Fighting For Your ERISA Claim In And Out Of The Courtroom
After their ERISA administrative appeal is denied, some people elect to pursue litigation to recover their ERISA long-term disability benefits. At McDermott Law, our insurance law attorneys have helped clients throughout Colorado successfully pursue ERISA litigation. We have prepared this list of general guidelines to introduce you to your rights under the law; however, nothing can replace the one-on-one advice of an experienced ERISA attorney.
The risk of disability may be greater than you think. Recent statistics have shown:
- On the average, about 2,340 disabling injuries occur every hour during the year (National Safety Council, Injury Facts, 2001).
- About 30% of Americans from ages 35 to 65 will suffer a disability for at least 90 days (Health Insurance Association of America, The New York Times, February 2000).
- About one in seven Americans can expect to become disabled for five or more years (Health Insurance Association of America, The New York Times, February 2000).
Guidelines On ERISA Long-Term Disability Litigation
Before beginning ERISA long-term disability litigation, it helps to be familiar with a few of the regulations that govern such suits:
- You have the right to sue for benefits in state court or federal court, although the judge will “remove” your case to federal court, if you file in state court.
- Your lawsuit is a claim for ERISA benefits that were wrongfully denied. You are only entitled to recover the amount of the past-due benefits and, usually, interest on the withheld benefits. You cannot make a claim for bad faith breach of insurance contract as it is typically asserted in cases not governed by ERISA.
- If your ERISA litigation is successful, your attorney’s fees might be awarded to you by the court.
- You are not entitled to a jury trial. A judge will make all determinations.
- Regardless of the insurance company’s conduct in denying your ERISA long-term disability claim, you are not entitled to punitive damages, nor damages for pain and suffering.
- One of the most critical issues is what standard of review the courts will apply. In ERISA litigation, it is necessary for the parties to agree on, or the court to determine, which standard of review the court will apply to the claim administrator’s decision to deny ERISA long-term disability or another type of benefits. There are two types of review a court may use, depending on the language found in the plan document: (1) de novo, in which no weight is given to the administrator’s decision; and (2) abuse of discretion (also called “arbitrary and capricious”). In this context, the Tenth Circuit Court of Appeals treats the terms “abuse of discretion” and “arbitrary and capricious” as interchangeable.
- Even if the plan gives the administrator discretion, the court will apply a less deferential review if it can be proven that the administrator is working under a conflict of interest.
- You should assume you cannot add any evidence to the administrative record during the course of litigation. The most crucial step in your claim is properly submitting an administrative appeal.
Begin Your ERISA Long-Term Disability Claim
ERISA long-term disability is a specialized area of the law governed by many complex rules. At McDermott Law, our ERISA attorneys assist applicants with all aspects of filing ERISA claims and appeals. We also specialize in the handling of plaintiffs’ ERISA benefits litigation and have done so hundreds of times. You likely will not find more experienced attorneys in Colorado in this area of the law.
If your ERISA benefits appeal has been denied and you are considering pursuing litigation in court, please contact our ERISA attorneys today for an honest review of your case. To set up a free consultation, call 303-964-1800 or complete our contact form. We have helped thousands of people throughout Colorado and the Rocky Mountain region get the insurance coverage they need and deserve.