Private vs. Employer Long Term Disability Claims: What's The Difference?
If you've ever wondered what the difference between individual long term disability / self employed disability claim and an ERISA (Employment Retirement Income Security Act) disability insurance claim, you're not alone.
Long term disability lawyers say that there are many differences between the two. Here's a look at each:
Individual long term disability insurance claim or a self employed disability claim:
- Cases are generally heard in state court under legal rules and procedures that are more favorable to the long term disability policyholder;
- Bad faith and punitive damage claims may be available;
- Lawsuits are decided by a jury instead of a federal judge;
- Many forms of damages are available;
- Witnesses can be brought in to support the claim and the policyholder may introduce evidence from the existing administrative record.
ERISA disability insurance claim:
- Claimants are not entitled to a jury trial;
- Judges decide the matter and generally rule by way of summary judgment;
- Awards for attorneys' fees are difficult to obtain;
- No bad faith or punitive damage claims are allowed;
- Damages may be limited to payment of past due amounts or interest.
Filing a long term disability claim
Regardless of whether you have an individual long term disability claim or an ERISA disability insurance claim, there are generally three questions to ask when you file a disability claim according to long term disability lawyers:
- What is the disease or injury that disabled you?
- How does that disease or injury result in restrictions and limitations in your ability to work? Legal experts say that those are magic words - restrictions and limitations - things you can't do and things you shouldn't do because of your medical condition.
- How do those restrictions and limitations translate into you being unable to do your job? For example, you may have a restriction or limitation that prevents you from raising your arm, but if you have a sedentary job which doesn't require you to raise your arm, then you may not be disabled from your job.
