Are you filing a claim or appeal for ERISA long term disability plans? You may have heard that submission deadlines have been suspended, allowing a longer period in which you can file your documents. You must know the amended dates, or you could miss out on your claim.
Unfortunately, these dates can be a little unclear. Below, we give you our guide on how you will have been affected and the new deadlines for ERISA disability plans.
What Are the ERISA Disability Plans Suspensions?
When the COVID-19 pandemic hit, the Department of Labor (DOL) rightfully saw how tough the pandemic had been on people, particularly those with illnesses and disabilities. In response, they suspended many long term disability deadlines.
This was great news for anyone who had failed to meet the claim submission dates or appeals deadlines throughout the pandemic. If you had a claim in process or filed a claim or appeal with the Employee Retirement Income Security Act of 1974 (ERISA) during the freeze, there are a few key dates you should know about.
When Will This Stop?
All deadlines will be paused until the state of national emergency is over. Once this ends, you will have 60 days to resume or file any claims.
Deadlines that are put on hold in this period include the dates you have to file a benefits claim under your plan’s claims procedures. It also includes the date on which you must file for an appeal, should you have had a negative result or regressive benefits applied.
How Does It Apply to Claims?
In general, ERISA disability plans require claims to be submitted within 90 days of a disability. However, the department of labor regulations do not provide a timeframe. Instead, they advocate that each plan must establish and maintain reasonable procedures over the time frame in which benefit claims are filed, making the area slightly unclear.
As an example, if your disability began on January the 1st, you have until March the 31st to file your claim. This is the designated 90 days since your disability began.
However, the DOL froze the deadlines starting on the 1st of March. To work out how much time you have to file, you need to take away the period between January the first and when you filed, and add it to the end of the date that the freeze ends.
Hypothetically, if you had filed on March the 1st, it would have been 59 days after your date of the disability. When the state of national emergency ends, you will have the remaining 31 days left to file the claim. This is also added to the outbreak period that ends 60 days later, giving you a total of 91 days after the emergency ends to file the claim.
How Does It Apply to Appeals?
For appeals, the DOl gives a period of 180 days to file after a negative result regarding your claims. This could include the termination of benefits, denial, or reduction in benefit amounts. Appeals can be given more time, but the minimum amount is the designated 18 days.
As an example, imagine your letter of denial arrived on the 1st of January. 59 days will have passed between receiving the letter and the March 1st deadline freeze. Deducting the 59 days from the 180 days filing period gives you 121 days.
Once the outbreak period ends, you will have that 121 days left to file your claim. Remember that the outbreak period will end 60 days after a state of national emergency, giving you 181 days in total.
What Do I Need to File a Claim?
During or after the freeze, you will need a number of items to file a claim. It may help to assemble these now, so you are not rushing when the time comes. In addition, you should anticipate a rush of claims and appeals to be processed on their end when the freeze ends.
Firstly, confirm the date that your disability stopped you from working. You must get confirmation of the date your employer asked you to file the disability claim. This is usually around 30 to 90 days from the date of the disability.
Then work out the time between the confirmed date of disability to the time of the freeze (1st of March). These are the day you were responsible for working out the claim. When the national emergency ends, you have 60 days plus this number to file the claim.
High-Risk Occupations
During the COVID-19 pandemic, while many businesses closed for safety reasons, there are many that have stayed open and are classed as essential businesses. If you work in one of these industries but are at high risk because of underlying health conditions, you may be able to claim disability.
You will need to start with a thorough check of your health and disability insurance policy or speak with the human resources department at your employment. You need to find what their definition of disability is. Some policies will exclude the risk to health as a disability, as you are able to still perform your job function.
Other policies may also exclude pre-existing conditions from the coverage. If you can see no mention of these terms, or you can see specific mention that risk to health is included, you may be able to put in a claim. The first step will be to get official confirmation from a doctor of your condition and the health risks posed.
Finding an Attorney
The whole process of ERISA disability plans, when claiming or appealing, can be made much easier with the right lawyer. You need to find someone you can trust, with a track record in the field and a record for success.
ERISA Attorneys is the home of Jonathan M. Feigenbaum, Esquire, who has helped clients with ERISA for 17 years. He can help you build a solid foundation for a case, defending your rights at all times. Time is of the essence, so click here to arrange a consultation and get the process started immediately.
