When people think of disability insurance, they often think of accidents. In truth, illness and ailments are the leading causes of short and long-term disability claims. Fewer than 10 percent of disability cases are the result of an accident. Diseases, especially cancer, frequently cause employee to miss work and file for disability cover for their daily expenses. As many as one in four workers will become disabled at some point in their career.
Should Your HSA Be Subject To ERISA?
Health savings accounts are growing in popularity. Most health savings accounts (HSA) are not subject to ERISA, the Employee Retirement Income Security Act of 1974. This federal law established protections for participants in certain health and retirement plans, such as a 401(k). However, without careful planning, your employer may subject your HSA to ERISA.
By subjecting the HSA to ERISA, the employer assumes a fiduciary duty and is required to comply with certain administrative and filing requirements as well as following the Department of Labor claims procedures. Here are recommendations that employers follow in order to avoid falling under ERISA requirements.
Church-affiliated hospitals exempt from ERISA
A recent ruling from the U.S. Supreme Court is a major victory for all church-affiliated hospitals. The justices ruled 8-0 that such organizations are exempt from the Employee Retirement Income Security Act (ERISA), a law which is aimed at protecting pension plan participants.
The lawsuit stemmed from an employee suit which alleged certain church-affiliated health systems had wrongly claimed a religious exemption. Federal agencies had historically interpreted the law as exempting church plans as well as church-affiliated organizations such as hospitals, but these lawsuits challenged that interpretation and application.
Fighting accidental death and dismemberment claim denials
A common employer-provided benefit is accidental death and dismemberment (AD&D) insurance. This is similar to life insurance in that the policy will pay out a sum of benefits in the event of an accidental death or an accident that costs someone their sight, hearing, speech or a limb. It can also cover paralysis.
Unfortunately, just like any other employer-provided insurance, insurance companies often find creative ways to dispute and deny claims. If you are grieving the loss of a loved one or your spouse is suffering from a serious injury, AD&D benefits are critical in dealing with the serious financial consequences of the accident.
Look out for limitations on mental health disability benefits
No one has to tell you how difficult it can be to do your job every day when dealing with the effects of a mental illness. Unfortunately, a stigma seems to persist by people who think they need to see physical signs of an illness or disability to believe that it is "serious."
Additionally, if you are eligible for short- or long-term disability benefits through a work-provided plan, the insurance companies may also see mental illness as not as serious as a physical ailment. Many people receiving private disability benefits are shocked to find their carrier limits benefits for mental illness to either 12 or 24 months.
An introduction to ERISA
If you work in the private industry and have a pension plan, you have probably heard of ERISA. Despite its importance for workers and employers, many people do not become familiar with it until a less than ideal situation forces them to learn about it. Fortunately, there are resources that can be used to inform yourself before any unfortunate circumstances forces you to do so.
The Employee Retirement Income Security Act
According to The United States Department of Labor, The Employee Retirement Income Security Act (ERISA) is "a federal law that sets minimum standards for most voluntarily established pension and health plans in private industry to provide protection for individuals in these plans." It was signed into law in 1974 by President Gerald Ford in response to a many private industry employees not being given the pensions they were led to believe they would receive.
Your health insurance claim was denied. Now what?
No one really wants to purchase health insurance or accidental death and dismemberment coverage, whether at work or on the individual market. You buy it because it will provide the protection you need when you or a loved one need it.
Unfortunately, your insurer is more likely to see you as a profit driver rather than someone who is buying a product to avoid accumulating a disastrous amount of debt if a medical emergency occurs.
Navigating through short-term and long-term disability claims
Many individuals with employer-sponsored ERISA plans have questions when facing the possibility of filing a disability claim. What is the difference between short-term disability and long-term disability insurance? How long do benefits last for? And, most importantly, what should someone do if their claim is denied?
At Willeford & Toledano, we represent those who have had their short-term or long-term disability claims denied. While we are known for our focus in working with those who have plans covered by the Employee Retirement Income Security Act, more commonly known as ERISA, we also represent those with non-ERISA plans. In this post, we will focus on the basics of disability claims.
Unable to work: The painful reality for some living with IBS
There is having an upset stomach -- occasionally -- and living with ongoing stomach and digestive issues that seem to just not want to quit. The two are quite different. While it is normal for a person to experience gastrointestinal discomfort from time to time, it is quite another to be living your life day-to-day in pain. In some cases, the pain can be so severe that holding down a job may even be impossible.
Irritable Bowel Syndrome, IBS, is one of such painful functional gastrointestinal disorders. Symptoms typically include abdominal pain, diarrhea or constipation -- or alternating bouts of both -- and a tight, bloated feeling. Many also report difficulties with sleep, which translates into lethargy and fatigue during the day. While for some, IBS can be managed through diet and lifestyle, others are simply unable to find relief.
Appealing denied disability benefits for oil field workers
While all workers throughout Louisiana can be hurt on the job, given the very nature of the work, those in the oil and gas field industry are in a unique spot when it comes to job risks. It's important for workers to not only understand these risks, but to also know where to turn for help after an injury results in the need for disability benefits.
Willeford & Toledano is a law firm based out of New Orleans. However, we are not bound to our office location and serve those who are entitled to receive disability benefits. Our focus is helping those who have had their disability benefits covered by ERISA denied. We also handle cases involving accidental death and dismemberment claim denials.
