Your Personal Injury, Workers' Comp, Disability and Family Law Concerns Put to Rest
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Is there a set length that I can get benefits from my employer's plan?
That depends on the group policy's terms. Your policy may provide short or long term disability benefits, which determines how long you can get benefits for lost wages.
If my claim is denied by my employer's insurance company, do I appeal to the company or to the Department of Labor?
You'll want to file an appeal with the insurance carrier first. If you can provide them with specific examples of why their decision was unfair, they'll probably change their decision. An experienced attorney can negotiate with insurance companies on your behalf.
How long do I have to file a claim under ERISA?
You have 180 days to file a claim of denied or unfair employer insurance claims under ERISA. After an appeal is denied by the carrier, you can file a complaint under ERISA.
My boss won't provide me with copies of the booklets that outline the insurance policies that I am participating in. What can I do?
If you don't have a copy of your plan's policies or claims procedures, you have the right to request one from your employer or the plan administrator. Submit a written request for the documents. If your request is unfulfilled, you can file a complaint to the Department of Labor, the administration that enforces ERISA.
Are there entrance requirements for these plans?
Requirements to start investing in these plans change from workplace to workplace. However, the Department of Labor states that typical plans require an employee to be at least 21 years old and work for the company for a year.
My employer doesn't offer a disability benefits plan. Is this illegal?
No. ERISA only requires employers to follow certain rules once a disability plan is established. The act does not require employers to start a disability plan, however.
My disabled adult child cannot manage his/her benefits from the SSA. Can I manage them?
Yes. Beneficiaries can choose a representative payee to manage their benefits for them. You can apply to be a payee at the Social Security Administration's website.
Will trying to work stop my benefits?
Not right away. You can participate in trial work programs and continue receiving disability payments. You can work and earn an income over what is considered "substantial gainful activity" for nine months, not necessarily consecutive, within a five year period. Once you reach this limit, your benefits will stop.
When will my benefits stop?
Your benefits continue for the length of your disability, until you return to substantial gainful activity, or become disqualified in any other way. When you reach retirement age, your Social Security disability benefits continue, but are called "retirement benefits" instead.
Does my SSI/SSD approval entitle me to any other benefits?
Yes. If your application for Social Security Disability benefits is approved, you can get Medicare coverage to help offset the cost of your medical care. Supplemental Security Income recipients can get Medicaid and food stamps to help them pay for essential services.