ERISA policy holders have very few legal remedies

Dying of cancer, Thomas Amschwand did everything he was told to make sure his wife would collect on the life insurance policy he had through his employer. “He was obsessed with dotting every i and crossing every t,” Melissa Amschwand-Bellinger recalled about her husband, who died in 2001 at age 30.

But Spherion Corp., the temporary staffing company where Amschwand worked, told Amschwand-Bellinger she would not receive any of the $426,000 in benefits she believed she was due. When she went to court, Spherion succeeded in getting her lawsuit thrown out. The Supreme Court on June 27 refused to review the case.

Amschwand-Bellinger received a refund of the few thousand dollars in insurance premiums she and her husband dutifully had paid. The total, she said, would not cover the costs of his funeral.

The story has played out often under the federal Employee Retirement Income Security Act. Designed to protect employee benefits, the law has been used by employers as a shield against suits.

Federal appeals courts, interpreting Supreme Court decisions dating to 1993, consistently have said companies that offer health, life and retirement benefits under ERISA cannot be sued for large amounts of money, or damages. Instead, they can be sued only for typically smaller sums such as Amschwand’s insurance premiums.

Several federal judges have bemoaned the unfairness even as they have felt constrained to rule in favor of employers.

“The facts… scream out for a remedy beyond the simple return of premiums,” Judge Fortunato Benavides of the New Orleans-based 5th U.S. Circuit Court of Appeals said in the Amschwand case. “Regrettably, under existing law it is not available.”

The Bush administration has argued that the appeals courts are misreading the precedents and has asked the high court at least twice to clarify the earlier rulings. So far it has refused.

Congress, which could amend ERISA to make clear such suits are allowed, also has taken no action.

The result, in the view of ERISA experts, the administration and some lawmakers, is perverse.

“The beneficiary under the policy didn’t get the promised benefit,” said Colleen Medill, an expert on ERISA at the University of Nebraska-Lincoln. “To say we’re just going to return your premiums, that’s a total farce. That’s not what they paid the premiums for. They paid them for the benefits.”

Sen. Patrick Leahy, chairman of the Senate Judiciary Committee, said at a recent hearing that before ERISA became law, employees clearly could sue for benefits in state courts.

The court rulings, said Leahy, D-Vt., have left people “more vulnerable than they were before the law was passed.”

Spherion’s decision to deny benefits to Amschwand-Bellinger turned on an odd set of facts. Spherion, which employs about 300,000 people, switched insurers after Thomas Amschwand was diagnosed with a rare form of heart cancer. The new policy did not take effect until an employee worked one full day. Spherion never informed Amschwand of the requirement.

Amschwand asked repeatedly whether there was anything else he needed to do and was told no. He asked that the new policy be sent to him. Spherion never did so.

He died without returning to work. His widow said he easily could have worked a day if that was what it took to activate the new policy. Spherion could have waived the one-day-of-work provision, as it did for other employees but not for Amschwand.

Spherion spokesman Kip Havel issued a brief statement when contacted by The Associated Press after the high court declined to review the case. “We are pleased the court has made its decision and the matter has finally been resolved,” Havel said.

The court also recently turned down an appeal from Louis Gerard “Gerry” Goeres, who sued Charles M. Schwab & Co. over hundreds of thousands of dollars in retirement plan benefits.

For 16 months, Schwab mistakenly refused to acknowledge Goeres as the beneficiary in the retirement plan of his domestic partner, Stephen Ward, a Schwab employee who died in 1999. By the time Schwab acknowledged its error, the value of the account had declined by more than $500,000. Goeres sued for the rest. Federal courts dismissed the suit. “Unfortunately, legal relief is not available,” U.S. District Judge Charles Breyer said in ruling against Goeres.

“You know the Schwab commercial, Talk to Chuck?” Goeres said. “I thought if Chuck knew this, he’d say, ‘Oh my God, this is so wrong. I live on naive dreams.'”

Schwab said in court papers that Goeres could have taken legal action soon after Ward’s death, when he first was told he was not the beneficiary.

Amschwand-Bellinger said the cases show the need for either the court or Congress to provide “some sort of meaningful remedy for employees when employers have a breach of fiduciary duty.”

A Texas native who lives in an unincorporated Houston suburb, she has since remarried and has an 18-month-old daughter. She is president and executive director of the Amschwand Sarcoma Cancer Foundation, which she founded with her first husband.

She recognizes that she is more fortunate than many others who have fought similarly futile battles for benefits under ERISA. “What if we had had children and I was a stay at home mom?” said Amschwand-Bellinger, who previously worked for a public hospital system. “What if I was 60 years old, with no skill sets, and I had to go back to work?”


Did you find this helpful?
Unhelpful (0)

Resources to Help You Win Disability Benefits

Disability Benefit Denial Options
Submit a Strong Appeal Package

We work with you, your doctors, and other experts to submit a very strong appeal.

Learn more

Sue Your Disability Insurance Company

We have filed thousands of disability denial lawsuits in federal Courts nationwide.

Learn more

Protect Your Benefits
Get Your Disability Application Approved
We help claimants throughout the entire application process.

Learn more

Prevent a Disability Benefit Denial
We manage every aspect of your disability claim following claim approval.

Learn more

Negotiate a Lump-Sum Settlement

Our goal is to negotiate the highest possible buyout of your long-term disability policy.

Learn more

Disability Company Reviews
(648)
Showing 8 of 648 Reviews
Unum

Unum Closed My Case Today

Reviewed by Scott C. on July 5th 2024   Verified Policyholder | March 2023 date of disability
Unum will keep you around, if they pay you 100 a month. But as soon as have to pay more than 2700 a month, they will drop you. We will be going to the attorneys office fir... read more >
Hartford

Ran me Around for Months

Reviewed by David on July 5th 2024   Verified Policyholder | January 2024 date of disability
Scammers. Immoral horrible people.
Reply
Sent on July 5th 2024 by Attorney Gregory Dell

David:

It’s horrible that Hartford did that to you.

Prudential

Denied but Not Denied but I am Denied

Reviewed by KDDK on July 5th 2024   Verified Policyholder | August 2022 date of disability
I went out in Aug. 2022 for neck pain. After seeing a neurologist I had to get an ACDF C5-7, it was also determined I had carpal tunnel in my right hand and bulging disk i... read more >
New York Life

Claiming They Are Not Receiving Paperwork

Reviewed by Macey on June 26th 2024   Verified Policyholder | February 2024 date of disability
After suffering from medical issues from my delivery in February, I had to have a colostomy bag placed. Now New York Life is trying to claim my condition was pre-existing ... read more >
Hartford

Truly Horrible and Immoral Company with No Customer Service

Reviewed by William M. on June 26th 2024   Verified Policyholder | June 2020 date of disability
My experiences with Hartford have been nothing short of cruel. They started off by claiming that having Glioblastoma, which has an expected life span of about fifteen mont... read more >
Hartford

Sent my Direct Deposit to a Strangers Bank Acct

Reviewed by Brad on May 2nd 2024   Verified Policyholder | February 2024 date of disability
I went on short term disability and The Hartford put my direct deposit into someone else’s bank account. Somehow they messed up a number or two and they are refusing to ... read more >
Sedgwick

AT&T Was Great and Sedgwick Horrible

Reviewed by From a great job to a complete nightmare on March 20th 2024   Verified Policyholder | March 2024 date of disability
My Physician recommended that I take some time from a toxic environment after several deaths in my family coupled with AT&T trying to run tenured employees out of the door... read more >
New York Life

Keeps claiming they will not approve claim for pre existing conditions but my illness is not preexisting

Reviewed by M.T. on February 15th 2024   Verified Policyholder | May 2023 date of disability
I have been appealing a claim for LTD for 8 months! New York Life keeps claiming they will not approve claim for pre existing conditions but my illness is not preexisting ... read more >
Answered Questions by Our Lawyers
(0)
Helpful Videos
(896)
Showing 12 of 896 Videos
Disability Benefit Tips
(331)
Showing 8 of 331 Benefit Tips

Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?

When it comes to securing your disability insurance benefits, it's vitally important that your disability insurance lawyer thoroughly understands the symptoms and impact of your disabling condition. Doctors can help you create strong medical records, but they're not accustomed to dealing with the rigorous documentation disability insurance companies require. Lea... Read More >

Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak

If you're seeking long term disability benefits from an insurance company, you may be concerned that you're facing an uphill battle. Fortunately, the stronger your medical evidence, the greater the odds that your claim will be approved. On the other side of the coin, one of the most common reasons for denial of long term disability benefits involves too-weak med... Read More >

Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company

When you're seeking disability insurance benefits, your medical records and treating physician's statement are two of the most important components of your claim. But because the insurance company has a vested interest in denying your disability insurance claim, it often will rely on tactics like ambushing your doctor with a phone call in an attempt to get them ... Read More >

Disability Benefit Denial Reason #3 - Video & Social Media Surveillance

One thing many disability insurance claimants don't know about (or expect) from the claims review process involves video and social media surveillance. Disability insurance carriers often hire people to follow claimants around with a telephoto lens - or even send social media friend requests from fake accounts - to glean whatever information they can about the c... Read More >

How Do You Fight a Long-Term Disability Denial?

Getting a denial letter from your disability insurance company is one of the ultimate insults. You are sick and not able to work, yet your disability insurance company is telling you to return to work. The disability insurance company has denied your disability benefit claim and is basically calling you a liar. When receiving a disability denial letter... Read More >

Disability Denial Reason #2 - Change of Disability Definition & Vocational Review

One of the top reasons for terminating a claimant's long term disability benefits involves the change in the disability insurance policy's definition of "disability." This definition change often happens in conjunction with a vocational review, or an analysis of a claimant's medical records that tells the insurance company which jobs the claimant should be able ... Read More >

Disability Denial Reason #1 – Paper Review & IME

At Dell Disability Lawyers, we've seen insurance companies give countless reasons to deny long term disability benefits. However, most disability benefit denials tend to fall into one of a few categories - and one of the biggest ones is the paper review and independent medical exam (IME). Learn more about what this review process entails and what your claim file... Read More >

How to Apply for Reliance Standard Disability Benefits & Top 5 Reasons for a Claim Denial

At Dell & Schaefer we’ve handled hundreds of long term disability insurance claims against Reliance Standard, and have learned a few things in the process. When you’re experiencing an injury or illness that makes it difficult (or impossible) to work, it can be tempting to file a claim as quickly as possible – but unless a claimant has all their ducks in a row, this could actually delay the ultimate r... Read More >
Dell Disability Cases
(375)
Showing 8 of 375 Dell Disability Cases

Seven Surgeries and The Standard Still Denies Disability Insurance Benefits

Our client was employed with the State of Oregon as a Technical Support Representative. She sought disability through her employer provider LTD Policy with Standard due to low back, hip, and lower extremity pain. She had two hip, two knee and three back surgeries.After paying her for 1.5 years Standard hired a board-certified neurologist to perform a review ... Read More >

Sun Life Wrongfully Denies Disability After Paying For 23 Months

We represent a 57 year-old claimant who’s occupation was selling commercial vehicles for many years.  Her job was very physical as it required her to climb in and out of semi-trucks multiple times a day as well as operate them which was very strenuous. She went out of work in due to ongoing and severe debilitating right hip, low back, and bilateral knee pain... Read More >

Nurse Denied Long-term Disability Benefits by Lincoln After the Definition of Disability Changed

Our client, a registered nurse for Dignity Health, found herself in a difficult situation after being diagnosed with lumbar spondylosis and left knee arthritis. She continued to work, however, struggled while attempting to work through chronic lower back pain and left lower extremity radicular symptoms on a daily basis. Sadly, her condition failed to improve and... Read More >

Lincoln Reverses Decision to Terminate LTD Benefits of Corporate Attorney after Dell Disability Lawyers Appeals the Decision

The claimant is an 64 year old former Corporate Attorney and at a prominent Florida business law firm who was forced to cease working in his highly successful and rewarding profession, job, and career on January 27, 2021, and to seek disability compensation under his policies with Lincoln due to severe symptomatology stemming from or following a viral COVID-19 i... Read More >

Transportation Manager with Brain Injury Wins Unum Disability Benefit Appeal

Unum unjustly terminated our client’s disability insurance claim after it had approved and accepted liability for six months. Unum unreasonably concluded, without any evidence of improvement, that the claimant had resumed the sustained work capacity to perform the material and substantial duties of her high level occupation as a Transportation Division Manage... Read More >

Prudential reverses decision to terminate LTD benefits of MRI Tech with Primary Progressive Multiple Sclerosis and degenerative Disc Disease

The claimant is a 58-year-old former MRI Technologist for Fairview Health Services who has long suffered from the debilitating effects of her chronic medical conditions. She has a history of neck pain as well as right arm pain and numbness dating back to 2005 with a reoccurrence of severe symptomatology in 2013. MRI of her cervical spine performed in August of ... Read More >

Engineer With Depression Wins Prudential LTD Appeal

The claimant is a former Senior Technology Services Engineer for Accolade, Inc. who was forced to cease working on May 25, 2021 and to apply for disability insurance benefits under his policy with Prudential because of severe symptomatology related to depression and anxiety. Prudential initially approved his claim for LTD benefits as his symptoms were demonstrat... Read More >

New York Life Approves Disability Benefits for School Teacher With Multiple Sclerosis

Our client, a former elementary school teacher suffering from Multiple Sclerosis, contacted our office after New York Life terminated her claim for short term disability benefits and spoke with Attorney Stephen Jessup. New York Life had initially approved her claim for short term disability benefits, but in doing so awarded benefits only on account of a mental health condition, even though our client had filed... Read More >
Disability Lawsuit Stories
(765)
Showing 8 of 765 Lawsuit Stories

Reliance Standard Disability Denial Upheld Due to Claimant's Lack of Strong Medical Record Support

In the case of Amy Wright v. Reliance Standard Life Insurance Company (Reliance), Plaintiff was the vice-president of health information services at Integrity Health Care when she stopped working on August 7, 2017. She brought claims for benefits under an LTD insurance policy and a waiver of premiums under a life insurance policy.In order to be approved for LTD benefits, Plaintiff ... Read More >

Unum Wrongfully Terminated Disabled Lawyer’s Disability Claim of Depression and Anxiety Despite Improvement in His Condition

This Unum lawsuit and appeal in federal court is a great victory for all Unum disability claimants. This case supports all claimants that are disabled and claim that they cannot return to work as the requirements of their job will aggravate their symptoms and make them unable to work.Mark was a personal injury litigation attorney, when he began struggling with symptoms of... Read More >

Federal Court Overturns Aetna Denial Of Disability Benefits

In the recent case of Ferrin v. Aetna Life Ins. Co. a federal judge from the Northern District of Illinois determined that Aetna improperly terminated Ferrin’s claim for long term disability benefits and ordered Aetna to reinstate Ferrin’s claim and pay all past due benefits with interest. Prior to filing for long term disability Ferrin was an employee of Southwest Airlines. In 2008, while at work, she suf... Read More >

Court Finds Irregularities in Procter & Gamble Disability Insurance Benefit Denial

In ERISA cases filed in a district court asking for judicial review of a plan administrator's denial of benefits, the court is generally limited to considering only the administrative record that was before the plan administrator. The case of Robert Stallings v. The Proctor & Gamble Disability, Committee, et al., is an example of how plaintiffs with cases filed in a District Court that is under the jurisdi... Read More >

Federal Judge Makes Companion Life Insurance Pay Disability Benefits

Companion Life tried to play games and deny disability insurance benefits, but thankfully a New Mexico Federal Judge made them pay disability benefits and attorney fees. The Plaintiff, Mr. Paul Chandhok, was recently awarded disability benefits in a decision by The United States District Court for the District of New Mexico, in a case decided on August 13, 2021. What makes this decision important for plaintif... Read More >

NFL Disability Review Board Ignores Evidence of Disability and Appeal Court Reverses Lower Court Decision

In Darren Mickell v. Bert Bell/Pete Rozelle NFL Players Retirement Plan (Plan), Mickell spent nine years in the NFL as a defensive end. He was repeatedly subjected to high speed contact hits which caused multiple orthopedic injuries to his “back, ribs, shoulders, arms, hands, knees, hips, legs, and feet." He had multiple orthopedic surgeries. Mickell also sustained multiple blows to his head t... Read More >

Judge Agrees that MetLife's Denial of Long Term Disability Benefits was Reasonable

In Anne Ehlert v. Metropolitan Life Insurance Company (MetLife), Ehlert was a consulting pension actuary for pension plans at Towers Watson. Her first day of work with Towers was September 8, 2003. Her last day of work was December 23, 2015. In August 2016, she applied for long-term disability (LTD) benefits under her employer’s disability insurance benefit plan which was administered by MetLife.In thi... Read More >

Can Standard Insurance Company’s Failure to Raise an Issue be Considered a Waiver?

The case of Jose Chavez v. Standard Insurance Company has quite a history with the United States District Court for the Northern District of Texas, Dallas Division. It began in September 2016 when Standard first began paying long-term disability benefits to Chavez. He had several operations on his wrist and was no longer able to perform the duties of his own occupation.Standard terminated his ben... Read More >

Reviews from Our Clients

Request a Free Consultation

Our Lawyers Respond Same Day

5 Ways We Help Get Your Benefits Paid

Get Your Disability Application Approved

Our goal is to get your application for disability income benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their "hired gun" doctor.

Through our experience of having helped thousands of disability insurance claimants, our disability insurance lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.

Submit A Strong Appeal Package

If your disability insurance benefits have been wrongfully denied, then our disability insurance lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.

Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of "disability". We encourage you to contact any of our attorneys for a free immediate review of your disability denial.

Sue Your Disability Company

98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability insurance attorneys have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the "little guy" against the multi-billion dollar insurance company giants.

We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.

Prevent A Disability Benefit Denial

Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.

Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.

Negotiate a Lump-Sum Settlement

Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our disability insurance lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.

Questions About Hiring Us

Who are Dell Disability Lawyers?

We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.

In more than 98% of our cases, our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.

We offer disability insurance attorney representation nationwide and we welcome you to contact any of our lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 850 videos and regularly provide tips to help protect your disability benefits.

Who do you help?

Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.

Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.

A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability insurance lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Helpful Resources