Kantor & Kantor, LLP Kantor & Kantor, LLP

ERISA

Portland ERISA Lawyers

What Is Erisa?

The Employee Retirement Income Security Act – more commonly shortened to ERISA – is a federal law that is meant to make it simpler for employees to collect and use long-term disability (LTD) benefits when they are too injured to keep working. Unfortunately, not all insurance companies intend to make it easy for employees who need their LTD benefits now more than ever. It is not uncommon to hear from people who filed for disability using a policy they earned through their employment only to be shut down at the first step.

At Kantor & Kantor, LLP, our Portland ERISA attorneys take pride in being the first name locals trust with all sorts of ERISA claims. Whether an insurance company is complicating your case, or you just need help figuring out your options through ERISA and an LTD insurance plan, we can help. Our legal team is backed by decades of collective experience, so you can be sure that there won’t be anything about your case that catches us off-balance, no matter how complicated it might seem now.

How ERISA Works

ERISA has helped set federal guidelines that mandate how long-term disability (LTD) claims are managed and paid to claimants. The Consolidated Omnibus Budget Reconciliation Act (COBRA) is one of the most notable amendments to ERISA, which allows certain workers to keep healthcare coverage for a limited period after experiencing unemployment.

A keynote to how ERISA works is that it requires disability insurance companies to manage all claims independently and any experts who assist with a claim investigation like a medical expert must be unbiased. When there is a discrepancy in how an LTD claim is handled, ERISA paves the way for legal action taken by the claimant.

Call us at (503) 744-5994 to arrange a consultation about your ERISA claim.

 

ERISA Violations Leading to Claims & Lawsuits

Most of our ERISA clients in Wilsonville and beyond call on us after their ERISA claim has already been complicated by an insurance company. From our position as the area’s trusted name in legal representation, we have seen all sorts of different case types started from ERISA violations carried out by insurance companies and sometimes even employers.

Some of the most common types of ERISA violations include:

  • Wrongful denials: There are always valid reasons for denying a long-term disability claim that involves ERISA law, such as the claimant’s disability is not covered under their LTD insurance policy. Issues arise when a denial happens without due cause. Some dishonest insurers might be tempted to outright deny a claim without investigating it at all in hopes that the claimant will just give up and move on.
  • Lost benefits: The benefits promised to an LTD claimant must be delivered after a claim is approved. When benefits are overlooked, canceled, or otherwise lost, it could be an ERISA violation worthy of an attorney’s attention.
  • Breaches of fiduciary duty: Many LTD benefits are paid through specialized financial accounts that must be managed carefully to ensure the funds are there when people need them. If an account manager acts negligently, or intentionally mishandled such an account, and the funds within it are lost or reduced in a way that impacts policyholders and claimants, then it could constitute a breach of fiduciary duty, which is an ERISA violation.
  • Wrongful terminations: An employer who is looking to save a little money each month might be tempted to fire an employee who files for LTD benefits because this tactic could keep their disability insurance premiums lower. If you were terminated after you informed your employer that you were going to use your disability benefits granted through your employment, which makes those benefits covered by ERISA law, let us know right away.

Common Reason for ERISA Claim Denials

Not every ERISA claim that is filed is going to secure the financial benefits that the claimant needs because there are valid reasons for ERISA claims to be denied. Our Portland ERISA attorneys can help you understand if your case is worth pursuing, or if we anticipate it would be denied without the opposition doing anything unlawful or incorrect.

Some of the most common reasons for ERISA claim denials are:

  • Claimant cannot back their disability with medical evidence
  • Claimant could reasonably be employed in another occupation
  • Claim was filed after a strict deadline expired
  • Claim was filed with incomplete information

However, it is worth noting that even when an ERISA claim is justifiably denied, there are often ways for our attorneys to navigate the situation and find a workable solution. The details, no matter how small, matter in these cases. Let us sort through them to figure out what to do next.

ERISA FAQ

Which Government Agencies Enforce ERISA?

The Employee Benefits Security Administration, the Internal Revenue Service (IRS), and the Pension Benefit Guaranty Corporation all have the means to enforce ERISA law. Depending on what is happening in your case and why your claim has been denied, our attorneys could possibly benefit from the assistance of these three agencies to back your case.

Are ERISA Settlements Taxable?

The end of a successful ERISA case will likely include a lump-sum settlement to be paid to the claimant, which should reflect the benefits owed to them originally and possibly additional damages for the undue hardship the insurance company made them endure. Money gained through an ERISA settlement is considered a form of income, though, so it will be subject to federal income tax laws.

Does Your Disability Need to Be Work-Related?

Commonly, employees are misled into believing that they can’t use ERISA-covered LTD benefits unless their disability was caused in the course of the employment. This is not true. Long-term disability insurance is not the same as workers’ compensation insurance in that you can get benefits for a disability, regardless of that disability’s origin. For example, you could be diagnosed with hereditary cancer and still seek LTD benefits if your cancer symptoms have made any sort of work painful or impossible, i.e., have left you disabled.

How Are ERISA Attorneys Paid For Their Counsel?

Typically, ERISA attorneys can charge contingency fees or hourly fees when working on a case. A contingency fee means they are paid only if the case ends with a settlement or award for the claimant, and that they are given a percentage of that amount. An hourly fee means the attorney is paid a flat rate per hour they work on the case. Before we begin working on your ERISA claim, we will make certain that you understand our fee structure and why it was chosen for your case.

Bring Our Attorneys On Board Today

Long-term disability benefits and related insurance policies are complicated. ERISA law is even more complex. Don’t try to deal with a subject so intricate and important on your own. Let our Portland ERISA attorneys from Kantor & Kantor, LLP help you navigate the process and stand up for you.

Want to speak with an attorney? Just call (503) 744-5994 at any time to schedule a free consultation.

 

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