Avoid These Six Common ERISA Disability Benefits Application Mistakes

Are you disabled and out of work? You may qualify for an employer-sponsored Long Term Disability (LTD). With this plan, you may be eligible to receive long-term disability benefits, but your chances of receiving these benefits hinge on the ERISA benefits application process. This entire process is challenging, and a single mistake could cost you your long-term benefits. It’s important, therefore, to have the help of an experienced ERISA attorney at Uscher, Quiat, Uscher & Russo, P.C.

Here are six common mistakes people make when filing an ERISA benefits claim and how you can avoid them.

#1: Assuming your claim has enough evidence if your employer backs you up.

Your employer does not pay your long-term disability benefits. That job belongs to the insurance company or Third Party Administrator (TPA) who manages the plan. Just because your employer believes you deserve your benefits doesn’t mean your claim go through. It can be a big mistake to assume that your employer’s opinion concerning your ability to work is sufficient to qualify for benefits. It’s up to the insurer to determine whether you meet the legal definition for disabled, based on the policy terms.

#2: Solely relying on your human resources department’s advice.

You will most likely get advice from your human resources department regarding your benefits. However, your human resources department is not trained in understanding insurance policies. They also have minimal influence over insurers. They frequently do not know the details of your ERISA plan, and cannot be safely relied upon to provide accurate advice, so be careful! You are the only one that can take action when trying to obtain long-term disability benefits. Do not solely rely on your human resources department’s advice. Doing so could cost you your benefits.

#3: Not documenting your disability claim with more than just insurance company forms.

On your insurance forms, your doctor must answer to establish whether you have restrictions and limitations which prevent you from doing your work. These questions are required by the insurance company. But you shouldn’t leave it at that. Meet with your doctor and explain the requirements of your insurance policy. You can even request a complete report from your doctor fully explaining how your disability hinders you from working. Sometimes doctors will charge for a report like that, however, it can be well worth it in the long run. Never rely solely on the basic forms provided by the insurance policy.

#4: Engaging in activities that contradict your disability.

When you submit an ERISA disability benefits application, the insurance company will be watching you. If you participate in activities that are inconsistent with your disability claim, you may look like you’re cheating the insurer. The insurance company will see these activities and then use them against you. The insurance company may even send you an activity log to complete. Your doctor will give you a list of activities you shouldn’t participate in. Follow that list carefully. Engaging in activities on that list will result in serious questions from the insurance company, or even a denial or termination of your benefits.

#5: Working with the insurance company’s lawyers to file for Social Security benefits.

If you plan to file an ERISA disability benefits application, you might have to file for Social Security benefits. The insurance company will offer “free” assistance filing for these benefits. Think twice, though, before accepting that offer. These services are in the pocket of the insurance company. Consequently, they may guide claimants into choosing disabilities on the Social Security benefits application that make it harder to prove long-term disability claims. Be careful with the insurance company’s vendors. Instead, seek the advice of your personal ERISA attorney.

#6: Seeking guidance from a lawyer who doesn’t have experience in ERISA.

The ERISA disability benefits application is a complicated process. Many rules apply and the law provides strict deadlines within which to prove your claim or appeal a denial. Seeking counsel from a lawyer not experienced in ERISA jeopardizes your long-term benefits. You need a lawyer with both knowledge and expertise in this area of law.

Uscher, Quiat, Uscher & Russo, P.C., has experienced ERISA disability attorneys read to help you. Call 201-342-7100 or send an email to get in touch with us today