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ERISA and Disability Claims

New Jersey ERISA and Disability Claims Lawyers

The Employee Retirement Income Security Act of 1974 (ERISA) was passed in order to ensure pension plans were managed more responsibly. Ideally, ERISA was supposed to protect employees from the financial mismanagement of their funds by requiring greater reporting, accounting and transparency from plan administrators. However, ERISA, being a federal act, takes precedence over state laws that would have provided a higher level of protection to disabled plan participants. As a result, ERISA unintentionally provided insured plans with a legal prerogative to effectively deny long-term disability claims. Employers who did not want to shoulder the financial cost of a disabled employee could now reduce their insured plan costs by contesting disability claims under the less stringent requirements of ERISA. At the law office of Lum, Drasco & Positan, our Litigation Group has extensive experience in representing clients at the state, federal, and appellate levels in regard to denied ERISA disability claims.

If you have been denied disability benefits owed you under the terms of your plan, contact the law office of Lum, Drasco & Positan today to schedule an appointment to discuss your case.

Why ERISA Presents Unique Issues for Disabled Plan Participants

There are several issues unique to ERISA that must be considered. First, unlike state law, ERISA disputes do not provide claimants with the right to a jury trial or to punitive damages if their appeal is successful. Second, insurance plans offered by government employers and churches are excluded from ERISA. Third, privately purchased disability insurance is not covered by the terms of ERISA. Lastly, under the terms of ERISA, a plan administrator has the right to decide if a person is disabled based only on the language of the insurance policy and any medical evidence contained in a claimant's file, and they are not required to use the broader disability language contained in the federal Social Security Disability Act.

The ERISA Appeals Process

If you are denied disability benefits from by your plan's administrator, you must first complete a 180-day appeals process before you can file a lawsuit. Too often, courts place greater credibility on the decisions of plan administrators than is justified; if pertinent medical facts and additional information can be brought to light, that credibility can be challenged. Since plan administrators have a financial incentive to deny as many claims as reasonably possible, ERISA plan administrators could choose to deny a disability claim based on a single opinion of a doctor or nurse. The fact that the doctor in question is not a specialist in the injury suffered or is not the claimant's primary physician often makes no difference.

Contact Experienced ERISA Disability Claims Lawyers

At Lum, Drasco & Positan, our Litigation Group attorneys have extensive experience in handling ERISA disability claims. We have experience in handling total, partial, and residual disability claims. Our attorneys actively participate in the ABA Tort and Insurance Law Section's Life and Health Insurance Committees and continue to write and lecture on a wide variety of issues related to ERISA and insurance law.

To schedule an appointment and learn how we can help you, contact ERISA disability claims attorney Kevin J. O'Connor at Lum, Drasco & Positan today.

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