Long Term Disability Insurance / ERISA

The ERISA Maze: Navigating every twist and turn in your long-term disability claim

Are you suffering from a debilitating injury or illness that has sidelined your career and left you indefinitely unable to perform your job? If so, you may be eligible for long-term disability (LTD) insurance benefits. While you may buy a private LTD insurance policy, most workers obtain LTD insurance through group policies provided by their employers. These group policies are regulated by federal legislation known as the Employee Retirement Income Security Act of 1974, or ERISA. ERISA governs, among other things, the obligations of LTD insurance companies in the event that a serious disability or illness prevents an employee from doing his or her job for an extended period of time.

ERISA is very different from workers’ compensation. Workers’ compensation covers what happens if you are involved in an accident while you are on the job. In cases of workers’ compensation, most states will prescribe fixed amounts a worker should receive for a specific injury, usually based on what part of the body is injured. Partial disability in your leg, for instance, may earn you $400 a week for five years. Partial disability in your arm may earn you $400 a week for four years. Related medical bills and therapy for an on-the-job injury are usually covered by workers’ compensation as well. The compensatory figures for workers’ compensation are reviewed and updated annually, usually by a state-appointed commission. Click here for more information on District of Columbia and Maryland Workers’ Compensation Laws.

While LTD benefits include coverage for injuries or disabilities that are incurred on the job, LTD insurance was designed to protect employees in the event of a serious injury or illness that prevents them from returning to work. With LTD, the extent of disability, rather than the cause of the disability, is what is important. Disabilities sustained through auto collisions, slips and falls or other personal injuries may qualify an employee for ERISA long-term disability benefits. Crippling diseases such as multiple sclerosis, Parkinson’s disease, and other acquired or hereditary diseases affecting mobility, coordination, speech, hearing or the immune system also qualify workers for coverage under ERISA LTD benefits.