ERISA has one of the broadest pre-emption clauses of any Federal statute. This means that any state law seeking to regulate an employee benefit plan is likely, with very narrow exceptions, to be pushed aside by the federal statute which governs employee benefit plans, the Employee Retirement Security Act of 1974 “ERISA.” In Gobeille v Liberty Mutual Insurance Company, the United States Supreme Court held that ERISA pre-empts a Vermont statute requiring health care services to report certain information to a state agency for inclusion in a state database. The Court held that the U.S. Department of Labor has the
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HOOPS AND HELP
Navigating through the process of private disability insurance can be disconcerting. The constant barrage of requests from the insurance company and steps you must complete can seem daunting. It may seem like the insurance company is always making you jump through hoops. This is part of a process which makes many abandon their disability benefits claims. If you are in your initial application phase, do the best you can to keep up with the demands for information from your claim administrator. Most disability insurance policies contain cooperation clauses which require claimants to assist the administrator in gathering information. If you
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OVERCOMING THE WORDS
Some people may not want to pursue their disability insurance claim because of the terminology. “I don’t want to be considered disabled. I worked hard all my life and I don’t like the stigma that comes with the word ‘disability’.” Keep in mind that policies typically specify a length of time that qualifies as “long-term disability“. The definition of “long-term disability” is usually different than that of social security, so don’t get hung up on the language. Seeking long-term disability benefits from a private insurance policy doesn’t mean you will never be able to return to work; however, obtaining benefits
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WHEN IS A WIN A WIN FOR ERISA ATTORNEYS’ FEES?
How a Remand Can Affect Your Attorney Fees An ERISA judge can remand (or send back) a case to the insurance company for further review. In Hardt v. Reliance Standard Life Ins. Co., 560 U. S. 242, 251 (2010), the United States Supreme Court unanimously held that an ERISA claimant need not be a prevailing party in order to qualify for attorney’s fees under ERISA. Instead, the Court in Hardt held that it was sufficient for the ERISA claimant to obtain “some success on the merits,” with the effect that obtaining an administrative remand rather than an award of benefits
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WHAT HAPPENS TO THAT PAST-DUE SOCIAL SECURITY DISABILITY CHECK?
In Montanile v. Board of Trustees of National Elevator Industry Health Benefit Plan, __ U.S. __, 136 S.Ct. 651 (2016), the United States Supreme Court recently held that ERISA does not permit an ERISA plan administrator to recover reimbursement in equity from a plan participant’s general assets and that strict equitable tracing requirements apply to equitable actions seeking reimbursement. This strongly suggests that disability insurers seeking recovery of social security disability overpayments cannot enforce such actions against a participant’s general assets and would encounter considerable difficulty enforcing equitable relief against the dissipated proceeds of a social security disability award. Legal
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Don’t Weather The Storm Alone
As Tropical Storm Colin moves in on Florida, it makes one think of how life can be while dealing with a disability and the insurance companies. Everything can be going fine one day, and then suddenly the rain is pouring, the winds are blowing, and everything seems dark and grey. Local agencies in our area offer sandbags and resources to help with the issues our communities face. If you need help weathering the storm with a disability insurance claim, Cremeens Law Group PLLC can help. Don’t go it alone.
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