• A Guide to Writing a Disability Benefit Appeal
  • Why You Need An ERISA Disability Lawyer
  • Are ERISA Law Changes Good For Claimants?
  • Top Reasons For Disability Denial
  • The Trap... Do Not Rush Your Disability Appeal!
  • Why Are ERISA Appeals Challenging?
  • Are FCE Exams Helpful To Prove Disability?
  • Senate Testimony On Disability Company Abuses
  • A Judges Perspective On ERISA
  • Disability Company Medical Reviews Are A Sham

ERISA Disability Appeal

If your long-term disability insurance benefits have been denied, then I know that you will find some relief after speaking with one our disability benefit attorneys. Our law firm’s goal is to get your disability benefits reinstated and paid until you decide that you can return to work. We win more than 75% of our disability benefit appeals and we have represented thousands of claimants with their ERISA governed disability benefit appeals and/or lawsuits since 1979. We would like to review your disability benefit denial letter and provide an immediate free phone consultation to discuss how we could help get your disability benefits paid. We encourage you to watch our video or read about How To Win Your Disability Benefit Appeal. We look forward to speaking with you.

1. Review The Disability Benefit Denial Letter And Identify The Appeal Due Date
2. Request A Copy Of The Claim File From The Disability Company
3. Review The Claim File And Plan Your Appeal Strategy
4. Obtain Additional Medical Support To Prove You Are Disabled
5. Prepare A Vocational Analysis Or Labor Market Survey
6. Prepare A Personal Statement And/Or Co-Worker Statement
7. Draft Your Appeal Letter


The challenge is that The Employee Retirement Income Security Act of 1974 (ERISA) is a horrible nationwide federal law that gives disability insurance companies an unfair advantage over disability insurance claimants. If you obtained either your short or long-term disability insurance coverage as employee benefit through your employer then your disability claim will be governed by the ERISA. The ERISA regulations for disability claims were modified in 2018, but these changes have only made it more difficult for claimants to win appeals and prevail in litigation.

The Insurance Companies

Our lawyers know the claim handling techniques of every disability insurance company and we are highly skilled at defeating them at their own game. Through our personal experience we have created and constantly maintain the most extensive resource on the internet for information about every disability insurance company. We want you to search below to learn as much as possible about your disability company, review our resolved cases against your insurance company and our experience in helping people with a situation similar to yours.

Videos, Questions, Resolved Cases, Lawsuit Summaries & Company Reviews

disability insurance companies complaints

The ERISA Facts

If your ERISA governed long-term disability claim has been denied following your initial application for disability benefits, ERISA regulations require the insurance company to establish and maintain a procedure by which a claimant shall have a reasonable opportunity to appeal an adverse benefit determination to an appropriate named fiduciary of the plan, and under which there will be a full and fair review of the claim and the adverse benefit determination. This means that your ERISA appeal must be reviewed by a person different than the original person that denied the claim. The idea is that a claimant is supposed to receive a full and fair review by the insurance company when an appeal is filed. Many people want to sue their insurance company and not bother with an appeal, but the law requires at least one appeal be filed and possibly two depending on your disability policy language.

Why Is It Important To Submit A Great Appeal?

  • The Trap... Do Not Rush Your Disability Appeal!
  • An ERISA Appeal Must Be Perfect

The insurance companies want you to draft and submit your own appeal, but it is nothing but a trap. The information submitted in an ERISA disability appeal is extremely important, as all of the documents submitted become part of what is known as the “administrative record”. In the event that your ERISA appeal(s) are denied and a lawsuit is filed, the court in most cases will be limited to their review of the administrative record. This means that if you were to have surgery after a final appeal decision is made by the disability company, then the court cannot review or consider any information about the surgery if it was not presented during the appeal. ERISA does not allow for a jury trial, therefore if a lawsuit is filed it will be decided by a Judge. A non-jury ERISA trial is usually a disadvantage for a claimant, because the Judge does not get to hear live testimony and the Judge is basically just reviewing documents in the administrative record. When submitting an appeal it is essential that a claimant submits every piece of information in support of a claim for disability benefits that the claimant would want a Judge to consider. The submission of a great appeal is an art and our disability attorneys are highly skilled at knowing what needs to be in an appeal and helping claimants to obtain the information needed to have the best chance to win an appeal.

How Do We Help?

  • Everything Must Be In the Appeal

In order to present our client’s appeal in a light most favorable to the insured, Attorney’s Dell & Schaefer work very closely with our clients and their treating physicians, to ensure that the appeals are submitted with an overwhelming amount of information and detail. Every case is unique and we work with your doctors to prepare statements that are specific to your medical condition and occupation. We make sure that every possible piece of objective medical evidence is obtained and we often recommend additional medical testing that could help prove your eligibility for benefits. In many cases, Attorneys Dell & Schaefer will retain a medical doctor or nurse to review all of our client’s medical records and make recommendations regarding additional evidence that would strengthen our client’s claim. The insurance companies often hire their own doctors to either review your records or examine you. We work very closely with your doctors and our nationwide medical experts to rebut the reports created by these insurance company hired gun medical doctors. In most disability appeals, Attorneys Dell & Schaefer will retain a vocational expert in order to determine what vocational skills a claimant can perform in light of the claimant’s medical restrictions and limitations. The vocational expert will also perform a labor market study in order to determine the availability of specific jobs in a particular market. We spend a great deal of time explaining the occupational requirements of a claimant’s occupation in order to make the insurance company understand why a claimant cannot work. We have access to all available medical research and we often rely on medical studies as further support for a client’s restrictions and limitations. The drafting of personal statements and statements from co-workers, family members and friends can be an important piece of an appeal we submit for you. In certain appeals we will submit a custom video to further explain the difficulties you are experiencing. We exhaust every option in order to submit the best possible appeal for you. We think outside the box and when we finally submit an appeal it is hard for the insurance company to disagree with us.

What Are The Important ERISA Timeframes?

  • Your ERISA Disability Benefit Appeal Must Include Everything

ERISA provides extremely strict guidelines and deadlines for disabled claimants seeking disability insurance benefits under their group policies. If sufficient information is not submitted within these timelines, a claimant may be forever barred from introducing the documentation to prove their disability. The disability insurance company is required to give a claimant 180 days from the date of initial denial to submit a first appeal. While 180 days seems like a long time to prepare a disability appeal, most of this time is required to submit an appropriate appeal. The appeal process is long because it often takes time to receive all of the claimant’s medical records, obtain new medical support and review the entire claim file provided by the disability insurance company. Once an appeal is submitted, the disability insurance company has 45 days to respond to a claimant’s appeal. However, the insurance company may request an extension for good cause. Attorneys Dell & Schaefer understand the importance of trying to obtain benefits for our clients in an expedient and efficient manner.

Frustrating as it may seem, the disability carrier will not tell you what is necessary to perfect your claim. Moreover, group disability income policies are drafted with ambiguous and confusing contractual terms. These ambiguities provide insurance companies with multiple reasons for delaying and denying disability income benefits. Furthermore, most policies provide the insurance company with full discretion in deciding whether sufficient information has been provided by claimants prior to approving a claim. Given the complexity of the legal issues involved and the tendency of insurance companies to vigorously defend claim denials, evaluation of any potential legal claim on behalf of an insured should be handled by a law firm experienced in ERISA disability insurance claims.

Attorneys Dell & Schaefer are available to provide you with a free consultation and review of your long term disability policy. Please keep in mind that there are time deadlines with ERISA disability claims and we must have sufficient time to evaluate your claim and take the appropriate legal actions on your behalf.

Questions About Hiring Us

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 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 telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. 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 attorney. We can be reached at 800-682-8331 or by email. Lawyer 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.

Dell & Schaefer Client Reviews   *****


I worked with Rachel Alters, who was very knowledgable about ERISA, my health condition and the best way to present information to my private LTD company. Being disabled, I am always tired, have little energy and have trouble concentrating, remembering things, etc. Rachel always maintained professionalism, would repeat the process if necessary and made things as easy on me as possible. She always made herself available if I requested a teleconference and her assistant was always prompt about returning my calls and providing information I requested.

In a professional setting, I’ve worked with attorneys for years and had to review and sign contracts. I know from personal experience that a contract is only as good as the people who stand behind it. I put my trust in Rachel and she delivered. We were able to get my LTD company’s denial decision reversed and I was put back on plan after she threatened to sue when they initially upheld their original decision to deny my claim. Having backpayment and being put back on plan definitely helps with my financial stress and I know it has taken its toll on my health.

I hope now that I have some financial security, I can focus more on getting better and do so more quickly. There is no doubt that I couldn’t have done this without Rachel. She guided me through the whole process, making sure that appropriate things were documented, we received the right information from the right medical professionals, had tests performed when needed, etc. It was a pleasure working with her and her team.

***** 5 stars based on 202 reviews

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Request a free legal consultation: Call 800-682-8331 or Email Us