ERISA Disability Litigation
How To Sue Your LTD Insurance Carrier
In United States Federal Court
Without an Attorney (Pro Se)
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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 Some Help.
General Legal Reference Areas
Legal Dictionaries
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.
- HR 4406
- 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 attorney)
- 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 List)
Webmaster's 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.
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