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Greg Prosmushkin

Employer Sponsored Disability Claims Philadelphia Lawyer

Many workers have private disability coverage through their employment. There are generally two types of disability insurance: Short-Term Insurance and Long-Term Insurance. Short-term coverage typically provides coverage for a portion of your salary of up to six months. Long term coverage kicks in after the short term coverage expires, and a person may be eligible to receive long-term benefits for the duration of his or her disability through retirement.

Most employer-sponsored Disability Plans are governed by a complex regulatory statute called the Employee Retirement Income Security Act, or ERISA. The ERISA is a comprehensive and complicated series of laws originally enacted by Congress to protect employees’ rights to their benefits. However, this is no longer the case. It is widely accepted that ERISA protects and favors insurers, rather than disabled claimants. The insurance policies are often complicated. The law interpreting these policies can be even more complicated. ERISA also provides for strict administrative guidelines. If a claim is denied, a claimant is given a hard deadline to submit an administrative appeal. Once the claimant exhausts his or her appeal, the only remedy is to file a lawsuit in federal court.

ERISA litigation is unique. A Disabled Claimant in federal court does not have the right to a jury trial. A disabled claimant in federal court will very likely never meet the federal judge who will make a decision on his or her claim. Most importantly, a disabled claimant in federal court does not have the opportunity to submit any additional medical records beyond what was sent to the insurance company at the appeal stage. Most often, to be successful in federal court, the claimant has to establish that the insurance company unreasonably denied his or her claim.

Due to its complexities and nuances, ERISA is a very specialized area of the law. Insurance companies are well aware that the law tilts in their favor, and often they have a team of specialists (i.e., adjuster, appeals specialist, insurance nurse, insurance physician, peer review physician, IME physician, private investigator, etc.) who work together in a concerted effort to deny legitimate claim.

Philadelphia Lawyer for Employer Sponsored Disability Claims

We specialize in leveling the playing field, and successfully handling all stages of ERISA claims from the application level to federal court. We also have successfully negotiated hundreds of buyouts (i.e., settlements) of ongoing claims. It is often in your best interest, however, to engage a specialized ERISA disability lawyer at the earliest stage of the disability process. It is never too early to consult with an ERISA disability lawyer when faced with the prospects of dealing with an insurance company.

We have successfully handled over one thousand disability claims at the following levels:

  • Claim Application
  • Claim Appeal
  • Claim Buyout
  • Federal Litigation

In addition to handling private disability claims, we also specialize in handling Social Security Disability Income (SSDI) claims. Most ERISA disability policies require a disabled claim to apply for SSDI benefits. Despite what an insurer may imply, a claimant can choose any SSDI advocate, not only the one hand-picked by the insurer. The best way to fight for the social security benefits you deserve is to have a Social Security Disability Attorney on your side who you can be assured will not be working for the insurance company, but instead fighting for your best interests.

This content was written on behalf of Greg Prosmushkin.