Introduction and overview

• Author: Scott M. Riemer/Jennifer L. Hess
• Pages: 19-20

I-1

INTRODUCTION AND OVERVIEW

S

       

claims through the initial application process, the appeal process,

and litigation in federal court. Even when handling an ERISA

disability claim during the initial application process, you always must

be mindful that the claim may need to be litigated and that ERISA dis-

ability cases are like no other type of case litigated in the federal courts.

ERISA cases are impacted by many rules and regulations, including:

regulations issued by the United States Department of Labor; certain

sections of the Employee Retirement Income Security Act of 1974, as

amended (“ERISA”); insurance statutes, regulations and concepts in

the 50 states; general concepts of contract and trust law; the specic

provisions of the disability plan and/or policy; and most peculiarly,

court-created procedures pertaining to exhaustion of administrative rem-

edies, scope of review, statute of limitations, venue, remands, remedies,

discovery, the award of attorney fees, and the admissibility of evidence,

none of which will be found in the Federal Rules of Civil Procedure. To

boot, the Federal Rules of Evidence do not necessarily apply.

is book attempts to provide at least some of the knowledge you

will need to represent a client with an ERISA disability claim. e empha-

sis will be on practical strategies, rather than on an exhaustive recitation

of caselaw. Helpful templates and forms will be provided where possible.

Although the authors practice primarily in New York City in the South-

ern District of New York, the book’s focus is national. Note, however,

there may be certain local variations not discussed in the book.

e focus of the book is employer-provided disability benets sub-

ject to ERISA. All employer long term disability (“LTD”) plans are

covered by ERISA, unless the employer is a governmental or religious

entity. Similarly, all short term disability plans are covered by ERISA,

unless the plan satises the safe harbor requirements of a payroll

practice exempt from ERISA. See 29 CFR §2510.3-1(b). STD policies

purchased by an employer to satisfy mandatory State requirements are

not subject to ERISA. Currently, ve States (California, Hawaii, New