Home » How Do Long Term Disability and ERISA Work in NJ?

How Do Long Term Disability and ERISA Work in NJ?

Navigating the intricacies of long-term disability and ERISA regulations in New Jersey can be a daunting process. Understanding the nuances of federal regulations, insurance policies, and individual rights can be a complex landscape for anyone.

Fortunately, working with our attorneys can make a huge difference when procuring the benefits you deserve. We can provide guidance on compliance, assist with disability claims and appeals, and represent you throughout the entire litigation process. Additionally, we can help clients understand their rights and obligations under the ERISA regulations, ensuring compliance with all federal laws. If a disability prevents you from working, options are available to help you through this difficult time.

For a free case review, contact our New Jersey disability lawyers at Young, Marr, Mallis & Deane today at (609) 755-3115.

How Does Long-Term Disability Work in New Jersey?

Long-term disability insurance is a type of coverage designed to provide a steady stream of income replacement to those unable to work because of a long-lasting disability. This type of insurance is typically obtained through an employer or purchased independently from an insurance company, unlike public disability programs.

In New Jersey, long-term disability benefits are generally paid until the claimant reaches retirement age, provided they continue to meet the disability criteria as stipulated by their specific policy. Our Trenton, NJ disability attorneys can help you determine if you are getting the benefits to which you are entitled. The length of these benefits underscores the term “long-term” in this context, which denotes an extended period of disability coverage.

Long-term disability income benefits coverage is obtained by paying premiums over time, either to an insurance company or into an employee plan. The cost of the premiums and the extent of coverage can vary widely based on several factors, including the individual’s occupation, income, age, and the specifics of the policy. Also, the premiums paid towards long-term disability insurance are typically tax-deductible, which can help offset the policy’s overall cost.

Generally, long-term disability policies provide a percentage of the policyholder’s pre-disability earnings if they are unable to engage in their “gainful” occupation because of a disability. A gainful occupation generally pays 60 to 80 percent of the individual’s pre-disability earnings. The specifics of what constitutes a “gainful occupation” might vary between policies and should be carefully reviewed before purchasing a policy.

In addition, long-term disability policies might also provide additional benefits, such as cost of living adjustments, survivor benefits, and rehabilitation benefits, among others. These additional benefits can help ensure that policyholders and their families are able to maintain their standard of living and financial stability in the event of a long-term disability.

How Does ERISA Work in New Jersey?

The Employee Retirement Income Security Act (ERISA) was enacted in 1974 to protect employee benefits by setting federal standards for employer-provided pension, retirement, and insurance plans. This law ensures that these plans meet certain minimum standards to protect the interests of the participants and their beneficiaries. ERISA is a federal law that applies to employee benefit plans offered by private employers and some government entities.

In New Jersey, ERISA covers a wide range of employee benefit plans, including both defined benefit and defined contribution retirement plans, as well as health insurance plans. However, it is important to note that ERISA does not mandate employers to establish a plan. Instead, it regulates the operation of a plan once it has been established.

For New Jersey businesses that offer employee benefit plans, ERISA compliance is crucial. Compliance means adhering to all the requirements outlined by the United States Department of Labor. These requirements include stipulations about plan disclosures, fiduciary responsibilities, and procedures for appealing denied benefits.

If an individual is denied benefits under an ERISA-covered plan in New Jersey, they have the right to file an ERISA claim. This process involves submitting a written appeal to the plan administrator. If the appeal is denied, the individual can then file a lawsuit in federal court.

However, self-funded ERISA plans are generally not subject to state insurance mandates because of a concept known as preemption. This means that these plans are primarily governed by federal law, with state laws playing a limited role.

How Our ERISA and Long-Term Disability Attorneys Can Help Your Case in New Jersey

Navigating ERISA and long-term disability claims in New Jersey can be complex and stressful. But you don’t have to go it alone. With our team on your side, you can have peace of mind knowing that your case is being handled by professionals who are committed to fighting for your rights and securing the benefits you deserve.

Personalized Attention and Support

Our firm strongly believes in delivering individualized attention to all our clients. We comprehend that each case is distinct and necessitates a customized approach. Our team of experts will dedicate ample time to comprehending your specific circumstances and requirements. We value transparency and will keep you informed and engaged throughout the process. We are committed to providing you with the best possible outcome.

We Protect Your Rights

Our attorneys have extensive knowledge and experience in ERISA and long-term disability law. We fully understand the complexity of these legal areas and are dedicated to advocating for your rights. You can rely on us to ensure that the insurance company treats you fairly and evaluates your claim in strict adherence to the legal guidelines. We will work tirelessly to secure the compensation and benefits you deserve and protect your best interests throughout the entire process.

Guidance Through the Claims Process

Our attorneys can provide expert guidance throughout the ERISA and long-term disability claims process. From understanding your plan’s specific provisions to preparing a comprehensive and persuasive claim application, our legal team can help maximize your chances of receiving the benefits you’re entitled to.

Ensure Deadlines and Procedures Are Followed

Strict deadlines and procedures govern the filing of ERISA and long-term disability claims. Missing a deadline or failing to comply with a procedural requirement can lead to the denial of your claim. Our attorneys can ensure that all necessary paperwork is filed correctly and promptly, thus avoiding unnecessary delays or denials.

Appeal a Claim Denial

If your ERISA or long-term disability claim is denied, it’s not the end of the road. Our attorneys can represent you in the appeal process, crafting a detailed and compelling appeal that addresses the reasons for the initial denial. If necessary, we can also represent you in litigation to fight for your rights to the benefits you deserve.