ERISA Disability Application Process in Washington DC

The idea of not being able to work and provide for your needs on a regular basis strikes fear into the hearts of most Americans. Unfortunately, a significant number of employees will find themselves unable to perform the duties associated with their occupation due to an illness or injury.

If this has happened to you and you currently receive disability insurance benefits through your employer, you are probably covered by ERISA laws. This means you have fair access to the coverage you have received from your employer.

If you believe you may be disabled, keep reading to learn about the ERISA disability application process in Washington DC.

Who is Considered Disabled?

Even with ERISA in effect, the definition of disability can still vary from insurer to insurer. For some insurers, a person is considered disabled if they are unable to perform the tasks associated with the occupation they work in.

Other insurers take a stricter approach, however, and defined disabled as not being able to perform the tasks associated with any occupation. Most insurers use the first definition, and some disabled employees will be able to obtain benefits while working full or part-time at another occupation.

For this reason, it is highly important for a person to understand the all the disability requirements outlined by their insurance company before they start the application process, which can be confusing and difficult. Most of these requirements can be found in the summary benefits packet provided by insurers.

Disability Application Process

The ERISA disability application process in Washington DC officially begins while a person is still at work. Most insurers require a person to take the following steps to apply for disability benefits:

  • Wait for a certain period of time. For most insurance companies, this waiting period consists of three to six months. Prior to this period, some insurers may require a person to use all of their sick days first.
  • After the waiting period ends, a person can officially begin the application process. This will involve completing numerous forms and submitting documentation from a medical professional.
  • Once all the forms are complete and evidence is submitted, the insurer will decide whether the claimant deserves benefits.

The medical documentation a person provides along with their claim is extremely important. If the claim of a disabled employee is approved, they may need to continue submitting medical documentation if they wish to receive benefits.

What is ERISA?

ERISA, officially known as the Employment Retirement Income Security Act, was enacted in the 1970s to provide employees with a myriad of income and employer-provided benefit protection.

The Act covers any employee who receives employer-sponsored benefits, such as health insurance, retirement, and of course, disability insurance. It requires employers and insurers to provide policyholders with information about their disability benefits.

If the disability claim (long or short-term) of an employee is denied, ERISA allows them to file an appeal. If they do not agree with the decision of the appeal, the Act allows them to take the insurer to court with the help of an attorney. The insurer must also provide employees with detailed instructions for filing an appeal.

Talk to an Attorney Who Understands the ERISA Disability Application Process in Washington DC

If you do not understand the disability claims process, or you believe your previous claim was unfairly denied, an attorney may be able to provide you with assistance. A skilled attorney may be able to help you better understand your benefits, and fight for you in court if they are denied. Talk to an attorney who understands ERISA disability application process in Washington DC today.