

On Behalf of | Oct 11, 2023 | ERISA Disability Benefits

The Employee Retirement Income Security Act (ERISA) is a law that can help protect people who seek benefits through their employers. It’s critical to complete all the necessary steps when submitting an ERISA claim. If not, you could miss out on necessary disability and health insurance benefits.

It’s possible to make a claim without too much difficulty with relevant information in advance. Unfortunately, a lot of employees lack enough knowledge, which undermines their claims. You should be aware of the following ERISA claim misconceptions before filing a claim.

Myth 1: The ERISA claim process is simple 

Truth: Many people think that applying for disability payments merely requires them to follow the directions on a short form. Unfortunately, the ERISA filing requirements are neither simple nor self-explanatory. Your claim might be rejected if you forget a minor detail or necessary paperwork. 

Myth 2: You automatically get benefits if you have a medical diagnosis 

Truth: Benefits are not always the result of a medical diagnosis. Your capacity to work should be impacted by your condition. You might not be eligible for benefits if you have a diagnosis of a disability or sickness but are nonetheless able to work.

Myth 3: A denied claim is easy to appeal 

Truth: A judge’s ability to overturn an ERISA denial is limited since they may only review for an “abuse of discretion.” In other words, there must be a clear error that resulted in an ERISA denial. Employees must adhere to ERISA regulations when submitting an appeal for a denied claim. It’s necessary to provide as much supporting information during the initial administrative appeal process. 

An appeal may be unsuccessful despite careful attention to detail. If an employee believes their disability benefits are being unjustly withheld, they may benefit from learning about their legal rights.