ESTRA Seattle Official Car Accident Blog: Why ERISA Hurts Employees

Will you be the next victim of an ERISA denial by Employer?

Seattle (ESTRA) - Congress approved ERISA Legislation which provides unfair advantages for Corporations. In fact, there is no recourse in the law which provides compensation for Employers holding back benefits just because they can. Most Employees are a single paycheck away from losing everything. Unfair legislation such as this encourage taking advantage of workers instead of treating them with respect and dignity.

Imagine, being in an enjoyable job which for most people today is rare, unfortunately. Most disabled who are able to return to work realize it is a privilege to get up each day and perform daily living activities, including work. In my opinion, for most, the joy this bring is unimaginable unless you’ve lost the ability to function on some level, and must deal with such restrictions. The saying, “you don’t miss the water until the well runs dry”, is applicable in this case. And, a worst experience from my perspective, is the use of ERISA legislation, power, and influence as an excuse to deny a long-term disability claims by employers whom received the faith and trust of employees, putting life goals and career aspirations in their hands for eight hours per day, and giving them your best work. Ouch! The betrayal may be worse than the injury, for most workers. Workers like family, really?

Even with corporate wealth are unfair denials.

But the true problems lay with U.S. Congress, both the House and the Senate. They are responsible for this written legislation which self-insured corporations follow. Perceptively speaking, employer and insurance company lobbyist, have left gapping wholes in the lives of the injured by allowing these organizations free reign to do as they please regarding these claims. By giving employers power to deny employee benefit claims without any repercussions, allows their investors to profit off the suffering of past employees.

Why would Congress write into legislation no options for employees to be compensated for losses incurred for breached ‘bad faith’ decisions by private corporations? It’s like telling them it is ok to deny disabled their benefits. Although comments made by individuals describing these ‘bad faith’ behaviors by private companies are posted over and over again via internet, and buried by individuals or corporation who would prefer their conduct remain underground via web, there are far too many individuals facing this same fate, causing these comments on these incidents to grow.

Think for a moment of being injured, yet comforted that a decision was made in advance to sign up for a group long-term disability policy with self-insured employer. Never realizing someday there would be a time for use however it turns out there is a need for benefits after all. Most employees have no idea the degrees some employers will go through in order not to pay benefits. Most workers are trusting, relying more on relationship development during working years. But can you really rely on this? In fact recent surveys have come out stating employee’s satisfaction with employer benefit plans are decreasing.

The hidden numbers of disillusion employees who’ve received a letter in the mail from their employer or LTD contractor can vouch for levels of dissatisfaction after being denied benefits initially, two, five, or ten years later. Sadly, many of these sick and injured people suffer loses in silence. How often do we hear these statistical numbers of these abuses? Traditionally they are not out in the open. Otherwise, in my opinion, many would be dropping out of their group insurance programs like someone yelling fire in a crowded nightclub. Imagine the surprise. In fact, current ERISA legislation has enough loop holes for insurance and employers.

First, are there in corporate legislation written by Congress where you cannot sue for unfair or bad faith behaviors? I personally have not found any. Only in ERISA Self-Insured Group Insurance Policies is this possible. Who would have thought this type of injustice would pass through Congress? Did you know they passed legislation for corporations to be paid out immediately after disasters? Yet, those unable to foot an additional month of bills are expected to wait years. How is this fair? More importantly, why hasn’t Congress made reforms to ERISA to correct this horrible injustice? Perhaps due to money, greed, and power in the hands of a few? Is Congress less concerned with a level playing field? There is one thing you can help, vote. Voting in 2014 for people who are interested in the average citizen’s life. People unwilling to ignoring what the majority value, such as ERISA Reform.

U.S. House and Senate can Reform ERISA today.

From my perspective, there will be no changes in Congress’ behaviors until they are held accountable for their actions or lack thereof. ERISA Reform is a great place to start because of the impact it would have on those with the least resources. This Congress has passed the least legislation, and what they have passed has not been in best interest of poor or middle class people. We hear a great deal of talk about help, without actions. Talk is cheap, and in my opinion, each year, its value becomes worth less and less, because their words are not attached with actions, especially in Congress.

The goal of ERISA in the beginning started out as a genuine good idea to protect workers. The need for legislation of this type is an indication that many employees where not getting a fair shake when applying for benefits.

This legislation started out to be in the best interest of workers, yet turned out to be in the best interest of corporations. As when money gets into the mix via lobbyist and corporations mainly managing ERISA, well intention legislation can turn into unfavorable position for those who need it most, poor and middle class employees.

In my opinion, the biggest mistake in this legislation is the little recourse available to insured with requesting ERISA Benefits from Self-Insured Employers. When companies realize there is a not consequence for bad behaviors against insured, some exceed with plans to eliminate legitimate LTD claims, from my perspective.

The second mistake in my opinion, is allowing same company that benefits from claim denial to review worker’s claim. Approving insured does nothing for their bottom lines and provides no incentive to be fair, especially with no repercussions for unfairly denying benefits.

It is up to Congress to amend these laws in order for them to level the playing field for workers, for which it was intended. There needs to be timelines for benefit payments to workers and a magistrate, someone outside these companies to review claims as part of the process. In my opinion, this would cost less and could be a part of the plan. This would protect employees from having to fight their employer in federal court, which primary favors large corporations which typically fight their cases there. Furthermore, allow these cases back into State Courts which provide an opportunity for sick and injured employees to receive a justice. I suspect less money would then be pocket by investors and employers and rightly benefit those this plan was set up to protect.

Making changes to the current legislation which provides a neutral third party with no ties to self-insured corporations or their associated lobbyist such as a magistrate to review validity of claims would ensure a greater chance of a fair claim review. From my perspective, fiduciary responsibilities over ERISA are difficult for some corporation to strike a fair balance between investors and sick or injured employees.

Employees often experience intimidation after filing LTD claims by Employers.

Another important thing to do is remove clauses placed in Employer Benefit Polices which allow abuses against insured. They provide opportunities for employers to cancel or eliminate benefits paid. Making these games illegal would also aid in claim process fairness. From my perspective, clauses are disguised for employer protections used to eliminate legitimate claims.

Allowing the sick and injured to be self-sufficient after injury helps take care of medical, physical, emotional, and financial well-being of these individuals. In my opinion, when receiving the benefits they paid premiums on, it allows them a quicker recovery time, provides the safety net promised, and creates trust between employer and employees.

Another question I would ask Congress is to consider not giving corporation outs on defining disability. Social Security Disability Insurance has one of the most restrictive requirements. In most cases, far more in depth than corporations, yet, many of these companies clauses placed in the group policy plans allow them to escape paying out claims. Again, Congress it is up to you to do right by workers. Revise ERISA, so these loopholes are eliminated for corporations. Tighten ERISA so it provides fair coverage for people injured in a car accident.

Again, many changes to ERISA would provide insured with hope of a least having a fair shake when their claim is being evaluated. The employee’s survival risk increase when denied auto or long-term disability insurance. It’s unfair for most sick and injured to lose not only the jobs, but assistance with livelihood which they were told would be available if an unforeseen event occurs.

ERISA can be a force for the protection of workers, when more workers are included in the decision making, fair legislation is put in place, and corporation views fiduciary responsibilities for the worker and not the investor or themselves.

If you have experience a claim with your employer, share your experience on Twitter hastage #ESTRAsRadioShow.