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ERISA NEWS: NEW DRUG PRICING LAWSUIT FILED UNDER ERISA

Express Scripts Inc. and Anthem Inc. are accused in a proposed class action of breaching their ERISA fiduciary duties (i.e., their obligations to the thousands of employees promised prescription drug coverage by the employer) by entering into a 10-year, multibillion-dollar prescription-drug agreement that caused plan participants to overpay for benefits ( Burnett v. Express Scripts,… Read More »

SSDI or ERISA?

Often, potential clients are unsure of what type of disability benefit claim they have.  While there are many Federal, State and local programs that may apply, there are 3 primary sources of disability benefits;  Social Security (SSDI);  benefits offered through a group plan, usually by an employer-sponsored plan;  and private policies.  All 3 are different,… Read More »

What is the Administrative Record and why is it important?

Your ERISA claim (life, medical, or long or short term disability) has been denied, and the insurance company is referring to “the Record” or “the administrative record.” So what is that? ERISA cases, unlike most civil cases, are not decided based on evidence generated during your lawsuit such (including the testimony of your medical providers). … Read More »

I forced myself to keep working … can I still go on long term disability?

This is a complex question, but a common one.  Many injured and disabled employees keep working longer then they should, and do so for many reasons.  Sometimes it is financial pressure, or it may be the desire to keep doing what he or she always has after building a successful career.  Insurance companies often use… Read More »

ERISA standard of review

In every case, the Court applies a certain standard of review, or the legal standards that will govern the claim.  Many people are familiar with the 2 most common;  the “reasonable doubt” standard that applies in criminal cases, and the “preponderance of the evidence” standard that applies to most civil claims.  ERISA —  of course– … Read More »

My disability claim is governed by ERISA …. what does that mean?

ERISA, or the Employee Retirement & Income Security Act of 1974 (“ERISA”), is a complex piece of Federal legislation that covers most employee benefit plans and how employers and their contractors (usually an insurance company) deliver those benefits to employees. For most Coloradans, their insurance benefits (life, medical, disability, vision, dental) are earned through our employment…. Read More »