Understanding Fees for ERISA and Employee Benefit Claims

If your employee benefit claim has been denied, or if an insurer denied or terminated your disability benefits, you probably have questions about the cost of legal help. That concern is valid, and you deserve a clear answer.

At DeBofsky Law, we offer different fee arrangements based on what works best for each client. Our priority is helping you obtain the benefits you deserve. This applies whether your case involves disability insurance, life insurance, accidental death and dismemberment, health benefits, or pension and retirement benefits. We take the same approach across all claim types: open conversations about cost from day one.

A denied claim often means lost income. You should not have to wonder whether you can afford experienced counsel on top of everything else. On this page, you will find a clear explanation of how we structure fees, what factors affect cost, and answers to the questions prospective clients ask most often.

How Attorney Fees Work in ERISA Disability Cases

ERISA cases differ from most other legal matters. The federal regulatory framework that governs these claims shapes both how cases move forward and how attorneys structure their fees. ERISA has its own rules, deadlines, and procedural requirements that set it apart from personal injury or other types of cases.

DeBofsky Law Offers Two Primary Fee Arrangements:

Hourly Fee Arrangements

We need to handle some cases on an hourly fee basis. This structure is common when we are asked to offer advice and counsel on a claim for benefits, and in cases where we are enforcing benefit plan terms but not recovering funds that are directly payable to our clients. We also offer hourly fee billing if that is our client’s preference. With hourly billing, you pay for the time your case requires. We keep you informed in advance of all costs so that nothing comes as a surprise.

Contingency Fee Arrangements

In many cases, we work on a contingency fee basis. Under such arrangements, we collect our fee only if your disputed claim succeeds on appeal or through litigation. If we do not reach a successful outcome, you owe no attorney fees for our work, although you may be responsible for any out-of-pocket costs that are incurred which you have pre-approved.

What Sets DeBofsky Law’s Fee Structure Apart

We base our contingency fees on benefits received when the claim resolves. We do not calculate them based on future benefit payments. This distinction matters. It keeps our fees proportional to the actual work we perform and the result we help you achieve.

Why We Offer Different Fee Arrangements

Every case follows a different path. The medical evidence, and the insurer’s reasons for denial shape how our approach for your case and how we structure fees.

This also applies to other types of employee benefit claims. A life insurance beneficiary dispute requires a different legal approach than a pension or 401k benefit dispute. We assess each situation during an initial consultation and recommend a fee structure that matches the scope of your case.

What to Expect When You Contact Us About Fees

We are open about fees from the very first conversation. During your initial consultation, you can expect:

• A candid assessment of your claim and the most likely path forward
• A clear explanation of the fee arrangement that fits your situation that will also be provided in writing
• An open conversation about cost so you can make a well-informed decision
• Time to ask questions about the process, timeline, and each stage of your case

It helps if we can review your denial letter, policy documents, and any insurer correspondence before this meeting. The more we can review up front, the more precise our assessment will be.

Factors That Influence the Cost of an ERISA Case

Several elements shape how we structure fees. Knowing these in advance can help you prepare.

• The stage of your claim. Appeals of denied claims involve building the evidentiary record within strict time deadlines. Federal litigation requires court filings, discovery, and sometimes trial preparation. Each stage calls for different types of legal work.
• The medical evidence in your case. Claims involving multiple diagnoses, conflicting opinions, or the need for independent evaluations typically require more preparation.
• Collecting additional evidence. Some cases require that we obtain additional testing or evaluations.
• How the insurer responds. Some insurers move toward resolution once experienced counsel is involved. Others take a harder position, which may extend the process into litigation. The insurer’s approach directly affects the overall scope of the case.
• Whether ERISA fee-shifting applies. Courts have discretion to award attorneys’ fees to the prevailing party in ERISA litigation. In some cases, the court may require the insurer to cover part or all of your legal costs. We explain how this may apply to your specific claim.

Frequently Asked Questions About ERISA Attorney Fees

How much does an ERISA lawyer cost?

The cost depends on your case. Key factors include the nature of the issue, the stage of the claim, the complexity of the issues involved, and which fee arrangement best fits your needs. DeBofsky Law offers both hourly and contingency options, and fixed fee arrangements in some cases as well. With contingency fees, you pay nothing for the lawyer’s services unless benefits are recovered or paid. We walk you through all of this during an initial consultation, so you have a complete picture before making any decisions.

Do ERISA disability lawyers work on contingency?

Many do, though the availability of a contingency fee depends on the case. At DeBofsky Law, we offer contingency arrangements in many situations. Under this structure, we collect our fee only when your claim succeeds. We calculate our fees on benefits received at resolution, not on future payments. This approach limits your financial exposure during an already difficult time.

What is the difference between hourly and contingency fees?

Hourly billing means you pay for attorney time as work is performed. Contingency means the firm receives payment only when the case results in a favorable outcome involving the payment of benefits owed to the client. We review each case individually and recommend the option that fits best.

Can the insurance company be required to pay my attorney fees?

In ERISA litigation, courts can award attorneys’ fees to the prevailing party. If you prevail in court, the court may order the insurer to cover some or all of your legal costs. This does not happen automatically, though, and does not apply to any work performed during the internal appeal process.

Should I hire a lawyer for my LTD appeal, or handle it myself?

You are not required to have an attorney for an ERISA claim denial appeal. However, the appeal carries significant weight. Under ERISA, the record you build during this stage is often the only evidence a court will review later. Gaps in the record or missteps during the appeal process can be very difficult to correct after the fact. An experienced ERISA attorney knows how to develop a strong record, address the insurer’s reasoning for the denial, and meet every regulatory deadline. Our guide on hiring a lawyer for a disability insurance claim covers the appeal process in more detail.
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What should I look for in an ERISA disability attorney?

ERISA is a specialized area of federal law. Very few attorneys have the expertise or experience to handle such matters. Look for a firm that concentrates on employee benefit claims rather than treating ERISA as one of many practice areas. Ask about experience with your specific claim type. A firm that can walk you through the claim, appeal, and litigation process, and explain what evidence matters, has likely handled similar cases. For a deeper look at this topic, read our article on choosing the right lawyer for benefit denial cases.

Is it worth hiring an attorney for a disability insurance appeal?

The appeal of a denied claim is often the most important stage of an ERISA claim. The evidence and arguments you present during this process typically form the entire basis for any future court review. An experienced attorney understands what insurers focus on during claim evaluations. They know how to respond to specific denial reasons and organize evidence effectively. For many people, skilled representation at this stage is far more valuable than the cost involved. Review examples of successful outcomes on our victories page.
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Talk to DeBofsky Law About Your Case

If an insurer denied your disability or other benefit claim, learning about your options is a good first step. Understanding how fees work is part of that. Contact DeBofsky Law to schedule a consultation. We will review your claim, explain which fee arrangement fits, and answer your questions about next steps.

DeBofsky Law represents clients in ERISA disability, life insurance, pension, and other employee benefit matters nationwide. We have offices in Chicago and Seattle.