The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that provides important protections for workers. ERISA regulates the retirement plans of private employers, as well as disability insurance plans offered by employers to employees as part of an employee benefits package.
Employee disability plan rights under ERISA
Workers who have health or disability insurance coverage through an employer-sponsored plan should understand the important protections of ERISA including:
- Detailed explanations of what is covered under the plan and what is not covered under the plan;
- Directions on how to file a claim for disability benefits if the employee becomes disabled; and
- Steps of the appeal process if a claim for disability benefits is denied.
In general, once the employee has made a claim for disability benefits, the disability insurance provider has 45 days to respond to that claim. The period to provide a response may be extended for 30 days if notice is provided to the employee making the disability claim.
If the claim has been denied, the disability insurance provider is required to provide a description of why it was denied in writing to the employee. The employee can then appeal that decision. If their appeal is denied, they can file a lawsuit under ERISA based on their denied claim and denied appeal for disability benefits which will be heard by an administrative law judge. There are important timelines associated with each phase of the process that disabled employees seeking disability benefits should be aware of.
Because of the importance of ERISA protections for workers, disabled workers seeking disability benefits should be familiar with the requirements of ERISA and also how to assert their rights under ERISA. Familiarity with the process can help disabled workers obtain the benefits they oftentimes badly need.