With more than 20 years of experience helping disabled clients settle claim denials, disability insurance attorneys Greg Dell and Rachel Alters share their expertise in ERISA appeals and resulting lawsuits. Once all administrative remedies have been exhausted in a disability insurance claim denial with The Standard, it’s crucial to understand the next steps forward and how to handle litigation in a court of law.

After many weeks or even months of dealing with a long term disability insurance claim, you finally get an answer from The Standard: you’ve been denied. You’re holding that letter in your hand stating that the insurance company does not believe you are disabled and therefore you have no rights to compensation. But you do have the right to file an ERISA lawsuit and have a judge review your case.

It can be an uphill climb for the person claiming a disability, but a seasoned disability attorney who has handled hundreds of lawsuits against The Standard can remove the stress and confusion from the process. Here’s a roadmap showing you what to expect and how to move forward to a successful outcome.

What happens once you hire an attorney?

The first thing to do after hiring a disability insurance attorney is to relax. Your attorney will send a letter of representation to The Standard, at which point the insurance company can no longer directly contact you for any reason. By law, they must go through your attorney, who is now busy requesting and then reviewing the original claim file.

Disability insurance attorney Rachel Alters explains that this file contains every medical record, every claim, every note in the administrative record. This includes the doctors they hired and the peer-review physicians who have given their medical opinions on the specific case. After determining what they based the denial on, the attorney then makes a detailed complaint and files the lawsuit in federal court. ERISA lawsuits can be filed in any federal court across the country, so a knowledgeable lawyer will choose one that best benefits your case.

How long does the process take?

It’s likely that every client who comes to disability insurance attorneys Dell & Schaefer has already been without benefits for six to nine months, if not longer. That includes potentially 180 of appeal and up to 120 days that The Standard took to make its denial decision. So, it’s understandable that financial considerations are coming to the forefront.

Unfortunately, it’s not a quick process. After filing the complaint in federal court, The Standard has 21 days to answer, plus any requested extensions. This can bring the response time to 45 days, after which they can file a counterclaim or move on to the judge entering a scheduling order. This order determines when a “motion for summary judgment” is due as well the mediation deadline, and it can also set the actual trial date.

The trial date in an ERISA lawsuit claim is typically anywhere from six to 12 months but can take longer depending on the circumstances and the court docket loads. However, attorney Rachel Alters notes that some judges appear to be speeding up the cases.

“Some of the judges lately are fast-tracking them,” she says. “It can be set within six months … and when that happens, it’s often better for the claimant because then we get a quicker mediation date. We can send out a demand quicker and try to get it resolved on a faster timeline.“

Settling Versus Going to Court

According to attorney Greg Dell, about 97 to 98 percent of disability litigation cases are resolved in what’s called a “lump settlement.” So, why would any person with a disability claim choose to settle the case in mediation instead of going the distance to a trial verdict, thereby releasing their right to full compensation?

Rachel Alters explains that every case is different and that the ERISA law (which stands for Employee Retirement Income Security Act), actually protects the insurance companies more than the claimants. The insurance companies can claim in court that they have “reasonable basis” for denying the claim, which puts the onus on the disability insurance attorney to prove that insurance carriers such as The Standard were “arbitrary and capricious” in their denial of the claim. In other words, the insurance company can have just one reasonable basis for denial that legitimizes their actions, such as a statement from their hired staff of doctors saying that the person is not disabled.

Another reason for settling the lawsuit in arbitration is that the disabled claimant will only receive past benefits if they win in court – with no guarantee of future benefits. So, The Standard can turn around and determine that no ongoing disability exists, essentially restarting the process all over again. It’s often not worth the time or the risk of losing in a new round of legal actions.

Risks and Rewards

All this starts to make a lump-sum settlement look pretty good. As attorney Greg Dell points out, it becomes a business decision at that point. If the policy is worth, for example, $200,000 but The Standard offers $75,000 to settle, you have to weigh the reduced reward against the possibility of losing and getting zero.

Dell stresses that the disability insurance attorneys at Dell & Schaefer are willing to go the distance for the client when it is in the best interest to pursue the case to a final court decision. The insurance company likely has no interest in dragging the case on for years while paying tens of thousands of dollars on their own attorneys. They know a client represented by a knowledgeable and experienced lawyer is going to cost them, so it’s highly likely that a settlement offer from them will hit the table. The question is just “how much” and “how soon.”

No matter where you live in the United States, attorneys such as Greg Dell and Rachel Alters can help you. There is never a fee or cost of any kind unless they win the case or negotiate a settlement, at which point they receive an agreed-upon percentage as your attorneys. You can also click the free consultation button on the Dell & Schaefer website to get the ball rolling. A lawyer will call you right away and let you know if they can take your case from denial to resolution in the most professional and efficient way possible.