ERISA Disability Attorneys

When your employer-sponsored disability insurance company denies your legitimate claim, the betrayal cuts deep.

You faithfully paid into a benefit plan that promised financial protection during your most vulnerable moments, only to discover that the same company now stands between you and the security you need.

Employee Retirement Income Security Act (ERISA) disability denials are not always random events. For many, they seem to be calculated business decisions designed to protect corporate profits at your expense.

At Sandstone Law Group, we level the playing field against insurance companies that abuse ERISA protections to avoid paying legitimate disability claims.

Our attorneys understand the federal court system, administrative procedures, and corporate tactics that make ERISA cases uniquely challenging.

Don't let complex and confusing insurance requirements work against you. Call (602) 615-0050 or message experienced ERISA disability attorneys online to schedule a free case evaluation that explores your legal rights and options.

Key Takeaways About ERISA Disability Claims

• Administrative exhaustion requirements typically mandate completion of internal appeals before federal court litigation, making the appeals process critically important to case outcomes. 
• Federal court jurisdiction varies significantly by district, with the Ninth Circuit (California and Arizona) generally providing more favorable interpretations than other circuits for disability claimants.
• Discretionary clause bans in states like California prohibit insurers from including language that gives them broad authority over claim decisions, resulting in de novo court review.
• Summary Plan Descriptions and plan documents often contain conflicting provisions that ERISA attorneys can leverage to challenge improper denials.

The Legal History of ERISA Disability Claim Denials

The Employee Retirement Income Security Act (ERISA), enacted in 1974, was designed to protect employees’ benefits, including long-term disability insurance. But the statute was primarily written for pension benefits, and Congress tacked on life, health, and disability right before the law’s passage. Our experienced long-term disability insurance. help clients navigate the complexities of ERISA and fight to recover the benefits they’ve rightfully earned.

Because the statute was not written with disability claims in mind, it was fraught with ambiguity, and the courts had to determine how to handle claims. Over time, the law generally evolved in such a way where insurers and plan administrators have been able to use ERISA to their advantage, creating significant challenges for claimants seeking the benefits they deserve. For instance, ERISA provides limited remedies and does not allow claimants the right to a jury trial. 

ERISA disability denials have sparked numerous lawsuits and regulatory actions, exposing systemic issues in how claims are handled.

In Glenn v. MetLife, the U.S. Supreme Court addressed the conflict of interest created when insurers decide and pay claims. This landmark ruling required courts to consider these conflicts, setting a critical precedent for ERISA cases.

Similarly, Heimeshoff v. Hartford Life & Accident Insurance Co. clarified the potential for strict timelines in filing ERISA lawsuits, underscoring the importance of timely appeals.

Tactics Insurers Use to Deny ERISA Disability Claims

Insurance companies managing ERISA disability claims often employ calculated strategies to deny or delay benefits, making it difficult for claimants to navigate the process alone. These tactics are designed to protect their bottom line at the expense of your rights.

Exploiting Discretionary Clauses

Many ERISA plans include discretionary clauses that give insurers broad authority to interpret policy terms and decide whether to approve or deny claims.

Insurers use these clauses to justify denials, knowing that courts often defer to their decisions unless claimants can prove a clear abuse of discretion.

This makes it critical to build a strong case that challenges their interpretation and demonstrates the validity of your claim.

Conducting Biased Medical Reviews

Insurers frequently rely on in-house or contracted medical reviewers who never examine claimants in person.

These reviewers often dismiss the opinions of treating physicians, downplay symptoms, or cherry-pick evidence to support a denial.

This biased approach undermines the credibility of your medical evidence and can make it harder to prove your disability without additional legal support.

Violating Procedural Requirements

ERISA imposes strict procedural requirements on insurers, including providing clear notices of denial, detailed explanations, and instructions for filing ERISA disability appeals.

However, many insurers fail to meet these obligations, leaving claimants without the information they need to challenge a denial effectively.

Identifying and leveraging these procedural violations can strengthen your case and improve your chances of success.

Twisting Policy Language

Insurers often manipulate vague or ambiguous terms in plan documents to deny claims. They may interpret policy language to limit coverage or impose additional hurdles for claimants.

This tactic forces individuals to engage in complex legal arguments to prove their eligibility, making it essential to have an attorney who can analyze and challenge these interpretations.

Why Choose Sandstone Law Group to Fight ERISA Disability Denials?

When your ERISA-governed disability plan denies your long-term disability benefits, it is a betrayal of the trust you placed in your employee benefits package. 

At Sandstone Law Group, we fight to restore your income, peace of mind, dignity, and sense of control. When plan administrators and insurance companies refuse to honor their obligations under ERISA, we step in with conviction, clarity, and relentless legal resolve.

We Know Insurance Company Tactics: Insurance companies and plan administrators often use calculated strategies to deny or minimize valid claims, including:

• Discrediting treating physicians.
• Downplaying symptoms using biased reviewers.
• Exploiting surveillance footage out of context.
• Misapplying policy language to limit or terminate benefits.

We have seen it all: Our attorneys have successfully challenged these strategies 

across ERISA-governed disability plans. We handle every stage of the process, including:

• Appealing internal denials with robust medical and legal documentation.
• Challenging biased IMEs, peer reviews, and vocational assessments.
• Litigating ERISA disability denials in federal court.
• Using procedural violations and fiduciary breaches to shift leverage in your favor.

We Are Courtroom-Ready: While many firms quietly settle or avoid litigation, we take the opposite approach: we prepare every case as if it will go to court. That mindset forces plan administrators and insurance companies to take our clients seriously, and it shows in our track record.

We Win Because We Care: We do not treat cases like files or numbers. We treat them like the deeply personal battles they are. Our clients are people whose lives have been upended by disability and corporate denial—and we treat their stories with the respect and legal firepower they deserve.

Our team brings a rare combination of legal aggression and personal compassion. We have seen the damage done by ERISA disability denials, and we fight like it is personal, because in many ways, it is.

Common Legal Challenges You May Face and How Our ERISA Disability Denial Lawyers Can Help

ERISA disability claims are fraught with unexpected hurdles, from complex federal regulations to insurance company tactics designed to deny or delay benefits. 

Our attorneys are here to help you navigate these challenges with actionable legal solutions, including:

• Guiding you through the appeals process: We ensure all procedural requirements are met, building a strong administrative record to support your case in federal court if necessary.
• Challenging biased medical reviews: Our team counters unfair assessments by presenting comprehensive medical evidence and securing independent evaluations from trusted specialists.
• Exposing conflicts of interest: When insurers act as decision-makers and payers, we highlight these conflicts to push for fairer claim evaluations and court review standards.
• Meeting strict documentation requirements: We know exactly what evidence is needed and how to present it effectively, ensuring your appeal is thorough and compelling.
• Decoding complex plan documents: Our attorneys analyze conflicting provisions in plan documents to identify favorable interpretations and challenge restrictive policies.

These legal complexities can overwhelm claimants already dealing with serious health challenges. Our team takes on the administrative and litigation burdens so you can focus on your recovery and well-being.

How to Appeal ERISA Disability Denials with Legal Support

Appealing an ERISA disability denial is a high-stakes process requiring more than submitting additional paperwork. It demands a strategic approach tailored to the unique challenges of ERISA regulations and the tactics used by plan administrators.

At Sandstone Law Group, we focus on building appeals designed to succeed, whether through administrative review or in federal court. Here’s how we approach the appeals process:

• Thorough case analysis: We dissect your denial letter, plan documents, and medical records to uncover weaknesses in the insurer’s decision and identify opportunities to strengthen your appeal.
• Strategic evidence development: Beyond gathering medical records, we collaborate with independent physicians, vocational experts, and other specialists to build a compelling case that supports your claim.
• Leveraging procedural violations: If your plan administrator failed to follow ERISA’s strict procedural requirements, we use these violations to strengthen your position and create leverage during appeals.
• Customizing legal arguments: Every ERISA plan is different, and we tailor our legal strategies to address your policy's specific language and provisions.
• Litigation-ready preparation: Even during the appeals process, we prepare your case as if it will go to court, ensuring that every detail is documented and every argument is airtight.

The ERISA appeals process is not something you should face alone. With Sandstone Law Group, you’ll have a dedicated legal team handling the complexities of your case, so you can focus on your health and recovery.

ERISA Disability Attorneys FAQs

Protect Your Federal Disability Rights With ERISA Disability Attorneys from Sandstone Law Group

Your employer-sponsored disability benefits represent a crucial safety net that you earned through years of work and premium contributions. 

When plan administrators deny legitimate claims, they violate the trust you placed in your employee benefits package and the federal protections ERISA was designed to provide.

The appeals process often determines the outcome of potential federal court litigation, and missing deadlines or submitting inadequate appeals can permanently damage your case.

At Sandstone Law Group, we have the federal litigation experience and ERISA knowledge to take on major insurance companies and employee benefit plan administrators.

We understand the unique challenges of ERISA disability law, know how to build compelling administrative records, and have a proven track record of holding plan administrators accountable under federal law.

Don't let ERISA's complexity work against you. Call (602) 615-0050 or complete a brief online contact form to schedule a free, confidential case evaluation with experienced ERISA Disability denial attorneys ready to fight for your rights.