ERISA Law Information

Charles J. Fleishman, a.p.c.
19839 Nordhoff Street, Northridge, California 91324
(818) 350-6285  erisa@erisarights.com

      Many employers set up employee benefit plans that provide benefits to employees in the form of life insurance, disability insurance, health insurance, severance pay and pensions. These benefits are funded either through the purchase of insurance policies or through the establishment of trusts, paid for either by the employer or both the employer and employee. When the money is put into a trust, the employer takes a tax deduction for its contribution to the trust. The trust money is then invested. The companies that receive the investments many times have also set up trusts with their own tax deductible contributions and contributions from their employees. Thus company 1 sets up a trust which then invests in company 2 which also sets up a trust that invests in company 3 that also sets up a trust that . . . invests in company one. The last thing a company/employer wants is an employee tapping into the trust funds with benefit claims. A successful claim from an employee lowers the amount of the fund available to invest in the "I'll scratch your back, you scratch mine" employee benefit trust fund game. If the benefits are payable through an insurance policy, need it be said, insurance companies are famous for thinking up excuses for their not having to pay benefits.

      This is where ERISA comes in. ERISA is perhaps one of the biggest successful con jobs affecting the American working person since the end of the Great Depression. ERISA, in the guise of protecting the working person's rights, replaced all state laws that protected an employee's rights to benefits from an insurance company or employee trust. Under the laws of most states, a wrongful denial of benefits can result in a jury verdict awarding the employee the denied benefits, damages for emotional distress, and punitive damages. Under ERISA, there is no right to a jury trial, and the most that an employee who has wrongly denied benefits can receive is the denied benefits. What has an insurance company or employee benefit trust fund got to lose from denying benefit claims? If they are sued, the most they can lose is the value of the benefits they denied in the first place. Where it used to be that an insurance company had to think hard and long before denying benefits because of the possibility of emotional distress and punitive damages, now, because of ERISA, denial is a no brainer. What is there to lose?

      As if to further encourage the practice of denying employee benefit claims, ERISA says that, in most cases, the insurance company's or employee benefits trust's decision to deny benefits will not be overturned, even if it is wrong, unless it can be shown to be arbitrary and capricious.

      If you are about to apply for benefits under an employee benefit plan or have already applied for such benefits and have had them denied to you, be aware that you are either entering or already in the middle of a legal mine field. At risk are important benefits that your future may depend on. If you do not wish to walk the mine field alone, contact me. I have been doing ERISA work for many years. If you have a good claim, I will represent you, in most cases, on a contingency fee basis. I know the pitfalls, the deadlines, and the strategies that you need to be successful. The sooner in the benefit claim process that you get to me, the better chance you have for a successful conclusion. ERISA fights are uphill fights for the employee. While I cannot guarantee that you will win with my help, we can at least make the playing field a little more level.

      If you have been denied benefits based on a "mental illness" or "mental and nervous condition" type of limitation, contact me. I can probably help you.

      If you have been denied benefits because you do not have "objective medical evidence," contact me. I can probably help you especially if you suffer with CFS or fibromyalgia.

Click here for us to help youMr. Fleishman's bio.

For an illuminating view of how ERISA affects medical benefits, go to www.harp.org

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