Retirement Plan Benefit Denials Under ERISA

You worked for years, earned a pension or saved in a workplace plan, and now the plan says you are not owed what you expected. Maybe it denied your claim, paid less than you calculated, or says it cannot find your records. Retirement plans offered by private employers are often covered by a federal law called ERISA, the Employee Retirement Income Security Act. This guide explains in general terms how benefit denials work under employer plans and what you can do.

What kinds of plans this covers

Employer retirement plans come in two broad types:

• Pension plans that promise a set monthly benefit based on things like years of service and pay.
• Savings plans, such as a 401(k), where the benefit is the money in your account.

Disputes in both types can involve how much service counts, whether you were vested, how a benefit was calculated, whether a spouse must consent, or whether an old plan still owes you money.

Plans for government workers and some church plans often follow different rules. A lawyer can tell you which rules apply to your plan.

Who to contact for information

The Employee Benefits Security Administration (EBSA), part of the U.S. Department of Labor, offers information and assistance on employer-sponsored retirement and health benefit plans. USAGov lists EBSA's contact options, including a toll-free number (1-866-444-3272) and a way to find a regional office.

EBSA can explain general rules and may help with some problems. It does not act as your personal lawyer.

Step 1: Get the plan documents

Your rights are set largely by the plan's own documents. Ask the plan administrator, in writing, for:

• The summary plan description.
• The full plan document, including amendments.
• Your benefit statements and the records of your service and pay.
• Any written decision on your claim and the documents the plan relied on.

Keep a copy of your request and note the date you sent it. If you are unsure who the plan administrator is, the summary plan description or your former employer's human resources office can usually tell you.

Step 2: Read the denial carefully

A denial letter should explain why the claim was denied and how to appeal. Look for:

• The specific reason, such as missing service, a vesting issue, or a different reading of the plan.
• The plan provisions it relies on.
• What additional information could help your claim.
• The deadline to appeal and where to send it.

Mark the appeal deadline on your calendar right away. Missing it can limit your options later.

Step 3: Check your own records

Plans sometimes have incomplete records, especially after mergers, sales, or changes in recordkeepers. Gather your own evidence:

• W-2 forms or pay stubs showing your employment years.
• Old benefit statements.
• Letters from the employer about your plan or your benefits.
• Records of any rollover or prior distribution.

Social Security earnings records can also help show where you worked and when. You can view them through a my Social Security account, which USAGov mentions on its retirement planning tools page.

Step 4: File the internal appeal

Many employer plans require you to use their internal appeal process before you go to court. Treat the appeal seriously. In many cases, the appeal is the main chance to put evidence into the record that a court may later review.

A strong appeal usually:

• Answers each reason in the denial.
• Points to the plan language that supports you.
• Attaches documents that support your service, pay, or eligibility.
• Asks the plan to identify any further information it needs.

Send the appeal in a way you can track, and keep copies of everything.

If the plan or employer no longer exists

Former employers close, merge, or end their plans. USAGov's unclaimed money page points to the Pension Benefit Guaranty Corporation's search tool for unclaimed pensions from former employers. It is worth checking if you cannot find who holds your benefit.

When to talk to a lawyer

You can file a claim and an appeal on your own. Many people talk to a lawyer when:

• The amount at stake is large, such as a lifetime pension.
• The plan reads its own terms in a way you think is wrong.
• The denial involves a spouse, an ex-spouse, or a court order from a divorce.
• Your internal appeal was denied.
• The deadline is close and you need records fast.

Lawyers who handle these cases often practice employment or employee benefits law. Ask how often they handle retirement plan claims, how the fee works, and who will prepare your appeal. Get the fee terms in writing. No lawyer can promise the plan will change its decision.

For free or low-cost help, the USAGov legal aid page lists resources for older adults, including the Pension Rights Center, which offers free legal help with problems involving pensions, profit-sharing, and retirement savings plans.

Frequently asked questions

Do I have to appeal to the plan before I sue?

Many employer plans require an internal appeal first. Read your denial letter and plan documents, and ask a lawyer about your plan's process.

How long do I have to appeal a pension denial?

The plan's denial letter should state the deadline. Plans differ, so check your letter and your summary plan description.

What if the plan says it has no record of my service?

Gather your own proof, such as W-2s, pay stubs, old statements, and your Social Security earnings record, and include it in your appeal.

Can EBSA help with my claim?

EBSA offers information and assistance on employer-sponsored plans and can be contacted by phone or online. For advice on your specific claim, talk to a lawyer.

Related: Browse more legal guides and employment lawyers.

General information, not legal advice. Laws change and every case is different — talk to a licensed attorney about your situation.