CONGRESS STACKED THE DECK Washington District of Columbia

SO YOU THINK YOU HAVE DISABILITY INSURANCE THROUGH YOUR EMPOLER?

I suggest you read this and consider a letter to your congressman about unstacking the ERISA deck. Its a little long but all employees need to understand how ERISA stacks the deck against you. Then limits the amount you can recover.

My experience:

My family physician and my cardiologist both write that I can't work.

My employer, says I can't work without my physician's release.

My employer, says I am not entitled to Disability Benefits.

My employer terminated be eliminating all benefits, because my physicians will not recant their evaluation and say I can return to work.

Employee Retirement Income Security Act (ERISA) sounds like it protects employees. When it comes to Disability Insurance provided through your employer, it falls under ERISA and protects only the employer.

Say, your employer has a two tier Disability Plan, Short Term Disiability (STD) for 6 months and Long Term Disability (LTD). Under the two tier plan STD starts paying immediately. But, immediately STD starts to determine why you should not be receiving STD benefits. They can even determine you are not entitled retroactively and you have to repay the money you have already received.

Then you you can file an appeal within 30 days. Your employer then has 45 days after they acknowledge receipt of you appeal to respond. They get an additional 45 days just by notifying you they need more time. (Thats up to 4 months)

Only if the denial was a final denial you can, at your own expense file suit for amount of the disability payments you should have received.

But your employer (For your benefit) can add another level of review. Then you have 60 days to appeal the denial. Again your employer has 45 days to respond plus an additional 45 days just by notifying you they need more time. (Now thats up to 9 months)

Only after you have received all your STD benefits will you be considered for LTD benefits.

After you have received STD benefits about 4 months STD should advise you to apply for LTD benefits. Remember STD is still trying to find you are ineligible for STD benefits. Now you have both STD and LTD contacting your physicians for information. The requests from both are on your employer's letterhead. Your employer has started the frustrate and confuse your physicians.

Of course LTD denies you claim because STD benefits have not been exausted. Are you confused yet?

Assuming you STD is finally approved you have to start all over again with LTD. Your employer then applies the same delaying tactics for LTD. LTD intensifies their efforts to justify denial of LTD benefits. Remember all payments stopped when STD ended. Apparently they they can even change the benefit plan and start using the new plan before it's effective date. My employer did.

Only after all your appeals are exausted do you have the right to bring suit against your employer. The amount of the suit is limited by ERISA to the amount of the denied payments. The cost of the suit is born entirely by the employee.

Now aren't you glad Congress looked out for you?

Ken
Chattanooga, Tennessee