Filing a Bridgeport ERISA Disability Lawsuit
A debilitating illness or severe injury could render you unable to work in the long term for your private employer. If you have experienced this type of injury, you could be eligible for a long-term disability benefits claim supported by the Employment Retirement Insurance Security Act (ERISA).
If you are familiar with the ERISA disability claim process, you may have applied, received a denial or two in response, and now face the challenging decision of what to do next. At this stage, you could benefit from consulting a Bridgeport lawyer about the prospect of filing an ERISA disability lawsuit.
The Claim Appeal
A disability claim denial can be discouraging, but it is not the end of the road for the pursuit of benefits. ERISA law requires independent reviewers to examine a claim at the initial submission stage, then at each level of the appellate review. Still, the insurance company may conclude that an employee’s claim does not meet the requirements.
The “Notice of Denial of a Disability Claim on Appeal”, or a similarly titled notification, indicates the insurance company’s decision is final. This notice should include the reasons for claim denial, citation to the specific plan provisions providing grounds for rejection, and a statement of claimant’s rights to receive a copy of the claim file free of charge.
The notice must contain an explanation of the claimant’s right to review by a court and by when, under the policy, the employee must do so. If the Bridgeport claimant has exhausted their administrative remedies through the insurer’s appeal process, the case could be filed for an ERISA disability lawsuit.
Insurer Error to Adhere to ERISA Process
If the insurer has failed to follow proper procedure either under the plan’s own rules or ERISA, the claimant can seek immediate judicial review. The court can then choose to review the violation. If the court elects not to hear the case, the insurer must treat the appeal as re-filed, and review once again.
ERISA Long-term Disability Lawsuit
ERISA law dictates that a denied applicant can file a lawsuit under certain conditions. In addition to exhaustion of plan-based remedies, a Bridgeport ERISA disability plaintiff should file in federal court. ERISA disputes are usually handled as administrative law matters by a federal or magistrate judge.
The plaintiff can bring the case against the insurer, the employer, and advisors. However, plaintiffs must be aware of two critical components of ERISA disability lawsuits.
The first is that the judge may only review the administrative record, specifically the paper trail submitted by the claimant through the submission and appeals process. The judge only reviews the information that was presented to the insurance company and nothing further.
The second is that the standard of review is “abuse of discretion.” In other words, the judge can only overturn the insurance company’s decision if it was clearly unreasonable, erroneous, or an arbitrary error of judgment.
Seek Help Filing a Bridgeport ERISA Disability Lawsuit from an Attorney
Though ERISA was written with the intention of protecting the rights of employees by ensuring a fair process through which applicants could receive long-term disability benefits, it can still present claimants with obstacles. Similarly, insurance companies can take advantage of the claimant’s unfamiliarity with ERISA procedures and deadlines.
For their benefit, claimants should consider consulting with an ERISA lawyer as soon as possible. If you are considering filing a disability lawsuit, seasoned legal counsel could offer guidance and advice on how to present your case. Contact a Bridgeport attorney today to learn more about filing an ERISA disability lawsuit.