Group Policy / Employee Benefit Plan If you have obtained your long-term disability insurance policy from your employer or a trade organization, then your policy is probably governed by the Employee Retirement Income Security Act of 1974 (ERISA). Unfortunately, ERISA is an extremely complex statutory scheme. ERISA covers every employee benefit plan unless there is a specific exemption. Benefit plans that are specifically excluded by ERISA include government plans, church plans, and plans designed to comply with state laws relating to worker's compensation, unemployment or disability insurance.

Once a claimant with an ERISA group policy has been denied, a lengthy uphill battle begins in order to recover the disability income that you may be entitled to. Prior to filing any law suit against the disability insurance company, a claimant must exhaust all of the internal appeal procedures in a timely manner. Once a lawsuit is filed, the courts will only overturn an insurance company’s decision, if they find the denial to be “arbitrary and capricious”. As long as there is "substantial evidence" presented by the insurance company to support a denial, the denial can be upheld by the court, even if it is technically wrong. This clearly gives the insurer a tremendous advantage over the claimant in any dispute over benefits.

The actions taken by an insured/claimant during the internal appeal process will have a significant impact on a claimant’s ability to recover disability income. Our law firm has the knowledge and litigation skills necessary to represent a claimant during any stage of a claim for disability benefits. We are available at any time to provide you with free evaluation of your claim for disability benefits. Additionally, most of our cases our handled on a contingency fee basis, therefore there are no fee or costs unless we make obtain a recovery for you.