What Is the Difference Between ERISA Long-Term Disability and an Individual Plan?
ERISA stands for the Employee Retirement Income Security Act of 1974. It established a set of standards for retirement and health plans.
If you have a long-term disability plan through your employer, it likely falls under ERISA standards.
An employer-sponsored plan isn’t your only option for coverage though.
You could also enroll on your own in an individual long-term disability plan, which is governed by state standards instead of federal ERISA standards.
There are important differences between these types of plans, including:
The cost: ERISA plans usually cost less than individual long-term disability plans. Your employer may also help cover the cost of premiums.
How hard it is to claim benefits: It is often harder to get benefits when you have an ERISA plan because these plans have strict rules for what qualifies as a disability, for example saying you must be unable to do any kind of job, not just your own job, to have a claim.
The amount of benefits paid: ERISA plans typically pay 50% to 75% of your salary in benefits. Individual plans can pay more, depending on the terms and coverage that you bought.
Ties to employment: If you have an ERISA plan through your employer, your coverage won’t come with you to another job. An individual long-term disability plan that you signed up for yourself is not tied to employment.
The most important thing to know is that the appeals process for when you’re denied benefits under these plans can look very different.
When a plan follows ERISA standards, you have to go through the insurer’s entire appeals process before you can file a lawsuit. With an individual long-term disability plan, you can usually go to court sooner.
Which court has jurisdiction when you have a dispute with your insurance company is also different. Cases with ERISA plans go to federal court, while individual plans governed by state law go to state courts.
No matter which kind of plan you have, getting denied benefits you’ve paid for is stressful and infuriating.
It’s tough to appeal an insurance company’s denial on your own, but a Georgia ERISA lawyer from Silver & Archibald can help you make your case.
Talk to us for a FREE evaluation of your long-term disability denial.
How a Georgia ERISA Attorney Helps When You’ve Been Denied Benefits
An ERISA long-term disability insurance plan is supposed to offer a lifeline so you can stay financially stable while you can’t work.
If your insurer denied your claim or sent you a lowball offer that won’t award enough to cover your expenses, you don’t have to accept it.
Instead, talk to an ERISA lawyer who can help you make your appeal and fight for the benefits that you deserve.
A long-term disability attorney:
- Helps you gather medical records and other evidence for your claim
- Keeps you updated about any deadlines, so you don’t miss your chance to claim benefits
- Protects your rights under state laws or ERISA
- Negotiates with the insurance company on your behalf
- Builds your arguments that you are unable to do any job, not just your current job
- Appeals insurance company decisions to stop benefits you’ve already been receiving
- Reviews any documents from the insurance company before you sign them
We’re familiar with the tricks that insurance companies use to get out of paying benefits.
You have enough to worry about, so let us help you get the benefits you deserve and restore your financial independence.
The attorneys at Silver & Archibald have a combined 80 years of experience helping people just like you.
Get to Know Silver & Archibald Social Security Disability Attorneys
Legal cases involving your health struggles are highly personal matters. When you’re looking for help, you want someone who treats you with the personal care, respect, and dignity this moment requires.
Answers to Common Questions About Social Security Disability
Social Security Disability is a huge program with a vast set of rules. As a resource for you as you sort out your disability claim, the disability lawyers at Silver & Archibald have prepared answers to some of the most common questions people have.
Common Disability Benefits Questions »
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