Denial of Disability Benefits in Ohio
ERISA Disability Insurance Claim Denial AttorneysA denial of disability insurance can be absolutely devastating to your livelihood. If you are disabled and unable to work, then you expect your disability benefits to kick in and assist you when you need it most.
Unfortunately, disability benefits are governed by the Employee Retirement Income Security Act of 1974 (ERISA). Although ERISA was intended to protect workers when it comes to employee benefits, when it comes to disability insurance ERISA protects insurance companies. You can read more about why ERISA has come to be interpreted by Courts to be in favor of insurance companies here.
Each insurance company has a slightly different definition of "disability." Disability insurance companies under ERISA get to decide what qualifies as a "disability" and then they get to decide who meets their definition of "disabled." This is a big time conflict of interest. The insurance company, who pays out the benefits, basically gets free reign to decide whether or not they will pay out the benefits. For insurance policies governed under the state law of Ohio, claimants could sue the insurance company for bad faith and if victorious would be entitled to reimbursement of their benefits and possibly punitive damages and attorney fees. Under ERISA this is not so, and there is a very specific process that must be done in order to sue the insurance company for reinstatement of benefits. The attorneys at Harris & Engler help people in Ohio who have had their disability insurance claims denied.
Ohio Disability Insurance AttorneysMany employers provide short-term disability coverage and long-term disability coverage to their employees. When this kind of insurance is paid for by an employer, it is governed by the federal ERISA law. With long-term disability and short-term disability denials covered by ERISA, the real only way to overturn a denial of coverage is to show that the insurance company's denial was arbitrary and capricious.
The Importance of an ERISA Disability AttorneyIt is critically important to consult with an ERISA disability attorney as soon as your claim for disability benefits has been denied. The ERISA statutory structure is so complex that you need not just any attorney, but an attorney experienced with ERISA.
If your claim for disability benefits is denied after you first file a disability claim, or you have been already receiving disability benefits before your claim is denied, you need an ERISA attorney to get involved as soon as you hear of the denial. If you have had your disability claim denied and you live in Ohio, then you need an ERISA disability attorney.
An ERISA disability lawsuit is different from other kinds of lawsuits in that you cannot bring in any new evidence once the lawsuit is filed. The entire lawsuit is based on the administrative record as it last existed with the insurance company. This is why the administrative appeals with the insurance company are so important - if you're going to win a federal ERISA disability lawsuit then you need to build your case at the administrative level with an ERISA disability attorney.
Only an experienced ERISA lawyer will know what language has to be in the insurance plan to give the insurance company deferential review in federal court. ERISA is very favorable to insurance companies because insurance companies can write in as a term of the plan that the insurance company has absolute discretion in determining whether or not a claimant meets the definition of "disabled." This gives the insurance company a lot of leeway to decide whether it has to pay disability benefits or not. This also gives the insurance company very few drawbacks for denying disability claims.
An ERISA disability insurance attorney can help you to best navigate all the hurdles that come up along the way when your claim for disability benefits is denied. You can speak with an disability claim denial attorney today by calling (614) 610-9988. The law firm of Harris & Engler is located in Columbus, Ohio, and its attorneys help people across Ohio with ERISA disability insurance claim denials and appeals.