The Firm handles claims for short term disability benefits under employer provided disability plans and programs in the Chicago area and in the rest of Illinois. Employer provided short term disability plans may or may not be governed by ERISA, often depending on the method of funding. Whether or not the plan is covered by ERISA dramatically alters the process by which you claim the benefits and appeal any denial. Under ERISA, the plan adhere to complex regulations regarding the claim and appeal process, dictating how the plan notifies you of a claim denial, strict time frames in which the plan must issue that notification, and how long you have to administratively appeal such a denial before your right to litigate the claim has been forfeited.
Many claims for short term disability will eventually lead to reviews of claims for benefits under a long term disability plan. Often employers self fund short term disability benefits, but utilize the insurer from whom it purchases long term disability insurance to review claims for short term disability. This can result in two recurring problems. The insurer may readily approve your claim for short term disability, while the employer is paying the benefit, and then turn around and deny your claim for long term disability benefits, which are paid by the insurer. Alternatively, the insurer may recognize your claim as one likely to lead to long term disability and promptly deny it at the short term disability stage. Either one often has a single objective in mind: to avoid paying you long term disability.
Increasingly, employers have been inserting forum selection clauses in these disability plans, which purport to require any lawsuit you file against the plan for the disability benefits be filed in one particular judicial district, most often someplace far from where you live. Many courts have held these restrictions enforceable, employing a contract law analysis. But recently, Michael Bartolic persuaded a court in Chicago that under ERISA, these clauses are not enforceable. Coleman v. Supervalu, Inc. Short Term Disability Program, 920 F. Supp. 2d 901 (N.D. Ill. 2013). When your claim is denied, do not waste any time in contacting us.
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