Many employers offer benefits to their workers as part of their total compensation package. These employee benefits can take the form of disability insurance and retirement plans, including 401(k) plans and pensions. These benefits are often governed by ERISA, the Employee Retirement Income Security Act of 1974.
ERISA is intended to protect the interest of employees who are enrolled in employee benefit plans to make sure they receive the benefits they were promised. If you are an employee and have been denied benefits from an employer-sponsored plan, you may have a claim. It is important that you get timely legal advice about how to assert and preserve your claim to receive these benefits. If you file a hasty or incomplete appeal, you can lose your rights. Many pitfalls can trap the unsuspecting claimant and lead to the denial of legitimate benefits.
In most cases, if an ERISA claim is denied, an employee must follow the procedure for administrative appeals set out by the insurer or plan sponsor. Only those issues raised during administrative appeal are typically preserved. For example, if you are appealing the denial of disability benefits, you should submit your medical records that show you are disabled and opinions from your doctors that support your claim. You must also raise all issues underlying your claim for benefits. If you do not resolve your claim with the company, a court will consider only the issues you raised in the administrative process and the records contained in the administrative appeals. Getting advice early can help preserve important rights.
ERISA is a specialized area of law that not all lawyers practice. If you have an ERISA claim, you should find an attorney with experience in this field. We would be happy to meet with you to help you to better understand your options and to pursue your claim.
ERISA claims are typically filed in Federal Court. A judge will hold a bench trial or hearing based on the paperwork you presented in the administrative record. There is no jury trial. ERISA claimants cannot recover claims for emotional distress or punitive damages. In some cases, however, a court may award attorney’s’ fees to the claimant. The court can award only past benefits that have accrued, and cannot award benefits for future expenses.
In 2019, 6,619 ERISA cases were filed, down from a peak of 8,938 in 2010, according to a report that analyzed court filings uploaded to the federal Public Access to Court Electronic Records, or PACER, database. Last year, 3,797 workers sued over benefit claim denials, according to the report. In 2010, 3,118 people filed these suits. The overall amount of damages awarded in ERISA suits has also remained relatively consistent, though the number of cases in which damages are awarded has fallen. Last year, 740 cases resulted in damages awards (roughly 20 percent of claims), resulting in a total of $280 million being awarded. In 2017, $343 million went to claimants in 806 cases, and in 2016, $232 million went to 843.