How do i file an erisa complaint

The Employee Benefits Security Administration EBSA is committed to educating and assisting the nearly million workers, retirees and their families covered by approximately , private retirement plans, 2. EBSA balances proactive enforcement with compliance assistance and works diligently to provide quality assistance to plan participants and beneficiaries. It is the policy of EBSA to provide the highest quality of service to its customers.

EBSA's goal in providing direct assistance is to raise the knowledge level of plan participants and beneficiaries, plan sponsors, service providers and other interested parties and to ensure that they have access to available plan documents filed with the Department of Labor.

This enables participants to better understand and exercise their rights under the law and, when possible, to recover any benefits to which they may be entitled. This also allows plan administrators and practitioners the opportunity to better understand and comply with the law. You will always receive straightforward information on how the law applies to your circumstances, information about options that may be available, respect for your privacy and the name of the EBSA employee assisting you.

Individualized participant assistance is offered by Benefits Advisors in our national and field offices. When you write, call, communicate with us electronically, or visit our offices in search of assistance, you will receive information that will inform you of your rights and responsibilities and help you in obtaining benefits to which you are entitled.

We are available to explain how the relevant statutes EBSA enforces apply to you and, in appropriate cases, the Agency will make inquiries on your behalf and seek resolution of disputes. Such resolution will be informal and generally will not include litigation on your behalf or provision of legal advice. We will be vigilant in identifying and acting upon patterns of complaints.

Those who file complaints with us can expect a prompt and courteous response from our staff. Every complaint received will be pursued and, if determined to be valid, resolution will be sought through informal dispute resolution. You can expect to receive a status report from the assigned benefits advisor every 30 days. If your valid complaint cannot be resolved informally, it may be referred for further review by our enforcement staff.

While we cannot ensure that every complaint will result in an investigation, at the conclusion of enforcement activity, if requested, we will furnish an understandable explanation of the outcome of our review and investigation. When you write, call or communicate with us electronically for assistance or with a complaint, we need certain information to help you.

It would be helpful to have this information available when you telephone. If you write us, you should include this information in your correspondence or email:. For technical assistance and complaints, you should call EBSA's toll free number at The claim will be reviewed by the insurance company or designated benefits personnel.

Depending on the nature of the claim, there are deadlines imposed by the U. Department of Labor for rendering a claim decision. If a claim denial is issued, claimants are usually obligated to submit an appeal with the benefit plan administrator as a precondition to challenging the denial in court. Appeal deadlines in such matters can be as short as three days.

ERISA claim appeals can be very complex. The U. An experienced and knowledgeable attorney will know how to handle the appeal by gathering the necessary additional evidence that may be required and to present a winning argument to overturn an unjustified denial.

Another reason to get an attorney involved early in the appeal process is that if the appeal is unsuccessful, a court may not consider new evidence, so the failure to get an attorney involved until after an appeal is denied could prove to be fatal to recovering benefits later. Deadlines for appeals are critical. Submitting an appeal even one day late could result in a loss of benefits that cannot later be challenged in court. Once the appeal is submitted, the claim decision can generally take up to 90 days.

For disability claims, if the insurer or benefit administrator obtains evidence during the appeal that is adverse to the claimant, that evidence must be shared and the claimant given an opportunity to comment before the appeal decision is rendered. If the appeal is denied, the next step is to bring a lawsuit. As mentioned above, there may also not be an opportunity to submit new or additional evidence in court. Once the appeal is completed, most court render a verdict based exclusively on the record assembled during the course of the claim and ensuing appeal.

With tolling, an insurer may claim it can take longer than 90 days to issue a decision. Unfortunately, all the disability insurance company has to do is send you a letter in order to get their automatic extension. Having experienced ERISA counsel will help keep the insurer on track with required deadlines and put you in a position to promptly file a lawsuit to enforce your rights if a timely decision is not made.

If you have not already contacted an ERISA lawyer, then you should do so immediately before losing your chance to collect disability benefits. Some deadlines for lawsuits may be as short as 60 days, so act immediately after getting a denial.

It is important to know that ERISA disability claimants are not allowed to seek bad faith damages or pain and suffering. The law only allows you to claim the disability benefits that were owed, attorney fees, and costs when you have employer-sponsored insurance benefits covered by ERISA.

When filing a lawsuit, the federal court will only review the evidence submitted by you or your attorney during the initial claim and the pre-lawsuit appeal.

These cases are almost always decided on written motions and briefs, with the federal judge reviewing your claim file without a trial. In an ERISA case, you and your doctors will never be allowed to testify in court, so getting all of the necessary information and expert opinions into the claim file during the initial claim and appeal is a must.

This further explains why it is crucial to have an experienced ERISA attorney on your side throughout each phase of your disability insurance appeal.

Your ERISA lawyer will have your best interests in mind when representing you during the disability appeals and lawsuit process. Without an attorney, you may be unable to collect disability benefits that you need and deserve. Click to learn more about the services we offer in your state. Do you need short term or long term disability insurance benefits? Your attorney will be able to help you every step of the way, from filing the initial claim to filing a lawsuit.

We look forward to helping you receive the benefits you deserve. This website is designed for general information only.