Many people have long term disability benefits through their workplace, but it is only helpful if it actually insures what you think it insures. Over the next few weeks, we'll be discussing long term disability traps. A trap is a device that catches you unaware. These traps deal with time limits, the definition and location of the occupations which you are able or unable to perform, earnings qualifiers, and others.
The second trap is regarding the limitation of action provision. This trap can be found in the plan document.
The “limitation of action” provision basically means that there is a contractually agreed upon statute of limitations. The reason that provision is a trap is because many times when lawyers are evaluating ERISA claims or trying to figure out how long they have to file a lawsuit, they may fail to recognize that the state statute of limitations does not apply.
In some cases, the state statute of limitations can apply, but it does not apply if the plan document includes a “limitation of action” provision. Accordingly, this is an easy way for a lawyer to make a mistake.
The limitation of action provision can be very complicated to figure out.
- It could be that you have 30, 60, or 90 days after the last appeal denial to file a lawsuit to ask a court to review the claim and the decision made.
- It could be that you have to run several calculations in the document to determine the limitation of action provision.
- It could be that the limitation of action provision is three years after proof of loss was required to be furnished to the plan. In that case, you would then have to look at the proof of loss provision, and that may say you have 30 days or up to one year to furnish proof of loss. So, you'd have to put those time periods together to determine the limitation of action provision.
If you miss the deadline outlined in the limitation of action provision of the plan document, you could lose your case for reasons tantamount to failing to file a lawsuit within the statute of limitations.
If you or a client have been caught in this trap, you need the help of an experienced ERISA attorney. Whether you or your client needs advice before applying or appealing for ERISA benefits such as long term disability, short term disability, life insurance, pension, or retirement, contact an experienced ERISA disability attorney or long term disability lawyer at The Martin Law Group at 800-284-9309.
The information presented in this video should not be construed to be formal legal advice nor the formation of a lawyer/client relationship. Therefore, no information of any kind that you provide us before such a relationship is created is confidential or privileged.