The Long-Term Disability Law That Is Your Worst EnemyIs ERISA Long Term Disability Insurance Law Fair?

Judge William Acker, a respected US District judge, has been serving in US courts since ERISA was enacted. He has called ERISA out as a twisted, legislative monster.


He has called ERISA is “beyond redemption.”


"Occasionally, a statute comes along that is so poorly contemplated by the draftspersons that it cannot be saved by judicial interpretation, innovation, or manipulation. It becomes a litigant's plaything and a judge's nightmare. ERISA falls into this category. […] ERISA is beyond redemption. No matter how hard the courts have tried, and they have not tried hard enough, they have not been able to elucidate ERISA in ways that will accomplish the purposes Congress claimed to have in mind."


There is very little incentive for insurance companies to be fair, let alone objective, in how they administrate their claims. One reason why ERISA is such terrible law in it's application is that it assumes (pretends) that insurance companies can (and will) be impartial when deciding on how and when cases that may mean they have to pay out lot of money over long periods of time. What kind of companies would be fair and impartial about that if they weren't being held accountable? Probably not many.


ERISA Long Term Disability Laws Are Often Unrealistic About How The Insurance Company Will Behave

There have been some courts that recognize the improbability of fairness when it comes to ERISA Claims. Burroughs v. BellSouth is one of the rare cases when the courts acknowledged the impossibility of an insurance company ever being impartial in a decision about whether to give away their own company’s money. And you'd better believe they are cultivating a culture for their employees where they are trained to find ways to limit benefits. We see it all the time.

In the real world of ERISA decision-making, the deciders are virtually always affected by self-interest, and that their decisions are presumptively tainted. Burroughs v. BellSouth Telecommunications, Inc., 446 F. Supp. 2d 1294, 1299 (N.D. Ala. 2006).


This court decision went on to read: BST's conflict-of-interest was and is so glaring that it pervaded and corrupted its decision, ... All of the participants in the denial decision in this case were so self-interested as to call into question, if not to annihilate, their expressions of opinion.


Whats' the deal with judges passing over the issue of impartiality? According to ERISA, their decision is limited to whether or not the insurance company acted "reasonably." As long as the insurance companies can demonstrate that their decision was not completely capricious or outrageous, they don’t have to pay a cent for a plan if your plan has the following clause: "We have the discretion to determine benefits."


The System Is Unfair - Don't Fight It Alone. Reach Out To Our Experienced Long Term Disability Lawyers Today!

 Most people who file for long term disability need a lawyer to protect them from the excessive power of the insurance company to deny claims and keep money in their own pockets. They have tons of specialists, lawyers, claims managers, vocational rehabilitation specialists. If your ERISA, long term disability claim has been denied, call us today at (202) 393-3320. We will help you beat the insurance company at their own game.

Frank R. Kearney, Attorney-at-Law
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Experienced DC Workers' Comp, Long Term Disability & Accident Lawyer