Long-Term Disability Insurance, Life Insurance, and Health Insurance Claims under ERISA
Congress passed ERISA — the Employee Retirement Income Security Act of 1974 — primarily to address pension abuse, but ERISA governs claims for more than pension benefits. With few exceptions, ERISA applies to all claims for employee benefits, including insurance coverage offered by an employer to employees or by a union to its members. With rare exceptions, ERISA applies to all such claims — long-term disability insurance, life insurance, health insurance, and others.
The legal procedures to obtain employee benefits under ERISA present unique hardships for claimants. Almost all courts have ruled that a person claiming ERISA benefits has no right to a jury trial and, in fact, no right to a trial in the traditional sense. In most cases, courts do not permit an ERISA claimant to offer any testimony or any evidence not already in the insurance company's own file. Finally, courts will even defer to an insurance company's decision, requiring a claimant to prove not only that the insurer incorrectly denied the claim but that the insurer did so arbitrarily or without any reasonable basis. (Courts describe this as the abuse of discretion or arbitrary and capricious standard of review.)
When to Contact a Lawyer Regarding an Employee Benefits Claim
To succeed with a claim for benefits under ERISA, good legal advice is crucial. And the earlier the claimant seeks legal advice, the better. Many ERISA cases are won or lost during the claim procedures, including the filing of the claim and, if the claim is denied, the "appeal" or "request for review." At Dwyer & Brennan, we have been helping ERISA participants and beneficiaries fight for their rights to obtain employee benefits for more than ten years. Our lawyers are experienced at handling these difficult cases, and we have achieved successful results in court, especially at proving that the insurance company or employee benefit plan had abused its discretion by denying the claim arbitrarily and capriciously.
If you have an employee benefit claim for long-term disability insurance, life insurance, health insurance, or any other employee benefit, contact our Manhattan law office to schedule a free consultation.
Examples of ERISA Employee Benefits Claims We Have Handled
Besides having knowledge of the unique procedural rules under ERISA, Dwyer & Brennan's lawyers have knowledge of and experience with many different medical conditions, both injuries and sicknesses. Dwyer & Brennan's lawyers have experience working with complicated medical facts, communicating effectively with treating doctors and experts, and impeaching self-serving insurance company physicians and other experts.
We have handled cases involving the following disabling medical conditions:
- Chronic neck and back pain (with and without herniated discs, sciatica, and radiculopathy)
- Chronic neurological conditions, including paresthesia and peripheral neuropathy
- Chronic vascular conditions, including ischemic optic neuropathy
- Arthritis
- High blood pressure and heart disease
- Orthopedic conditions, including spondylolisthesis and degenerative diseases
- Thoracic outlet syndrome
- Myofascial pain syndrome
- Migraine headaches
- Lupus
- Fibromyalgia and chronic fatigue syndrome
- Mental and emotional illnesses, including depression, OCD, bipolar disorder, and anxiety
Contact our downtown Manhattan law office to schedule a free initial consultation. Our office hours are 9:30 am to 7:30 pm.
The attorneys at Dwyer & Brennan represent clients throughout New York City in state courts in Manhattan, Brooklyn (Kings County), Queens (Queens County), and the Bronx, and in all New York federal courts.
