If it were a car accident or even a workers compensation case, I would tell you that you may or may not need an attorney's help to manage your claim. This is not true of ERISA long term disability cases. With these cases, I can tell you that it's a massive mistake not to hire an attorney.
The reality is: this area of law is simply too nuanced and difficult to learn on your own in a short amount of time.
Here at Donahoe Kearney, we pride ourselves on being honest and forthright with people when we think they DON'T need an attorney, We also have a lot resources for people who want to save the money and try the case themselves (how many lawyers say that)?
We will be honest with you if we believe we won't be adding value to your case. In fact, just the other day we heard from someone who we told they didn't need an attorney for their workers' compensation case. We explained the forms to her, as well as the process. When she called us about her ERISA case she said
"if you guys would point me AWAY from hiring an attorney, I knew I could trust you to look into my long term disability insurance case."
Although I wish there were, there are no simple tools or forms that we can give you in order to help you manage your ERISA long term disability insurance case, especially if it's in the appeal stage. The law is simply too friendly to insurance companies, and there is too much complexity involved when only have 180 days to appeal a denied claim.
Don't take it from me, here's what federal judges have to say about ERISA:
"Sometimes it feels as if the only thing that purchasing insurance actually ensures is that one will eventually have an unpleasant dispute with the insurer over payment on a claim." from Judge Richard D. Cudahy of the 7th Circuit : Great West Casualty Co. v. National Casualty Co., 385 F.3d 1094 (7th Cir. 2004).
"Caveat Emptor! This case attests to a promise bought and a promise broken. The vendor of disability insurance now tells us, with some legal support furnished by the United States Supreme Court, that a woman determined disabled by the Social Security Administration because of multiple disabilities which prevent any kind of work cannot be paid on the disability insurance she purchased through her employment.
"The plan and insurance language did not say, but the world should take notice, that when you buy insurance like this you are purchasing an invitation to a legal ritual in which you will be perfunctorily examined by expert physicians whose objective it is to find you not disabled, you will be determined not disabled by the insurance company principally because of the opinions of the unfriendly experts, and you will be denied benefits. Fortunately, the law, though left moribund by the Supreme Court's legal interpretations, does not allow the purveyor of such empty promises to win the day" Judge Enslen from the W.D. Mich. in Loucks v. Liberty Life Assur.Co. of Boston, 337 F. Supp. 2d 990; (W.D. MI. 2004).
"A hyperbolic wag is reputed to have said that E.R.I.S.A. stands for "Everything Ridiculous Imagined Since Adam." . . . [T]his court is willing to believe that ERISA has lurking somewhere within it a redeeming feature. However, this is not the case in which to find it." Florence Nightingale Nursing Serv. v. Blue Cross & Blue Shield, 832 F. Supp. 1456 at 1457 (N.D. Al. 1993).
The moral of the story: you should talk to an experienced law firm about your case. Not many firms do ERISA regularly, and those who wander into the ERISA world unprepared are in for a big (and costly) surprise. Don't blow your chances on appeal by choosing the wrong attorney.
We are eager and excited to talk to you about your case - just give us a call at 202-393-3320. In the end, our goal is to help you make the best legal decision possible, whether that means hiring us or not.