Complaint sample. PDF. Complaint fill in. PDF.In this post, we discuss the ERISA claim process, appealing your ERISA claim, filing an ERISA complaint, when to hire an attorney, and more. ERISA liens require you to pay back your healthcare provider after recovering compensation. Our lawyers can explain more. This pamphlet is intended to provide Employers and Employees with general information about their employment rights and responsibilities in New York State. The forms can be filled in on the computer. How Do I File an ERISA Claim? Different types of claims have different procedures. Dependents can be removed or "disenrolled" due to losing an eligible status as a dependent under the plan, including divorced spouses, young adult children.