The pandemic has raised challenges in nearly every part of our lives—including completing the tasks required for ERISA claim approval.
When you apply for disability, you must typically produce proof of loss within a certain timeframe. If not, the insurance company or plan may deny your benefits. For this reason, it’s important to provide proof of loss within the deadlines
Even so, the law requires that insurance company or plan make exceptions if meeting this burden is impossible or unreasonable. These kinds of laws can extend the time that you have to provide proof of your losses—including recent rules related to delays caused by the pandemic.
To learn more about getting vocational or medical claims approved by working with ERISA lawyers during COVID-19, keep reading.
Filing an ERISA Claim in the Face of the Pandemic
On July 24, 2020 the US Centers for Disease Control reported, “COVID-19 can result in prolonged illness, even among young adults without underlying chronic medical conditions.” https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm. The CDC remarked, “Relatively little is known about the clinical course of COVID-19 and return to baseline health for persons with milder, outpatient illness.” CDC data, however, shows COVID-19 impacted millions of working age adults. Couple this fact with an October 15, 2020, Harvard Health Publishing’s Editor comment that “Tens of thousands of people in the United States have lingering illness following COVID-19… Published studies (Journal of the American Medical Association and MMWR Morb Mortal Wkly Repv.69(30); 2020 Jul 31P) and surveys conducted by patient groups indicate that 50% to 80% of patients continue to have bothersome symptoms three months after the onset of COVID-19 — even after tests no longer detect virus in their body.” https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173The take-away is the pandemic is likely to lead to more short-term and long-term disability claim.
You may have to miss work due to symptoms caused by COVID-19. If so, physicians may have diagnose you with any one of several long-term or short-term illnesses. If so, it’s in your best interest to file a disability claim early. Many people wonder if they can file a claim for COVID-related sicknesses. The answer is that you can file for disability if you must miss work for any medical condition—even if it’s related to the pandemic. The ability to file presumes that your private sector employer provides disability coverage. Disability claims from private sector provided benefit plans fall under the Employment Retirement Income Security Act of 1974 (ERISA). Fewer than ten states require mandatory short-term disability coverage. Not one state mandates long-term coverage. If you are fortunate that you have a good employer that provides both short-term and long-term disability coverage, be sure to seek the benefits that you earned if you are too ill to work.
How ERISA Lawyers Can Help During COVID-19
An ERISA disability attorney can also help you evaluate whether it’s appropriate for you to file a claim. That attorney can help you begin obtaining a statement from your physician.
You may have already filed a claim. But your insurer may have denied it. If so, it’s vital that you consult with an ERISA attorney. The earlier you seek help the better. Every disability claim encompasses different facts. An experienced disability attorney can help you to assess your condition as it applies to your claim.
Changes in the Face of the Pandemic
Fortunately, the government has made concessions about submission deadlines. For now, disability submission deadlines are suspended based on an emergency orders of the US Departments of Labor and Treasury effective March 1, 2020. The orders are in the Federal Registrar dated May 4, 2020. Given that a year has passed, the US Department of Labor issued guidance in late February 2021 that is less than clear. The ERISA statute has a provision for emergencies but when enacted Congress did not expect an emergency to last more than one year.
The Department of Labor notice provides: “Individuals and plans with timeframes that are subject to the relief under the Notices will have the applicable periods under the Notices disregarded until the earlier of (a) 1 year from the date they were first eligible for relief, or (b) 60 days after the announced end of the National Emergency (the end of the Outbreak Period).”
-The notice provides a COBRA illustration of: “if a qualified beneficiary would have been required to make a COBRA election by March 1, 2021, the Joint Notice delays that election requirement until the earlier of 1 year from that date (i.e., March 1, 2022) or the end of the Outbreak Period.”
*If client received her denial letter on January 12, 2021, the normal 180-day deadline would be July 12, 2021.
A. If the outbreak period is still ongoing, the new deadline is1 year after the date when the Department of Labor relieved her of the deadline.
B. If the outbreak period is announced as ended on September 1, 2021(let’s hope for the best) then the deadline will be 60 days later, or October 31, 2021.
Although deadlines have been suspended, its better to act now rather than wait. The suspensions may change due to other orders of the Departments of Labor or Treasury, or by an Act of Congress of court challenge.
Getting Help During This Uncertain Time
Even if your physician believes that your symptoms warrant disability, don’t think that their opinion alone will help you to win your claim.Keep in mind that illness does not mean disability. Symptoms of illnesses sometimes lead to occupational impairment. Although insurers have classified some of these conditions, as “self-reported,” all pain is “self-reported” as there is no dipstick or laboratory test for pain. Federal Circuit Courts universally hold demanding “objective proof” for an illness for which there is no laboratory test is unlawful but requiring objective proof of occupational impairment is permissible. History tells us to look to insurance company’s approach to handling fibromyalgia and chronic fatigue syndrome claims if there is a significant uptick of COVID-19 long hauler claims and litigation.
If you have a disability claim, the best thing that you can do is seek advice from an experienced ERISA attorney immediately. What’s more, you should file your disability claim as soon as you find out that you can no longer work.
We Can Help You With Your ERISA Claim
Now you know more about getting vocational or medical claims approved by working with ERISA lawyers during COVID-19. If you have a condition that affects your ability to work, what you need now is a well-qualified ERISA attorney.
The law offices of Jonathan M. Feigenbaum, Esquire has specialized in ERISA and insurance law for more than 25 years. Over those years, we’ve delivered unrivaled results for policyholders.
An insurance company, employer, or union may have denied your ERISA claim. If so, we can help.
Contact the law offices of Jonathan M. Feigenbaum, Esquire today at (866) 816-3171 or connect with us online for a complimentary review of your claim. We’ll provide you with important next steps to help you win your disability benefits.
