SMDA was recently able to convince a Long Term Disability Insurer to settle a challenging claim brought by a local public school teacher.
Long Term Disability insurance claims for public school teachers (or other public school employees) are somewhat unique because these claims are not governed by the Employee Retirement Income Security Act (ERISA). This is because the ERISA statute does not apply to government plans (or church plans). Accordingly, the normal rules (which apply to the vast majority of LTD claims) regarding ERISA and the Department of Labor regulations do not apply. There is usually no claim appeal or exhaustion requirement. There is no discretionary standard of review. These are just a few of the important differences that apply to Long Term Disability Insurance claims for public school teachers.
Instead of filing a federal court lawsuit for a violation of the ERISA statute a public school teacher’s claim is filed as a breach of contract claim usually in the circuit court for the county where they either work or reside. Unlike ERISA, these cases proceed with discovery, case evaluation and a trial. These are very important differences that impact the claim and the litigation strategy from day 1.