Colorado Springs ERISA Claims Lawyer

Colorado Springs ERISA Claims Attorney

The Employee Retirement Income Security Act (ERISA) is a set of federal laws and regulations that protect and enable employees to request benefits from their employer. While it does uphold the rights of US employees to request and appeal for these benefits, it also places strict limitations on how an employee might do so. It is wise to consult with an experienced Colorado Springs ERISA claims lawyer to ensure your chances of success are maximized.

Compared to other areas of law, ERISA is not as thoroughly represented, and it can be difficult to find an attorney who is familiar with its particular limitations. Our team at McDermott Law, LLC, has assisted with hundreds of ERISA claims in Colorado. Whether you are just beginning to file your claim or need assistance with appealing a denied claim, McDermott Law is well-equipped to handle your disability benefits needs in a comprehensive and professional manner.

Common ERISA Violations

Violations can occur when employers fail to enact the obligations set upon them by ERISA. These violations can look like any of the following:

• Wrongful denial of benefits
• Failure to perform necessary fiduciary duties for employees as outlined by insurance plans
• Interference or denial of employee rights that are covered by insurance plans.

What ERISA Doesn’t Cover

ERISA regulations only cover private-sector employees whose employers have already provided retirement plans. They do not cover benefit plans that are provided by government or religious institutions.

ERISA cannot require employers to provide benefit plans. However, for private-sector employers that have pre-established benefit plans, ERISA upholds standards for administering benefits to applicable employees.

Timelines for Submitting ERISA Claims

It is crucial that employees seeking to hire an attorney for their ERISA claim do so in a timely manner. Early involvement in a claim could be your key to success. An attorney can guide you toward creating a strong initial claim.

If your benefits claim is denied, you have 180 days to submit an appeal for disability claims, however the appeal deadline can be as short as 60 days for life and health claims. During this time, an attorney can assist you in gathering evidence and other supporting documents to defend your case. It is up to the terms of the insurance company to permit you more than one chance to appeal before you exhaust the administrative process.

Four Reasons Why an ERISA Claim Can Be Denied

An ERISA claim can be denied for several reasons, although most insurance policies allow for at least one appeal to be made. Some of the reasons your claim might be denied are:

• You cannot provide evidence that your disability warrants the requested benefits
• Medical records conflict with the benefits requested
• An employee does not provide sufficient documentation due to lack of knowledge
• Your claim was not filed in a timely manner

In addition to claim denials, your claim could be affected by delays. Delays in a decision can occur through lack of evidence or by sheer negligence. If your employer’s insurance company needs more time than the 45 days they are allotted under ERISA, they must notify the employee of an extension. In this case, they must notify the employee within 15 days of the decision and provide the employee with an additional 45 days to submit more relevant information. It’s also important to be aware of the important mistakes to avoid when appealing a denied ERISA claim. To verify your documents, you may want to consider hiring an attorney.

Appealing an ERISA Claim

Appealing an ERISA claim can be tricky to navigate without an attorney. Due to the specificities of insurance policies, the appeal process can vary. Variable circumstances include how many times you are allowed to appeal before exhausting the administrative process. Many insurance companies only allow an employee to file an appeal once.

If you are no longer allowed to appeal based on the guidelines set in place by your insurance company, especially when appealing a denied ERISA claim, this does not automatically disqualify you from receiving benefits. An attorney may advise you not to pursue further legal action if you do not have sufficient evidence. However, they may find that a violation of ERISA has occurred. If this is the case, an attorney can help you escalate the issue into a claim against the insurance company.

What Can an ERISA Attorney Do?

At McDermott Law, our experienced attorneys have handled several ERISA claims in Colorado Springs. We can help you determine the strongest path of action to achieve the benefits you need amidst this confusing system. We know how burdensome it can be to pursue legal action, and we are prepared to offer comprehensive legal counsel.

FAQs:

What Is Required of Employers From ERISA Claims?

ERISA provides extensive standards for private-sector employers who sponsor their own insurance plans. ERISA’s requirements supersede the standards set in place by the state, except when the insurance plan is provided by the government or a religious organization. Requirements of employers under ERISA include:

• Vesting
• Funding
• Disclosure and reporting
• Nondiscrimination
• Beneficiaries
• Administrative fiduciary standards

Can You Appeal an ERISA Claim Denial?

ERISA claim denials can be appealed, but they should be approached with caution. Many insurance companies limit the amount of appeals an employee can submit. It is important to exercise caution and consult with an experienced ERISA claims attorney to ensure your appeal has a high chance of success. The sooner you engage an attorney, the better.

What Is the Statute of Limitations on ERISA Claims?

The statute of limitations on ERISA claims differs based on employers’ specific insurance plans. However, once an insurance company receives the initial claim, they have 45 days to make a decision. If this is not enough time to make a decision with the evidence available to them, they may extend it an additional 45 days, following a written notice to the employee.

Does ERISA Preempt State Law?

ERISA does preempt state laws, but not all of them. ERISA supersedes state laws that relate to employee benefit plans. The Supreme Court has interpreted the involvement of ERISA differently as it pertains to state law. In some cases, the court found that ERISA prohibited state laws meant to regulate employer-sponsored health benefit plans. ERISA also does not account for benefit plans merely offered by insurance companies when they do not bear the risks.

Contact a Colorado Springs ERISA Attorney Today

Navigating ERISA claims can be challenging due to the particularities of individual insurance policies. For help filing or appealing an ERISA claim, schedule a consultation with a Colorado Springs ERISA claims lawyer today to find out how we can help you.