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ERISA and SSDI

Many of our clients assume that if they get SSDI benefits from the government, this guarantees that they will win their ERISA long term disability case.  Unfortunately, that is not always the case. The recent decision in  Ortiz v The Hartford, 2019 WL 5697784 (D. New Mexico November 4, 2019) is a good example.  There, the employee was awarded SSDI, but after his appeal to the ERISA insurer was decided.  The Court held that: “[W]hen Social Security decisions arise after the close of the ERISA record, there is nothing for the administrator to assess, and the administrator needn’t reevaluate the ERISA claim.”

If you are fighting for short or long term disability benefits, do NOT assume it is enough that you won your SSDI case.  The ERISA statute is complex, and more is required.  You should consult with an experienced ERISA lawyer as soon as possible!

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