Pekas Smith Disability Attorneys represent people in ERISA claims including disability benefits claims. When you need an Arizona ERISA and employee benefits attorney, we can represent you at any stage of your case.
We can assist you with:
- Understanding your eligibility for benefits
- Filing for ERISA benefits
- Appealing the denial of an ERISA claim
- Judicial review of a decision
- Addressing termination of benefits
If you participate in an employee-sponsored disability plan, ERISA protects your rights. Our employee benefits attorneys understand ERISA and the protections that it provides for workers. We want to help you exercise your rights and get the compensation that you deserve.
To see how our law firm can help you, contact Pekas Smith Disability Attorneys today.
Attorneys for ERISA and Employee Benefits Claims
To receive a favorable result in an ERISA benefits claim, it’s important to understand the qualification requirements. You must present the information that the examiner needs to reach a favorable result. This may require:
- Medical records
- Expert medical opinions
- Vocational evaluations and professional reports
- Statements from others
Too many initial claims and appeals are denied because information is lacking or incomplete. You may qualify for benefits, but you may not have provided the information that the claims examiner needs.
Our attorneys know what makes a claim successful. We know the mistakes that people make, and we know how to address any specific reasons that the insurance company gave for a claim denial.
From drafting the paperwork to preparing the medical information that needs to be provided, our law firm represents you in everything necessary to your ERISA claim. With experience, commitment, and compassion, we pursue your claim in full. Our team is equipped to continue with your case through appeals and judicial federal review, if necessary.
How does ERISA regulate disability plans?
For disability plans, ERISA regulates:
- How claims are reviewed
- How much time the insurance company has to decide on a claim
- Rights and remedies when the insurance company denies benefits
Your employer should provide a Summary Plan Description that includes information on how to file a claim. They can’t charge you for filing a claim or appealing a decision.
The regulations pertaining to disability plans apply for any employer-sponsored benefit program where an award of benefits depends on a finding of a disability. This includes disability insurance, and it can also include pensions and other programs. Government-sponsored plans and some religious organizations are not subject to the requirements.
What are my rights under ERISA?
Under ERISA, you have the right to:
- File a claim for disability
- Have your claim decided within the timeframes required by ERISA
- Receive written notice of why your claim is denied
- Ask for all documents related to your claim
- Pursue internal appeals through the insurer
- Take your case to court
Appealing Denial of Your ERISA Benefits
When you appeal the denial of your ERISA benefits, a new person looks at the claim. Usually, they consult with medical professionals to understand health information.
The internal appeal is de novo. That means that the new person deciding the appeal must look at it new. They can’t deny the claim just because the first person denied it.
There are time limits – Generally, an insurance company that allows one appeal has 45 days to reach a decision. They may request an extension. When there are two administrative reviews, the time period for each level is compressed.
Taking Your ERISA Case to Federal Court
ERISA is a federal law. It applies throughout the United States, including in Arizona. When a person pursues their case beyond internal appeals, they file it in federal court. A judge can review the decision made by the insurance company or their claims representative. Seeking judicial review is your right.
ERISA Benefits Lawsuit FAQs
What is ERISA?
ERISA is a federal law, the Employee Retirement Income Security Act of 1974. The law governs the creation and administration of many employer-provided benefits programs including health, pension, and disability plans.
What does ERISA do?
ERISA creates minimum standards and uniformity for employer-sponsored benefit plans. The law promotes fair management and timely administration of covered benefit programs.
I know the insurance company must decide my ERISA disability claim within 45 days. – Is that business days or calendar days?
An insurer must decide your ERISA disability benefits claim within 45 calendar days. That includes holidays and weekends.
How many days do you have to appeal a denial of your ERISA disability claim?
ERISA requires at least a 180-day window to appeal a denial of your disability benefits claim.
Where do you send your ERISA disability appeal?
Your denial notification should include information about where to submit your ERISA disability appeal. When you send your appeal, get tracking information and a return receipt so you can prove delivery.
Should I wait to get an attorney until my case goes to court?
The federal court looks only at the information submitted to the insurance company during the appeals process. It is critical to have an attorney as early in the case as possible to ensure you build the foundation for any potential court action. Also, having an attorney may help you be successful at the appeals level, so court isn’t necessary.
Serving Phoenix, Tucson, and all of Arizona
Wherever you are in Arizona, our attorneys can help you with your ERISA claim. We help employees seek ERISA benefits wherever they are located.
You’ve worked hard. When you need to file a claim, the benefits should be there to help you and your family.
Pekas Smith Disability Attorneys is a team of experienced professionals. We work on your behalf so you can get and maintain the benefits that you deserve.
Consultations Available – Talk to an ERISA Lawyer Today
Pekas Smith Disability Attorneys are available for consultations and case evaluations. To talk to an Arizona ERISA and employee benefits attorney, contact us now. We are happy to discuss your case and answer your questions. We can start representing you today. Contact us to begin.