For workers in Washington, D.C. and across the country, employee benefits can be a critical part of their compensation and their preparation for the future. The Employee Retirement Income Security Act (ERISA) aims to protect workers' pensions, insurance plans and other benefits from being squandered. However, the procedures for filing ERISA benefits claims can be complex.
In one case before the U.S. Court of Appeals for the Fifth Circuit, some complex issues related to ERISA claims were raised. These claims can also be brought by workers who are denied benefits by an insurance plan provided through the workplace, as in the case considered. A former employee of Turner Industries sued the company as well as the insurer, Prudential, for denying his claim for long-term disability benefits. He also challenged the insurer's demand for repayment of short-term disability benefits it provided. Much of the case hinged on the proper section of the law under which an employee can bring a claim. While one section of ERISA covers benefits claims, another addresses other breaches of fiduciary duty.
The court said that benefits claims like this one appropriately should be considered as part of the former section of the law, even though they addressed claims procedures. It dismissed the worker's claims for being filed under the wrong section. However, the court did uphold the worker's right to challenge the insurance company for interfering with his ERISA rights and not only his employer, a claim which was earlier dismissed by a lower court.
When people are denied benefits that they have paid into or relied on throughout their working lives, the financial and emotional impact can be significant. Workers facing unfair benefit denials or mismanagement of employer programs can consult with an ERISA benefits attorney. An experienced lawyer might be able to help them file a claim to protect their rights and recoup costs.