Do ERISA plans have to abide by Social Security Disability benefit award?

No, the United States Supreme Court in MetLife vs. Glen, 554 US 105 (208), was troubled when MetLife encouraged Mr. Glen to apply for Social Security Disability benefits, reduced his long term disability benefits by the receipt of the Social Security benefits and then ignored the Social Security finding entirely in denying the long term disability benefits.

Many ERISA plans require claims to apply for Social Security Disability benefits and they even provide legal assistance to provide those benefits. Since the Glen decision, many long term disability insurance companies have been careful to reconcile the Social Security determination with their ultimate ERISA plan denial. In other words, they simply can’t ignore the decision but they are not bound by it.

Why?

The Social Security Administration has unique rules and procedures in making Social Security rules and determinations. As a result, courts do not view an award of Social Security benefits as the equivalent of disability on a ERISA disability policy.

As a result, ERISA long term disability insurance companies are now required to make a distinction between a Social Security Disability benefit decision and their denial. If they don’t, that can be grounds for appealing a denial of long term disability benefits.

If you have been awarded Social Security Disability benefits, and your carrier doesn’t discuss those benefits in it’s denial decision, you should contact disability attorney Nancy Cavey who can get the long term disability benefits that you deserve regardless of where you live in the United States.