What Is ERISA?
ERISA, an acronym for the Employee Retirement Income Security Act of 1974,1 is one of the most important federal laws ever passed by Congress, but hardly anyone knows what it is or what it does. […]
Articles
Updates on the latest in benefits news and practical pointers for your benefits-related issues.
ERISA Ruling Shows Lax Enrollment Practices Can Be Costly
A life insurance decision issued by the U.S. Court of Appeals for the Eighth Circuit may be summed up by quoting a single sentence from the opinion: “Misleading an [Employee Retirement Income Security Act]-plan participant has consequences.” Skelton v. Reliance Standard Life Insurance Co.[1] teaches how lax benefit enrollment practices can be costly. […]
What Is the Significance of “Restrictions & Limitations” in a Disability Benefit Claim?
Disability insurance companies base their claim decisions on the claimant’s medical restrictions and limitations. “Restrictions” are what some cannot do as determined by their doctor, while “limitations’ are what someone is limited in doing. In the absence of restrictions or limitations, there is no “disability” as defined by the policy […]
4th Circ. ERISA Ruling Shows Plan Discretion Is Not Limitless
A recent ruling from the U.S. Court of Appeals for the Fourth Circuit made it clear that the Employee Retirement Income Security Act’s deferential review standard is not a rubber stamp of claim determination made by
benefit plans. […]
Should I Appeal a Denial of Long-Term Disability Benefits on My Own?
If your employer-sponsored long-term disability benefits have been denied, your first instinct may be to appeal right away, potentially without a lawyer, in the hopes that your benefits will be reinstated as quickly as possible. Your disability plan administrator may even try to deceive you into thinking it’s easy, by encouraging you to submit […]
New Research Offers Clues for How to Prove Disability Due to Long Covid
An estimated one in three people who contract Covid-19 will continue to experience symptoms months later, even if their initial symptoms were mild or absent. Known as “long Covid,” this disease is only beginning to be understood, but one of its more […]
9th Circ.’s Hasty UnitedHealth Reversal Is Disappointing
The COVID-19 pandemic has affected our health care system in many ways over the past two years. While much of the focus has been on vaccines and treatment, COVID-19 has also caused an increasing demand for mental health treatment, [1] including treatment for substance use disorders. [2] […]
ERISA Ruling Was Right To Seal Sensitive Records
The U.S. judicial system is admired around the world due to the openness and transparency of judicial proceedings. Courtrooms are open to the public, and the pleadings and evidence introduced in court cases are considered public records. However, there are times when access to court proceeding documents need to be balanced with the person’s rights to privacy. […]
What Is an Incontestability Clause?
An incontestability clause is a provision in a life or disability insurance policy that prevents the insurance company from canceling the policy based on misstatements in the policy application after the insurance has been in effect for a certain period of time, usually two years. Most states require the inclusion of such clauses in insurance policies […]
Reimagining ERISA Civil Procedure
Claimants seeking benefits brought under the Employee Retirement Income Security Act (“ERISA”) have been authorized to bring a “civil action” to seek redress. Although the term “civil action” is supposed to have identical meaning under the Federal Rules of Civil Procedure regardless of the type of claim being brought, ERISA claim litigation differs dramatically from ordinary civil procedure. […]
Narcolepsy Disability Benefits
Narcolepsy can be a debilitating, chronic neurological disorder that affects every aspect of a person’s daily living. People who suffer from Narcolepsy generally experience Excessive Daytime Sleepiness (“ESD”) due to the brain’s inability to control the sleep-wake cycles […]
The Winds of Change Are Blowing in ERISA Litigation
If you receive a benefits package from your employer in addition to your salary, there are specific laws that will apply. Those laws may limit the damages you are entitled to receive if your benefits are denied or terminated. Other legal requirements and hurdles will arise as you navigate the appeal process […]