The Employee Retirement Income Security Act (ERISA) is a federal law that governs most employer-sponsored plans, including long-term disability, health insurance, pensions, and other retirement plans. Although ERISA was designed to protect employees, figuring out its complex regulations can be overwhelming, especially when you’re already concerned with your benefits being wrongfully denied or delayed.
That’s where an ERISA attorney comes in! As legal professionals, we are well-versed in the specific processes, deadlines, and documentation required to pursue ERISA claims effectively. Without the help of an experienced ERISA attorney, it’s easy for you as a plaintiff to make costly mistakes that jeopardize your right to the benefits you’ve worked hard for.
If you’re wondering if you need an ERISA attorney, the answer can depend on your specific situation. In this month’s article, we’re discussing five of the most common and compelling reasons to seek out and hire an ERISA lawyer to help fight your case. Keep reading to see what they are!
Key Takeaways
- ERISA attorneys help protect your employee benefits if your disability, retirement, or healthcare claim is delayed or denied.
- Filing an ERISA appeal without help from an ERISA attorney could ruin your chances of winning your case if it goes to litigation.
- An ERISA lawyer can help you uncover and prove fiduciary misconduct by your employer or plan administrator.
1. Was Your Benefits Claim Denied?
One of the most common reasons people hire an ERISA attorney is that the plan administrator denied their disability, life insurance, or health benefits claim. Even though this can feel like a dead end, it’s actually just the beginning of a long process. Under ERISA, you can appeal a denied claim, but there’s a catch.
The administrative appeal process can be rigid, giving plaintiffs just one chance to get it right. If you don’t include the proper evidence, miss a deadline, or fail to follow the plan’s procedures, your appeal could be thrown out entirely. And plans aren’t written in layman’s terms, so they’re hard to understand, on top of having no flexibility. In fact, insurers often rely on vague policy language or alleged pre-existing conditions to deny claims. However, a skilled ERISA lawyer knows how to challenge the reasons given for denial and gather the necessary medical or vocational evidence to strengthen your appeal.
Like we said, a denial isn’t the end. It’s just your sign that you need an expert who knows how to fight back.
2. Are You Filing an Administrative Appeal?
Even if your claim has not been denied yet, hiring an attorney with experience in ERISA law during the appeals process can drastically improve your chances of a successful outcome. Under normal circumstances, once you submit your appeal, you can’t add new evidence later in court, so what you submit during this stage is of the utmost importance.
An experienced ERISA lawyer will know exactly what a judge is going to look for if your case goes to litigation. We can help you build a comprehensive administrative record, collect expert opinions, and draft persuasive arguments based on ERISA regulations. Think of the appeal stage as your legal foundation. An expertly crafted appeal by an ERISA attorney can be the difference between approval and further delay of much-needed resources.
3. Are There Fiduciary Breach Red Flags?
Suppose your employer or plan administrator is abusing plan funds, showing favoritism towards other employees, or failing to act in your best interest. In that case, you may be dealing with a fiduciary breach. They are legally required to manage your plan prudently and do right by you. Yet, sometimes they cut corners by lying or failing to disclose important plan details.
As ERISA attorneys, Sinclair Law Firm can investigate whether fiduciary duties were breached nd pursue legal remedies on your behalf. These breaches can result in significant losses, not just to you, but to the plan as a whole.
Fiduciary misconduct can be subtle but still devastating, and an ERISA lawyer can help reveal misconduct (if any), protect your interests, and potentially hold your employer accountable.
4. Are You Facing a Complex Disability Claim?
Disability claims under ERISA can be especially taxing on you as a plaintiff. Insurance companies are known to delay, underpay, or deny valid disability claims flat-out by using vague plan language and narrow definitions to avoid having to pay out.
As ERISA lawyers, we understand these tactics and can see them coming from a mile away. More importantly, we know how to gain the advantage. We’ll communicate directly with the insurer, gather the necessary documentation, and ensure your claim meets the plan’s requirements. If your condition makes it difficult to manage your claim on your own, hiring an Alabama ERISA attorney can take the pressure off and increase your chances of approval.
When your livelihood is on the line, expert legal support becomes a necessity.
5. Are You Preparing for Litigation?
Sometimes, even the best-prepared appeals are denied. However, an ERISA attorney will have ensured your appeal includes every piece of evidence and argument needed to hold up in court later. Without a strong appeal foundation, a strong case doesn’t really stand a chance. It’s worth noting that litigation under ERISA is governed by strict rules, limited evidence, and extremely specific procedures, even more so than standard personal injury cases.
At Sinclair Law Firm, our team knows what it takes to prepare a compelling legal argument and stand up to insurance companies and employers who don’t play fair. Increase your chances of success when filing a lawsuit by hiring a specialized advocate.
Protect Your Benefits with an ERISA Attorney from Sinclair Law Firm
You don’t have to face the system alone when your benefits are denied, delayed, or mishandled. Our ERISA attorneys at Sinclair Law Firm have the expertise, tenacity, and compassion to help you win back what’s rightfully yours.
We understand how personal these cases can get, and we treat them and you with the respect you deserve. Our team is ready to evaluate your case, explain your legal options, and advocate for you at every turn. Contact us today to schedule your free consultation with a knowledgeable Alabama ERISA attorney.