Employee Benefits & ERISA Claims
Employee benefits such as health insurance, disability coverage, pensions, and retirement plans are often governed by a federal law known as ERISA.
When these benefits are wrongfully denied, delayed, or mishandled, employees may have the right to take legal action under the Employee Retirement Income Security Act (ERISA).
What Is ERISA?
The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for most voluntarily established retirement and health plans in the private sector. ERISA governs:
- Group health insurance
- Long-term and short-term disability plans
- Life insurance benefits
- 401(k) plans and pensions
- Severance plans and some vacation policies
ERISA requires employers and plan administrators to manage benefit plans responsibly and in the best interests of plan participants.
Case Results
Common ERISA Violations
ERISA claims often arise when:
disability benefits is wrongfully denied
plan documents upon request
or underfunded
proper notice or process
Disputes involving long-term disability (LTD) denials are among the most common ERISA-related claims.
Who Is Covered?
ERISA generally applies to private employers who offer benefit plans to employees. It does not cover:
- Government employers (federal, state, or local)
- Churches and religious organizations
- Plans established solely to comply with workers’ compensation, unemployment, or disability laws
Filing an ERISA Claim
Before filing a lawsuit, employees must exhaust the internal appeals process provided by their benefit plan. This usually means:
- Submitting a written appeal within a limited timeframe (often 180 days)
- Waiting for a final decision from the plan administrator
Only after this process is complete can an employee file a lawsuit in federal court. ERISA claims are typically resolved by a judge, not a jury, and the court’s review is often limited to the administrative record.
Remedies Under ERISA
ERISA offers limited but important remedies, including:
Punitive damages and compensation for pain and suffering are generally not available under ERISA.