Attorney David G. Schiller represents North Carolina employees in a wide range of employment law cases — including the Employee Retirement Income Security Act (“ERISA”).
ERISA is a federal law that governs private disability insurance policies or “ERISA Plans.”
The complete text of the Employee Retirement Income Security Act is available in the Library section of the law firm website.
Many employees do not consult an attorney until they have completed the insurance company’s appeal process. This can be a big mistake! These next few paragraphs explain the insurance company’s appeal process and illustrates why having an experienced ERISA attorney assisting in this process can be very helpful.
In ERISA cases, the employee is required to provide documentation (primarily medical records) to the insurance company to establish whether or not the employee is disabled under the definition of the insurance company’s disability Plan. The Plan Administrator reviews the employee’s documentation and makes a determination as to whether or not the employee is disabled under the definition of the Plan.
The compilation of documents in the company’s appeal process is called “the Record.”
When the Plan Administrator finishes the appeal process, the Record is closed, and the Insurance Company informs the employee of the Plan Administrator’s decision. If the insurance company rules against the employee, ERISA gives the employee the right to file a case in federal court.
ERISA does not give the employee the right to jury trial. Instead, the federal court makes a ruling based on the evidence in the Record.
An attorney who regularly handles ERISA claims will understand how to build the best Record for the federal judge. Therefore, it is extremely helpful to have an experienced ERISA attorney assist the employee throughout the administrative review process in presenting the medical evidence to the Plan Administrator.
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You are welcome to contact us regarding your ERISA issue.
We can be contacted by telephone at (919) 789-4677 or by completing the email form below.