ERISA Disability Litigation
How To Sue Your LTD Insurance Carrier
In United States Federal Court
Without an Attorney (Pro Se)
This site is oriented to
those persons who are disabled by Chronic Fatigue and Immune Dysfunction
Syndrome (a.k.a. CFIDS, CFS, M.E.) and other so called "self-reported
conditions" such as Fibromyalgia Syndrome (FMS) and Multiple Chemical
Sensitivity (MCS) who must sue to recover long term disability benefits
from employee benefit plan providers (insurance companies). This site
has not been reviewed for content or accuracy by lawyers. Use it at your
own risk, it is here just in case it will help you avoid a lot of the
tedious research many of us have had to do just to get this far. THIS IS
NOT LEGAL ADVICE.
Jump to Other Sites Covering SSDI, RICO, Non-U.S. Disability, etc.
If You Are a Lawyer and have found that this site made your job easier, please
make a donation to
The CFIDS Association of America Pro Se Website and Research Fund,
citing this URL.
Finding a Lawyer
Pro Se is a last resort for those who
can't pay a lawyer or find one willing to work on contingency or pro
bono. If you can get a decent lawyer, do so.
Proceeding Pro Se
Ok, You Must Represent Yourself. Here's
United States Claimant Information Bureau (Although this looks like
a government site it is not a .gov)
A part of the above site that I could not find easily through the
discussion door. Note the different file name (seamless).
General Legal Reference Areas
Civil Procedure Rules and Forms
General Background Material
- We'll lead with an exerpt from
the notes of Jason Wolff, who took on an HMO in an ERISA case
and won without having to sue. Yes, it's not a disability case, but
it is instructive nonetheless.
"I added that people much worse off than me are being denied every
day and there is nobody to speak up or fight for them. Three times I
tried to get a lawyer to fight for me, but because of the way the
plans are protected under federal law (ERISA), no lawyer would take
the case on a contingency fee basis before the grievance and appeals
process was completed - because they can't get punitive damages
(only the total of the claims) which would normally cover the
attorney's fees. I said that people see what happens in glass towers
and, as one lawyer told me, it is "settlement though attrition":
most people can’t or won’t fight because they don’t have the time or
the strength to do it, even though they have legitimate claims
against the insurance company. For the insurance company there is no
down side. They can deny legitimate claims with impunity: if you
file a state case against them (where you can get punitive damages),
they will preempt it with federal law (ERISA), or, in the event you
don’t try and sue, they can (and will) deny the most meritorious of
cases clear up until the end of an overly convoluted process.
Fortunately for them, if they do settle in the end, they will only
have pay what they should have paid to start with. No interest. No
fees. No lost time. Nothing."
Here's a Briefing on topic by Michael McKuin, an ERISA lawyer.
- ERISA's Dark Side (short title) This DePaul Business Law
Journal, Volume 9, Number 2, Spring/Summer 1997 article written by
three ERISA law attorneys will give you an idea of what you are up
against when trying get equity in an ERISA case.
Health Hippo ERISA Primer A good read for an overview of what
this area of law is all about.
About HR 4406 A fine discussion of the above proposed
legislation from 1998. Discusses "Standard of Review" of ERISA Plan
Administrator Decisions by Courts (De Novo or Deferential).
CFIDS Assoc. of Am. Testimony to US Dept. of Labor
"Independent Medical Exams? Not!!!" (written by a plaintiff's
Consolidated Consultants Co. Search Engine (The bad guys have
IME "experts," so why shouldn't you get a hired gun or two?
American Academy of Environmental Medicine is another potential
source of expert testimony, particularly if your problem is MCS.
Cases On Topic (But NOT an Exhaustive
Comments -- In VERY general layman's terms, ERISA describes and covers
two categories of Employee Benefit Plans: Pension Plans and Welfare
Plans. In THIS website we are not concerned with Pension Plans. Within
the Welfare Plan category, there are three PRIMARY subsets: Life
Insurance, Health Care Insurance, and Disability Insurance (DI). This
Website is oriented towards DI, in its Long Term Disability (LTD) arena
only, since Short Term Disability (STD) benefits aren't worth the
trouble to sue for them.
HOWEVER, the case law on all of these areas is intertwined, so
be careful. You can't just study LTD ERISA cases.
This Section Has Moved Yep, the list go so big that it used up all
the available memory and took ages to load. So we moved it and broke it
down by sections.
Filing "In Forma Pauperis"
(Stolen From Bill Hammel's Website, See Below)
One of the insurance cartel's favorite
negotiating goals, especially if you have been severely injured, is to
make sure, through denials and delays, that you are stripped of property
and your ability to be employed. They expect that then you will accept
any small crumbs that they may offer "in settlement", if in fact, they
ever offer anything. You are then destitute and cannot afford the many
hundreds of dollars in succeeding lumps for filing costs, document
reproductions, or necessary service. These are the burdens that the
court will lift from you if you file 'in forma pauperis', and here is
generally how it works.
You give your complaint to the court
clerk, telling him of you desire to file as a pauper. He will tell you
what the local requirements, or the judge's requirements are, and you
will write a brief petition to the court, in a form that may be
prescribed, that will outline how you are a pauper, and then submit that
to the clerk. The judge will decide whether he will admit your filing in
forma pauperis. The moment he does, your complaint will be so filed, by
the Clerk of the Court, and all appropriate relief will be automatic
from then on.
Another advantage to filing this way, if
it is appropriate, is that often the court is more flexible when it
comes to deadlines for filings and such. As a rule of thumb, Federal
courts tend to be more exacting and persnickety about not only the
letter of the law, but also about the letter of the rules.
The controlling case in this regard is:
ADKINS V. E. I. DU PONT DE NEMOURS & CO. 331,335 U.S. 331 (1948)
Also see in Re: Petition to file in forma Pauperis;
Sup. and Dist. Ct. cases citing this case
FindLaw: United States Case Law citing Adkins v Dupont
FindLaw: United States Case Law Circuit Courts citing Adkins
as well as
Federal Guidelines which actually define 'poverty':
Poverty Line Contacts and References
Federal Register Notice: Update of the HHS Poverty Guidelines
Related Topics, But Broader Issues and
Mirror or Similar Sites:
I. The McCarran-Ferguson Act and
RICO Filings vs. Insurance Companies
II. Other Disability Issues Pages,
Including U.S. Social Security Disability Income (SSDI), Private and/or
ERISA U.S. Disability Income Insurance, and non-U.S. (Primarily Canada
and U.K.) sites for similar situations.