What is an ERISA claim? ERISA stands for the Employee Retirement Income Security Act. ERISA is responsible for ensuring that private employers offer basic benefit plans to their employees. Among these is disability insurance. If you become disabled and are no longer able to work, your employer’s disability insurance, which is likely governed by ERISA, will continue to pay a portion of your salary.
However, these claims are commonly denied. Here are four reasons why you haven’t been approved for the disability benefits you feel you’re owed.
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1. Not enough evidence to back up your claim.
It should go without saying that appropriate and thorough medical assessments and reports are essential to bolstering a disability claim. If you haven’t seen a doctor and are merely reporting what you believe is your disability, you’ll never be approved.
But even if you did see a doctor and got a diagnosis, this may not be enough. Records indicating check-ups and treatment relevant to this disability, as well as second opinion visits, go much further in supporting your claim.
2. They believe you can still work.
Here’s something interesting we learned from these ERISA disability attorneys. You may be denied your benefits if the powers that be feel you can still work, even if not at your old job.
For instance, let’s say you worked in a warehouse, and a permanent leg injury has prevented you from continuing. However, you also have experience working as a bookkeeper, a desk job which doesn’t require the standing and lifting you did before. If it’s determined you could still be gainfully employed elsewhere as a bookkeeper, your claim might be denied.
3. They’ve gathered evidence against you.
No insurance company wants to pay up if they can avoid it. That’s why they’ll investigate you, sometimes going so far as to have a private investigator follow you. They’ll even keep a close eye on your social media accounts.
If they obtain any evidence of you performing or enjoying certain activities despite your disability claim, they’ll use that to deny you. So if you’re disabled, follow a doctor’s orders and stick to activities you know are safe for you. And be careful about posting anything online that could be misconstrued.
4. Improper execution of the filing process.
Many people opt to hire a disability lawyer with ample ERISA claim knowledge for this reason. If there is absolutely any area you haven’t covered in your paperwork, or if it’s ruled that you provided the information, but it isn’t complete, you can be denied. Furthermore, you must meet each and every deadline, or risk outright rejection of your claim.
These are just a few common denial reasons. The truth is, claims are denied all of the time for essentially any reason at all. Some people are even denied for opting for alternative therapies over conventional treatments, even when alternative therapy is more effective in alleviating pain and discomfort for them. It’s best to choose a law firm to assist you in completing the ERISA claim process – they may give you a much better idea of what to expect, and help streamline the process for you.