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ERISA Lawyers

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Turning Denials Into Victories

Denied LTD claim after 2 years. Mark was fantastic—responsive, clear plan, deep LTD knowledge. Won full claim with back pay & interest. – J.S.

Relief After a Denial

Matt led my ERISA long-term disability appeal with precision. His strategy and communication gave me confidence—and delivered the outcome I needed. – R.K.

Clarity in a Confusing Process

Marie guided me through a difficult pension claim. She was calm, organized, and always made me feel my case mattered. – A.L.

Peace of Mind Restored

When I felt overwhelmed, Mark simplified the process, gave me peace of mind, and resolved my LTD case during a stressful time. – P.D.

Benefits Reinstated

After my insurer cut off LTD benefits, DeBofsky Law laid out a plan, fought back, and reinstated everything I had earned. – K.M.

ERISA Protects Your Promised Benefits

Employees who receive benefits such as health care, disability insurance, and a 401(k) retirement plan from their employers have legal rights under the federal Employee Retirement Income Security Act (ERISA) and its amendments. Under ERISA, you have the right to:

  • Establish a grievance and appeals process to get your benefits
  • Sue for your rightful benefits
  • Sue for breaches of fiduciary duty
  • Keep your health insurance for a limited time after a loss of job
  • Fight discrimination in health care

ERISA law covers more than you think. It protects the benefits you rely on. To ensure the protection of those rights, you need an ERISA attorney you can depend on. With over 60 years of combined legal experience and over 100 appellate decisions to our name, DeBofsky Law knows how to use the ERISA statute to hold employers accountable and get you the benefits you were promised.

What Is the ERISA Law?

ERISA (29 U.S.C. § 1001 et seq.) is an expansive federal statute that was enacted in 1974 to prevent pension plan abuses. ERISA requires that pension assets be held in trust, and it imposes fiduciary duties and reporting requirements on employers and plan administrators. ERISA also established the Pension Benefit Guarantee Corporation (PBGC), which provides relief to participants in failed pension plans.

ERISA has broad preemption language (29 U.S.C. § 1144) that supersedes all state laws that relate to employee benefits, except for criminal laws, insurance laws, and laws that regulate banking and securities. ERISA provides the exclusive remedy for a denial of benefits or breach of fiduciary duty, and it supersedes state bad faith laws and laws providing compensatory and punitive damages.

ERISA (29 U.S.C. § 1140) makes it unlawful for an employer to retaliate against a plan participant or beneficiary for exercising his or her right to employee benefits, or for blowing the whistle on plan abuses and fiduciary misconduct.

We Set the Bar in ERISA Litigation

We fight for our clients in state, federal, and appellate courts in disputes with employers, insurance companies and retirement fund managers.

Our Founding Partner, Mark DeBofsky, Explains ERISA:

Mark DeBofsky is the founding partner of DeBofsky Law and a nationally recognized authority on ERISA and employee benefits law. With decades of experience representing individuals in disability, retirement, health, and life insurance benefit claims, Mark has argued landmark cases before federal courts, shaping the interpretation of ERISA Nationwide. He is also a frequent lecturer, author of numerous articles on employee benefits litigation, and an adjunct professor at a leading law school.

What Does ERISA Apply to?

ERISA is noteworthy for its breadth. It applies to all employer-sponsored benefit plans, including not just pension benefits but also health insurance, disability insurance, life insurance, accidental death and dismemberment insurance, and even severance benefits, among others.

ERISA applies to all employer-sponsored benefit plans, regardless of the size of the employer or number of employees, subject to only a handful of exceptions:

  • Government employers are exempt from ERISA;
  • Religiously-affiliated employers (aka “church plans”) are exempt from ERISA (but can opt into ERISA regulation);
  • “Payroll practices,” such as short-term disability plans that pay an employee’s salary from an employer’s general assets, are exempt from ERISA;
  • Voluntary insurance that is made available by an employer, but where participation is voluntary, not endorsed by the employer, and the employee pays the premiums, is exempt from ERISA; and
  • Individual insurance or retirement benefits that are purchased or obtained by the employee outside of the employment context are exempt from ERISA.

What Does an ERISA Attorney Do?

An ERISA lawyer can help you by confirming that ERISA applies to your claim and by obtaining the governing plan documents from your employer. The lawyer should counsel you as to the plan terms and identify other employee benefits and employment laws that are implicated by your situation. An ERISA lawyer can assist you in preparing a benefits claim and can anticipate issues to avoid a claim denial. If your claim is denied, an ERISA lawyer should obtain the claim file and use that information to inform his or her strategy concerning your appeal.

If your appeal is denied, an ERISA lawyer can assist you by filing a suit on your behalf against the appropriate parties, in the ideal jurisdiction, citing all viable theories of recovery. An ERISA lawyer can negotiate a settlement with the other side or, if settlement discussions fail, take your case to judgment (and, if necessary, to the court of appeals) until you receive justice.

What Remedies Are Available Under ERISA?

ERISA remedies for a denial of benefits are very limited. An ERISA plan participant can recover the benefits due to him or her through the date of judgment, as well as potential interest and attorneys fees. Claimants cannot recover compensatory or punitive damages. Similarly, in a suit for plan-wide relief, individualized relief is generally not available, although a participant in a 401(k) plan may sue a plan administrator for losses that affect only that participant’s account.

A participant may use an ERISA plan administrator to obtain “other appropriate equitable relief” (including, potentially, “make whole” relief), but such relief is generally not available where the plan language unambiguously forecloses benefits.

Remedies are also available if a plan administrator fails to respond to a request for plan documents, and employment retaliation related to benefits claims and whistleblower claims.

What Does an ERISA Attorney Charge?

There are a variety of ways in which an ERISA lawyer may structure his or her attorney’s fees.  Attorneys handling an appeal or lawsuit over the denial of benefits typically operate on a contingency fee basis, in which they charge a percentage of the total recovery in exchange for assuming the risk of losing the case and recovering $0.

In some circumstances, it may not be possible to offer a contingency fee arrangement because the underlying benefits have already been received, as is often the case in an ERISA health insurance dispute. In those circumstances, the attorney may offer his or her services on an hourly or flat fee basis.

Attorney’s fees are recoverable under ERISA, but an award of attorney’s fees is subject to the discretion of the trial court. Courts typically consider the following five factors in deciding whether to grant an award of attorneys’ fees:

  • the degree of the offending parties’ culpability;
  • the degree of the ability of the offending parties to satisfy personally an award of attorneys’ fees;
  • whether or not an award of attorneys’ fees against the offending parties would deter other persons acting under similar circumstances;
  • the amount of benefit conferred on members of the pension plan as a whole; and
  • the relative merits of the parties’ positions.

Additionally, in the Seventh Circuit, courts consider whether the losing party’s position was substantially justified.

Notably, attorneys’ fees may be awarded not just to prevailing plaintiffs but to prevailing defendants as well. Thus, a claimant can be ordered to pay the attorneys’ fees of a prevailing ERISA plan administrator or fiduciary, though such awards are rare.

Why Choose Us as Your ERISA Lawyer?

ERISA disputes are technical and unforgiving. Insurers lean on plan language and procedure to deny valid claims. You need counsel that understands the law, the record, and the path to a result.

At DeBofsky Law, every matter begins with a clear plan, careful record development, and precise advocacy. Our focus is on restoring the benefits you have earned and protecting your financial future.

How DeBofsky Law Helps You in Your ERISA Case

What Makes DeBofsky Different

  • Precedent setting appellate work that helps shape ERISA law
  • Service on national advisory bodies and ongoing legal education and publishing
  • ERISA only focus that avoids a one size fits all approach
  • Appeals prepared with litigator precision to strengthen the record before court
  • Direct attorney communication and clear expectations at every stage

Know Your Rights

ERISA is a complex law that governs a wide range of employee benefits. We can help you understand your rights, and if your benefits are denied, we can help you protect those rights.

Does This Apply to You?

Contact DeBofsky Law for an attorney consultation. We will work with you to figure out your problem, and how we can help.

How DeBofsky Law Structures Fees for ERISA Cases

We have different fee arrangements for ERISA benefit claims. Depending on your case, we can offer hourly or contingency fee options. With contingency, you owe nothing for our services unless your claim succeeds. We cover all of this during your initial consultation. Learn more about our approach to ERISA case fees.

Contact us today!

DeBofsky Law ERISA lawyers focus on employer-sponsored benefit claims, including disability, life, health, accidental death & dismemberment (AD&D), and retirement plans. We do NOT handle matters involving Social Security, workers’ compensation, veterans’ benefits, ADA claims, Medicaid/Medicare, or employment law.

Successfully Appealing Wrongfully Denied ERISA Claims

Your case doesn’t end at the initial denial or even when you receive an adverse court ruling. There’s no need to give up. There are resources to fight on. Whether we represented you at trial or not, we may be able to appeal.

Insurance companies count on people not understanding the law, and not understanding the specific procedure to appeal a denied ERISA claim. Our expertise in ERISA law lets us understand what errors occurred during the trial that impacted the outcome.

Once we accept your appeal, we will effectively present your case and work toward getting the verdict overturned. We don’t stop until you get what you deserve.

ERISA litigation strategy for employee benefits disputes
MASTER YOUR ERISA CLAIM | YOUR ERISA DENIAL AND APPEAL GUIDE

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Our Recent ERISA Victories

In ERISA cases, the odds are stacked against claimants. We’re here to fight on your behalf. See How We’ve Won for Our Clients.

Disabilities Insurance | Covid Syndrome

Ward v. Reliance Standard Life Insurance Co.

DeBofsky Law achieved a favorable ruling where the court found that Reliance Standard Life Insurance Company abused its discretion in terminating long-term disability benefits for COVID syndrome. The court determined that the insurer failed to properly consider comprehensive medical evidence of cognitive impairments. Consequently, the case was remanded for further proceedings to ensure a thorough review of the disability claim.

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Disability Insurance

Robinson v. Aetna Life Ins. Co.

DeBofsky Law won two cases for our client. In the first case, the court denied Aetna’s motion to dismiss, noting the plan did not address retroactive SSDI awards. The judge found Robinson’s claim was not time-barred due to her voluntary appeals. In the second case, the court ruled the denial of benefits arbitrary and capricious due to Robinson’s retroactive SSDI award and found Aetna’s refusal to toll its review problematic.

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Disability Insurance 

Scanlon v. LINA

A system analyst with spinal pain and a sleep disorder won his appeal with the help of DeBofsky Law. The court ruled that the district court erred in its assessment, failing to properly consider the claimant’s functional capacity and inability to earn 80% of his income due to his condition. This decision underscores the importance of thorough evaluations in chronic conditions and long-term disability cases.

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ERISA Frequently Asked Questions (FAQs)

What plans are covered under ERISA?

ERISA, or the Employee Retirement Income Security Act, is a U.S. law that was passed in 1974. It protects people who have retirement and health plans through their jobs. The law sets standards for these plans to make sure they are managed fairly and provide the benefits promised. ERISA covers things like retirement savings, pensions, and health insurance. It requires companies to give clear information about the plans and follow certain rules to protect employees’ money. However, it doesn’t require employers to offer these plans; it just regulates them if they do.

Who does ERISA apply to?

ERISA applies to most employers who offer benefit plans like retirement, disability, and health insurance to their employees. It mainly covers private companies, including corporations and partnerships, but it doesn’t apply to government or church plans. ERISA sets rules to protect workers’ benefits and ensures that employers manage these plans fairly. It treats employers and their agents like fiduciaries, and it imposes fiduciary duties on those actors to act solely in the interest of plan participants and beneficiaries. If you work for a private company that offers a 401(k) or health insurance, ERISA probably applies to your benefits. Anyone with discretionary authority or control over your benefits is probably a fiduciary subject to ERISA.

What is an ERISA violation?

An ERISA violation happens when someone breaks the rules of the Employee Retirement Income Security Act (ERISA), a law that protects workers’ retirement and health plans. ERISA sets standards for how these plans should be managed, and it makes sure that workers get the benefits they are promised. A violation could include things like misusing funds, not giving workers the information they need, or failing to follow the plan’s rules. If a company or person in charge of a retirement or health plan breaks these rules, they could face penalties or legal action.

What companies must comply with ERISA?

ERISA applies to private companies that offer retirement and health plans to their employees. This includes businesses of all sizes, like corporations, partnerships, and sole proprietorships. However, it does not apply to government employers or churches. The law sets rules for these companies to make sure they manage their employees’ benefit plans responsibly and fairly. ERISA helps protect the money that employees put into their retirement and health plans.

Who is protected under ERISA?

ERISA, or the Employee Retirement Income Security Act, protects employees who are part of employer-sponsored benefit plans, like retirement or health insurance plans. It makes sure that people working for private companies get fair access to their benefits and that the companies follow certain rules when managing the plans. ERISA doesn’t cover government employees, church plans, or plans outside the United States, but it helps protect many workers in private businesses.

How do I know if ERISA applies?

To know if ERISA applies, ask if your job provides benefits like health insurance or retirement plans. ERISA usually applies to private companies that offer these benefits to employees. However, it doesn’t apply to government or church-run plans. There are also certain exemptions to ERISA, such as for payroll practices (which includes many short-term disability plans) and stock incentive plans. If you work for a private employer and get benefits like 401(k) plans, pension plans, or health insurance, then ERISA probably applies to protect your rights. You can also check with your employer or plan administrator to make sure, or request the plan documents to see if they reference ERISA.

What retirement plans are subject to ERISA?

Retirement plans that are subject to ERISA (the Employee Retirement Income Security Act) include most private-sector employer-sponsored plans, such as 401(k) plans, pension plans, and profit-sharing plans. ERISA sets rules to protect people who participate in these plans, making sure employers meet certain standards for managing and providing benefits. However, plans for government employees, churches, or those offered by some non-profits usually aren’t covered by ERISA.

What is ERISA vs non-ERISA?

ERISA, which stands for the Employee Retirement Income Security Act, is a federal law in the United States that sets rules for retirement and health plans in private companies. It protects employees by ensuring that they receive the benefits promised by their employers and establishes standards for managing these plans. Non-ERISA plans, on the other hand, are those that are not subject to these federal regulations. This often includes plans offered by government employers or churches. Because ERISA covers many private employer plans, it provides more protections and rights for workers compared to non-ERISA plans, which may have fewer rules and protections. One notable exception to that rule, however, is in insurance law. ERISA preempts state law bad insurance faith remedies. Thus, a participant in a fully insured non-ERISA plan may enjoy greater protections than a participant in a fully-ensured ERISA plan, whose relief is typically limited to the benefits due under the plan, plus interest and possibly attorney’s fees.

Who is exempt from ERISA?

ERISA sets rules for most private-sector retirement and welfare benefit plans. However, some groups are exempt from ERISA. Government employees, like those who work for federal, state, or local governments, do not have to follow ERISA rules. Churches and other religious organizations are also exempt. Additionally, plans created just for self-employed people without employees are not covered by ERISA. This means these groups do not have to follow the same retirement plan rules as private companies.

How can a company be ERISA compliant?

To be ERISA compliant, a company must follow the rules set by the ERISA statute (29 U.S.C. § 1001 et seq.) and regulations, which are promulgated by the Employee Benefit Security Administration (EBSA), Internal Revenue Service (IRS), and Department of Health and Human Services (HHS). These rules protect employees’ benefits, like retirement plans or health insurance. First, the company must provide detailed information to employees about their benefits, such as how the plan works and what it covers. Second, the company must follow certain rules when managing the plan to make sure employees’ money is handled fairly. Lastly, the company must file reports with the government and offer ways for employees to resolve any disputes about their benefits.

What is an example of ERISA?

An example of ERISA is a 401(k) retirement plan offered by a company to its employees. Under ERISA, the company must follow certain rules to make sure the plan is managed fairly and that employees’ retirement money is protected. This law requires companies to give clear information about the plan, keep the funds safe, and let employees know about their rights. ERISA also helps ensure that employees get the retirement benefits they are promised if they meet the plan’s requirements.

Who can sue under ERISA?

Under ERISA (the Employee Retirement Income Security Act), several types of people or groups can sue. These include employees or former employees who are part of an employee benefit plan, plan beneficiaries (like someone named in the plan to receive benefits), and plan participants who believe their rights have been violated. In some cases, the people who manage the plan, known as plan fiduciaries, can also sue. Finally, the U.S. Department of Labor is charged with enforcing the ERISA statute and has special enforcement rights. Typically, lawsuits under ERISA involve issues like unpaid benefits or improper plan management.

What makes a company subject to ERISA?

A company is subject to ERISA if it offers employee benefit plans like retirement (such as 401(k)) or health insurance. ERISA applies to private companies and ensures that they manage and protect these benefits fairly. However, government agencies and churches are usually not covered by ERISA. The company must follow certain rules about how they handle the money in these plans to make sure employees are treated fairly and get the benefits they’ve been promised.

How is ERISA enforced?

ERISA is enforced by different government agencies as well as by private civil litigants. The Department of Labor (DOL) is mainly responsible for making sure companies follow the rules, especially when it comes to protecting workers’ retirement and health plans. The DOL can investigate companies and take action if there are problems. The Internal Revenue Service (IRS) checks that companies’ retirement plans follow tax rules, while the Pension Benefit Guaranty Corporation (PBGC) steps in to protect pensions if a company can’t pay. These agencies work together to make sure workers’ benefits are protected. In addition, plan participants, beneficiaries, and fiduciaries may bring suit under 29 U.S.C. § 1132 to enforce ERISA if their rights have been violated.

What are the vesting rules for ERISA?

The vesting rules for ERISA are designed to protect employees’ rights to their retirement benefits. Vesting refers to the process by which an employee earns the right to keep the money their employer contributes to their retirement plan, even if they leave the job. Under ERISA, there are two main types of vesting schedules: cliff vesting and graded vesting. With cliff vesting, employees become fully vested after a certain period, like three years. In graded vesting, employees earn a percentage of their benefits each year until they are fully vested, typically over a period of six years. These rules ensure that employees have a fair chance to receive their retirement benefits after working for their employer for a certain amount of time.

“Thank you. A thousand times, thank you.”

“Mark, I’m not very good at saying thank you. But I’m going to try. I don’t know what I’d do right now, or where my mind would go, if I didn’t have someone like you beside me, who knows the whole case… There are dark places I could go, and to which I’m not going, largely because your help and the resultant safety net that provides. Thank you. A thousand times, thank you.”

Todd B | Client

Learn More About ERISA to Protect Your Rights

How Can I Tell If My Benefit Plan Is Governed by ERISA?

How Can I Tell If My Benefit Plan Is Governed by ERISA?

Apr 3, 2026 | , ,

ERISA is an acronym for the federal Employee Retirement Income Security Act of 1974. Most people have never heard of ERISA, but its comprehensiveness impacts the vast majority of American workers and their dependents. The original intent behind ERISA’s enactment was to remedy pension plan abuses; however, just prior to Congress’ passage of the ERISA law, the scope […]

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