Filing an ERISA Disability Lawsuit in Virginia

ERISA is the federal law that governs most employer-sponsored disability benefits plans, as well as other types of employee benefit plans. When you file a claim for disability benefits under your employer’s plan, you are not automatically entitled to those benefits.

Rather, the plan may determine that you are not entitled to the disability benefits that you are claiming for one reason or another. In this case, you should look into filing an ERISA disability lawsuit in Virginia.

Defining ERISA Denial of Disability Benefits Claims

ERISA § 502(a)(1)(B) allows plan participants and beneficiaries to file suit against plans, and in some cases, their administrators, for the denial of benefits available under the plan.

Although ERISA does not require or guarantee the payment of certain benefits to plan participants, it does mandate that administrators follow the terms of the plan and provides an enforcement mechanism when administrators fail to do so.

Likewise, ERISA § 503 requires plan administrators to follow the procedural rules for the administration of benefits as set forth by the plan, and allows plan participants to enforce those rules if administrators fail to follow them.

In the context of long-term disability benefits, plan participants may file claims for benefits in accordance with the terms of their plans if they become disabled and unable to work. When the plan denies those disability benefits, plan participants may file an ERISA disability lawsuit in Virginia after they have exhausted all of their administrative remedies as outlined in the plan.

Elements in an ERISA Disability Lawsuit

In order to sustain a successful claim for the denial of disability benefits by an ERISA-governed plan pursuant to § 502(a)(1)(B), individuals must prove the following elements:

  • They made a proper claim for disability benefits under the plan.
  • They exhausted the plan’s administrative appeals process prior to filing a lawsuit regarding the denial of benefits.
  • They are entitled to the disability benefits under the terms of the plan.
  • The plan wrongfully denied them the disability benefits to which they were entitled.

Individuals must meet similar requirements in bringing claims under § 503. The difference with these claims is that they must allege that the plan failed to substantially failed to comply with one or more procedural requirements for determining entitlement to benefits as set forth by the plan and § 503.

These claims might allege that the plan administrator failed to properly review the claim pursuant to the plan’s procedural guidelines, that the plan administrator failed to provide a specific reason for the denial of disability benefits, or that the notice of denial is unclear or does not provide a clear statement of the reasons for the denial.

Recovery of Damages in ERISA Disability Lawsuits

The typical relief sought in a § 502 action for the denial of ERISA disability benefits is the payment of benefits that the individuals were denied by the plan. However, they also may seek an award of attorney’s fees, as well as equitable relief, if applicable in a particular case.

In a § 503 action, individuals more often seek an order in which the court remands their claim for benefits to the plan administrator for an appropriate and proper review that follows all applicable plan procedures.

Consult an ERISA Disability Attorney for Assistance

Filing an ERISA disability lawsuit in Virginia can be a complicated endeavor. Prior to filing this lawsuit, the law requires that you exhaust all administrative remedies under the plan.

An ERISA disability claims attorney may be able to assist you not only in filing the lawsuit, but also in building a successful claim for disability benefits at the administrative stages of appeal from the denial of benefits.