As a city, county, state or federal employee you are considered a public employee. Public employees enjoy many benefits, including participation in a government sponsored retirement pension plan, but there is one other great benefit you may not be aware of. Your long term disability insurance claim is exempt from the Employee Retirement Income Security Act (ERISA) which governs employee benefit plans. ERISA is an arcane federal law which is complicated and ambiguous and affords less protection to employees than Congress intended when it passed the act in 1974. Under ERISA, the deck is stacked against the employee when filing for long term disability insurance benefits. Therefore, as a public employee your long term disability insurance claim is considered non-ERISA.
As a non-ERISA claim, your claim is treated similarly to that of an individual who went out into the open market and purchased a private long term disability insurance policy. This is important because your legal rights are affected for the better since you are afforded more favorable consumer protection laws. If you should become disabled due to sickness or injury and are unable to perform the material and substantial duties of your occupation, you can file for long term disability benefits. If your claim is denied, you are entitled to bring suit for breach of contract in state court, have a jury trial, bring new and additional evidence into trial, recover attorney's fees, and sue for bad faith and punitive damages.
In essence, the difference between having your claim handled under non-ERISA vs. ERISA provisions can mean the difference between having your long term disability insurance benefits granted or denied. As a public employee in the local, state or federal government, you have this added benefit.
The Law Firm of J.P. Gonzalez-Sirgo, P.A. represents individuals that have had their valid long term disability benefits denied, delayed or terminated irrespective of whether the policy was purchased individually or issued through an employer group policy. The firm is available to assist individuals with the initial application process, during the administrative appeals process, handling denials of claims or termination of benefits, litigation in state or federal court, and negotiating a one-time lump sum settlement or buy-out. Please contact our office to discuss your case in more detail.