Pennsylvania employees who become ill or suffer an injury may need to file a claim for benefits. Known as an ERISA claim, this type of claim is intended to tap into long or short term disability benefits for the disabled employee. Unfortunately, not all claims are approved, and sometimes employees may have to file an appeal to receive compensation.
Filing early is a must
ERISA benefits can only be claimed for a specific period of time once the illness or injury happens. For this reason, it’s highly advisable to file your claim as soon as you are diagnosed. You can get the insurance information to file your claim from your employer. When the insurance company receives your claim, they will either make a decision or ask for you to provide more information.
Receiving a denial
In some events, you may receive a flat-out denial from the insurance company. If this happens, you have the right to file an ERISA appeal to the decision. Pay close attention to the letter of denial because it will reveal how long you have to file an appeal before you give up your right to do so.
Once your appeal is received, along with any additional documentation, the insurance company will review your appeal. They will approve or deny it based on the information. Appeal decisions vary in the amount of time that the insurance company takes. If your appeal is denied, you may file another appeal through the U.S. Department of Labor.
Filing an ERISA claim is a necessary part of cashing in on your long-term disability benefits. In the event that your claim is denied, you have the right to file an appeal. It’s always a good idea to speak with an attorney about your ERISA claim as they can properly advise you of the procedure.