How Does ERISA Impact Disability Insurance Claims?
If you purchased your long-term disability policy through your employer or received your long-term disability coverage as an employee benefit, then your disability policy is almost always subject to the restrictive ERISA regulations.
The Employee Retirement Income Security Act of 1974, also known as “ERISA”, is a federal law that sets the minimum standards for pension plans and disability insurance plans in the private industry. ERISA was initially created to protect the rights of individuals; however it’s pro- insurance company regulations have increased the profits of insurance companies and made it difficult for a claimant to overturn a denial of disability benefits. The principal purpose of ERISA was “to protect… the interests of participants in employee benefit plans… by establishing standards of conduct, responsibility, and obligation for fiduciaries of employee benefit plans, and by providing for appropriate remedies… and ready access to the Federal courts.” ERISA is a very complex statute which sets forth claim handling procedures that insurance companies must follow when administering a long-term disability claim. The ERISA claims procedures statute for the handling of ERISA disability claims is 29 CFR Section 2560.503-1.
Unfortunately, each insurance company has their own interpretation of what they must do in order to comply with ERISA claim procedures. To make matters even more difficult, the federal court decisions on the interpretation of ERISA generally differ from one state to another.
Attorneys Dell & Schaefer have handled ERISA long term disability denials against every major disability insurance carrier throughout the country. Due to the complexities of ERISA and the constantly changing court rulings, it is important to hire a law firm that handles ERISA long-term disability cases on a daily basis. Attorneys Dell & Schaefer represents claimants at all stages of an ERISA long-term disability claim, which includes application, appeals, and lawsuit.
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Disability Company Reviews
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Showing 8 of 668 Reviews
Mutual of Omaha
90 days and still waiting
I filed for benefits in July, 2024 with an effective date of 7/30 (after the 14 day wait) and today is October 18th and my claim is still pending. They either don't want t... read more >
New York Life
NY Life Short Term Disability Team is Terrible
I am a physician and was in a high velocity rear impact car accident. The person slammed into my stopped car going almost 50mph. Was not physically or cognitively able to ... read more >
Sedgwick
Sedgwick will use the false need for discovery to deny your claim
Sedgwick will use the false need for discovery to deny your claim for as long as possible to wear you down because you are out of work and need the money.Lie, cheat and ... read more >
Unum
Unum does not act as a fiduciary
I received paycheck from 2 sources at work. I was approved for LTD by Metlife within 40 days, no questions asked. I was approved by NWM which was my private own occupation... read more >
Unum
UNUM denied my LTD claim after 6 months although my health continues to decline
An attorney is needed to monitor an open, ongoing claim. I naively thought payments would continue. Review of medical records by a disability attorney before submission to... read more >
MetLife
Horrible STD Service. Run !!!!
For the first time since I can remember my employer did not offer STD as one of my paid benefits so I’m paying for this policy. Had to file a claim on 6-14-25. Went thro... read more >
Reliance Standard
Reliance Standard cut off LTD suddenly claiming I could do sedentary work after 10 plus years… no paperwork sent to appeal
I’ve been on STD then LTD with Reliance since 1/2015. They sent a medical review in December 2024 to my old address which of course I never got the paperwork for. I emai... read more >
Sedgwick
Denial for benefits, Sedgwick is the worst
I was not paid for 7 months on STD. My appeal was finally approved, but in the meantime I lost company match on my 401k, and then they canceled my company insurance. Out o... read more >
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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 or a ph... 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
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Showing 8 of 374 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 >
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