Skilled ERISA Lawyers Serving The State Of Arizona
Many Arizona residents devote little thought to the possibility of missing work because of disability. However, it’s a growing problem in the state, and across the country, particularly as many people have inadequate disability insurance coverage.
If you have employer-sponsored short- or long-term disability insurance coverage, you may think you don’t need to worry about this issue. Regrettably, it’s not always that simple. Arizona ERISA insurers often do their best to avoid paying out on legitimate, genuine claims, leaving claimants in hugely difficult positions.
When this occurs, hiring an Arizona ERISA lawyer is the best way to secure your monthly disability benefits.
How Does ERISA Work?
The Employee Retirement Income Security Act (ERISA) of 1974 governs the majority of short- and long-term disability insurance policies that employers provide for their workers as benefits. The rules the law sets out are less favorable for disability insurance claimants than those that apply to individually purchased policies.
Significantly, ERISA has specific rules under which you must file a timely, comprehensive administrative appeal following an unsuccessful initial group disability insurance claim. Rather than taking your insurance provider straight to court, you must do an administrative appeal laying out why your sickness or injury restricts or limits your ability to work.
ERISA Federal legislation limits the case to evidence submitted during the initial claim and the administrative appeal. You’ll only be allowed to use the records submitted during that appeal, as well as the initial claim. That means you need to be as comprehensive as possible during your group ERISA appeal, submitting all the medical, occupational, and vocational evidence at your disposal. Once you submit your appeal, you’ll no longer be able to introduce additional reports or records as evidence in your federal ERISA case.
Additionally, you cannot call or cross-examine witnesses during an ERISA court case, and you do not have the right to a trial by jury.
These distinctions make the help of a seasoned and successful disability insurance attorney essential in Arizona ERISA cases. Without a good ERISA lawyer on your side during the administrative appeals process, you might neglect to include a pivotal doctor’s report or medical record. However, our award-winning lawyers know exactly what needs to go into an administrative appeal to give claimants the best chance of success after an initial claim denial.
The Role of Employers In Arizona ERISA Cases
Following your departure from work after the onset of a disabling condition, you may be in close contact with your employer or their HR department. This is especially likely if you’re filing a claim under an employer-sponsored group disability policy.
You might think to rely on your employer for help with your ERISA claim or appeal. However, you need to exercise caution. When employees collect on group-purchased disability insurance claims, employers will pay more for subsequent premiums. Your company, therefore, has a financial interest in seeing your claim fail and may not be properly motivated to help you if you encounter difficulties in the claims or appeals process. The only reliable professional help with employer-sponsored group disability insurance issues comes from expert ERISA attorneys like ours.
Certain employer-sponsored group plans do not fall under the jurisdiction of ERISA. For example, if you work for a government agency or a church, the legislation may not apply in your case.
Your Entitlements Under An ERISA Short- Or Long-Term Disability Insurance Policy
You should become entitled to income replacement benefits under a short- or long-term disability insurance policy when:
- Your physician has confirmed that your condition is preventing you from doing the important duties of any occupation for which you are trained, educated, or suited if your policy uses an “any occupation” definition of disability. Alternatively, you may be considered disabled under an “own occupation” disability definition if you can no longer carry out the duties of the position you had directly prior to your claim. However, “any occupation” language is more common in group ERISA policies.
- You have received appropriate treatment from your physician for the sickness or accident that restricts and limits your ability to carry out full- or part-time work.
- The relevant elimination or waiting period, as specified on your policy, has elapsed.
The average ERISA policy offers less generous monthly benefits to successful claimants than the average individually purchased long-term disability insurance policy. ERISA policy beneficiaries usually receive 60-66.67% of their working income under long-term plans.
Employer-sponsored policies are also less generous in other areas; they usually have longer elimination periods, for example, and the “any occupation” language most ERISA policies use is less generous than an “own occupation,” definition of disability, as described above.
Every policy is different, so you’ll need to do your own research or ask an Arizona long-term disability lawyer for a free consultation to discover exactly what kind of coverage you have.
Disability Statistics In Arizona
Around 13% of Arizona residents live with a disabling condition of some kind, with especially high disability rates in La Paz, Mohave, and Gila Counties. Statistics also show that 22.4% of the state’s workforce are in full- or part-time employment despite having a disability.
The Workforce Innovation and Opportunity Act (WIOA), which the state government passed in 2014, contains a number of measures aimed at getting people with disabilities and other barriers into the workforce. Since the pandemic, campaigners in Arizona have pushed lawmakers to focus on changing the state’s labor market so that it continues to be accessible for those with physical and mental conditions that limit their access to the world of work.
Cognitive disability (serious difficulty with memory, concentration, or decision-making) is the most common form of disability among Arizonans of working age, affecting 13% of the state’s adult population according to the most recent CDC statistics. Mobility-related disabilities were the next-most common, affecting 12% of Arizona residents over the age of 18.
How An Arizona ERISA Lawyer Can Help You
The process involved in claiming ERISA disability benefits, and doing a comprehensive, winning appeal once your initial claim has been denied, can be daunting. Many people lose hope after their group disability insurance carrier makes life difficult for them. The help of an experienced Arizona ERISA lawyer is crucial in situations like these.
If you need help with a disability ERISA claim in Arizona, whether it’s an initial filing or an appeal, contact DarrasLaw today. We offer a free initial policy and claim analysis. If you are at the appeal stage, remember that filing a timely and comprehensive appeal boosts your chances of success, so don’t delay.