There are over 1.3 million lawyers in the U.S. today, but when you’ve been wrongfully denied a critical benefit, choosing the right lawyer can make all the difference. How can the average person figure out how to choose the right lawyer to handle your benefits claim denial case? Many people resort to the internet, thinking that a well-phrased search will lead them to the right lawyer. Unfortunately, too many people choose the first result that pops up, not realizing that someone paid to be listed in that spot. Search terms are for sale to the highest bidder, and that lawyer may not be the best one for you. So, why does the right lawyer matter and how do you choose the right lawyer for your benefits denial case?
Table of Contents
Why Does the Right Lawyer Matter
Leveraging the Right Legal Counsel: Strategic Moves to Enhance Your Benefit Claims
Finding the right lawyer and not just any lawyer is critical to the success of the claim. The right lawyer will know how to analyze the insurance company’s rationale for denying benefits, identify what is needed to turn the claim around, and assist the claimant in securing the necessary evidence. The right lawyer also anticipates the insurance company’s response to a claim appeal and will carefully build a record for a possible lawsuit if the appeal is not successful that is ready to go to trial on day one.
The wrong kind of lawyer may lack the necessary experience or expertise to address the client’s unique issues and to know what courts are looking for to prove the insurance company’s decision was wrong.
While no reputable lawyer can guarantee a favorable outcome, the right lawyer will do everything necessary to enhance the probability of success.
If You’ve Wrongfully Been Denied Disability, Health, or Life Insurance Benefits, How Do you Choose the Right Lawyer to Help You Get the Benefits You Deserve?
Even if you know a lawyer or know someone who knows a lawyer, any lawyer isn’t good enough. You need to find the lawyer who is best suited to handle your case. You would not hire a lawyer who concentrates on divorce law to handle a criminal case, and the same rule applies when you are looking to hire a benefits lawyer.
So, what should you look for?
1. Look for a Lawyer Whose Practice is Concentrated in Handling Benefits Claims
Most disability, life, and health benefit matters arise under employer-sponsored benefit plans. In most instances, that means the claim is governed by the ERISA law (Employee Retirement Income Security Act). If ERISA and benefits are not the focus of the lawyer’s practice and some other area of practice such as personal injury law is, find another lawyer. Even though Social Security lawyers handle “disability” claims, they might not be the right fit for an ERISA disability benefit case.
Our practice is focused on disability, life, health, and other benefits issues – that is all we do, and we have been handling such benefits-related cases since the 1980s.
2. Look for a Lawyer Who Has the Experience and a Track Record of Successfully Handling Benefits Cases Like Yours
Every case is unique, but many involve issues that recur. Don’t just settle for a lawyer who claims they have handled cases similar to yours; find a lawyer who has actually litigated similar cases and achieved results. Court rulings are public records and can be looked up.
The right lawyer to hire should also have appellate court experience – a lawyer who has lost in the trial court but won in the court of appeals is a lawyer who knows their way around the courthouse and is a proven fighter for their clients who doesn’t just settle cases. We like to say about our firm that we don’t just follow the law; we make the law. Here are just a few of our court victories in courts around the country over more than 25 years:
- Fontaine v. Metropolitan Life Ins. Co., 800 F.3d 883 (7th Cir. 2015). ERISA Claim – Court of Appeals found that Illinois Insurance Regulation 50 Ill. Admin. Code § 2001.3 was not subject to ERISA preemption and precluded applicability of arbitrary and capricious standard of review.
- Raybourne v. CIGNA Life Ins. Co. of N.Y., 700 F.3d 1076 (7th Cir. 2012). ERISA Claim – Court of Appeals upheld district court ruling finding insurer improperly terminated disability benefits – The court found the Social Security disability benefit determination was not properly taken into consideration by the insurer, that the insurer was motivated by a financial conflict of interest, and that the insurer’s reliance on an independent medical examination was misplaced. The court also upheld an award of attorneys’ fees to Raybourne’s counsel.
- Stephan v. Unum Life Ins. Co. of America, 697 F.3d 917 (9th Cir. 2012). ERISA Claim – Court of Appeals overturned district judgment in favor of insurer – The court found Unum’s interpretation of the term “earnings” was arbitrary and capricious; the court also applied the fiduciary exception to attorney-client privilege to permit discovery of communications between claim analyst and inhouse counsel during course of claim administration.
- Holmstrom v. Metropolitan Life Ins. Co., 615 F.3d 758 (7th Cir. 2010). ERISA Claim – Court of Appeals overturned district court denial of disability insurance benefits recognizing significance of pain in disability assessment and criticizing insurer for presenting claimant with “moving target” as to what evidence to submit.
- Diaz v. Prudential Insur. Co. of America, 499 F.3d 640 (7th Cir. 2007) and 422 F.3d 635 (7th Cir. 2005). ERISA claim – Court of Appeals overturned district court rulings for insurer finding that court should not have given deference to insurer’s findings. Court overturned two prior rulings and set precedent regarding standard of review applicable to ERISA claims and method of adjudicating ERISA claims.
- Feibusch v. Sun Life, 463 F.3d 880 (9th Cir. 2006). ERISA claim – Court of Appeals overturned district court ruling for insurer and ruled that lower court improperly applied discretionary standard of review. The court also ruled the district court improperly construed insurance contract.
- Seitz v. Metropolitan Life Insur. Co., 433 F.3d 647 (8th Cir. 2006). ERISA claim – Court of Appeals overturned district court ruling for insurer and ruled that even if claimant can perform some job duties, he qualifies for disability benefits if he cannot perform all job duties.
- Ruttenberg v. U.S. Life, 413 F.3d 652 (7th Cir. 2005). ERISA claim – Court of Appeals overturned benefit denial and established doctrine of contra proferentem and “reasonable expectations of the insured” in benefit claims brought under ERISA.
- Herzberger v. Standard Insurance Company, 205 F.3d 327 (7th Cir. 2000). ERISA claim—court overturned prior precedent to issue sweeping ruling modifying standard of review applicable in employee benefit cases.
- Ladd v. ITT Corp., 148 F.3d 753 (7th Cir. 1998). ERISA Claim – Summary judgment for defendant reversed on appeal based on inconsistency between position taken by insurer with respect to Social Security disability payments; benefits awarded to plaintiff.
Our website, within the Resources section, also contains a wealth of information about the issues that arise in cases relating to disability, life, and health insurance, which includes articles our lawyers have published in leading journals, lectures our lawyers have presented at seminars around the country, articles in major national publications such as the Washington Post and others which our lawyers have been quoted, and Congressional and other testimony presented by our lawyers.
3. Look at What the Lawyer’s Clients Have Had to Say: Client Testimonials
Most law firms post client testimonials but potential clients need to take the time to read them. Client testimonials attest to the lawyer’s skill and expertise but also tell you about how the lawyer deals with their clients – responsiveness, and caring are critical things a client needs to look for in a lawyer.
Clients need to look for words such as caring, concerned, and empathetic, and expect that their lawyer understands their concerns and goals. Our firm’s testimonials speak for themselves and include comments such as the following:
“Thankful for all of your help in this appeal process .. and hopeful that other long covid clients have the same result.”
“Impressed and encouraged by an excellent appeal by Mark DeBofsky – succinctly, effectively and efficiently presented, researched and argued.”
“Mark and his team repeatedly exhibited a dedicated, ethical, caring attitude and a deep level of expertise that is uncommon”
“The best thing I ever did was contact DeBofsky Law. I cannot speak highly enough of everyone at this Firm. From the beginning I was treated respectfully, answers to questions were answered almost immediately, and most important of all, they listen to you. The two attorneys who represented me were Martina Sherman and Matthew Maloney. Their work forced the Insurance Company to reverse their decision to deny my claim. Knowing I had them behind me gave me made this difficult process so much easier. That trust was not misplaced and if you need help with an appeal, look no further. DeBofsky Law is the only firm you want to work with. Absolute professionals who are worth their weight in Gold in my Opinion. Thank You so much for all of your help.”
“The kindness, respect and professionalism afforded to me from my ﬁrst meeting … up to the Appeal letter by Martina is a model of how people should be treated.”
“Marie singled handedly changed my life. She is an exemplary attorney with Integrity!”
“I was amazingly fortunate to have found Attorney Marie Casciari and her team at DeBofsky Law”
“You made a hard time a lot better.”
“Mark DeBofsky is an outstanding attorney”
“Mark DeBofsky is extremely knowledgeable and caring and doesn’t leave stones unturned.”
4. Where Is the Lawyer Located – Consider a National Practice
Many lawyers who handle disability, life, and health insurance cases, including ourselves, have nationwide practices and have successfully handled cases for clients across the United States. We have even successfully represented clients in Europe and Asia who had worked for American companies. Technological advances have made it easier to do so. In picking a lawyer, location is less important than choosing the right lawyer for the case.
5. How Am I Going to Be Charged?
There is no such thing as a “standard” or “flat” fee, and clients need to know how they are being charged and be comfortable that the charges are fair and appropriate for the services being performed. Clients should not assume that every lawyer who handles cases involving benefit denials charges the same fees and should not be afraid to seek other representation if they feel they are being charged an excessive fee. However, clients need to understand that the lawyer who charges the lowest fee may not be the best lawyer for their case.
We take pride in our fee arrangements with our clients – our fees are always spelled out in advance and we always live up to our promises.
Making the Right Decision:
Cases involving disability, life, and health insurance are complex; and when faced with the need for legal consultation or a legal representation to fight an unwarranted benefit denial, the choice of a lawyer is the most important decision a client needs to make. Choosing a lawyer with the right combination of skill, experience, compassion, and zeal can be a challenge. However, investing a little time in finding a lawyer who best meets the client’s needs rather than making a hasty choice based solely on internet rankings or clever marketing is more likely to lead to a better outcome for the client.