An Attorney’s Guide to ERISA Disability Claims

“I am an attorney with more than 16 years’ experience in ERISA, primarily helping plaintiffs and other attorneys with pension and retirement savings plan claims – a practice area for which there are volumes of treatises and other legal resources available to the practitioner. However, when it comes to helping clients who have been denied their employer-sponsored disability benefits, there is a dearth of information specifically on point. For attorneys needing guidance in this complicated area of the law, this book is nothing short of a Godsend! Attorney Riemer has done an excellent job of organizing this dauntingly complex area into an accessible outline that can help an attorney from start to finish. You will still have much work to do after reading this book, but it is an accurate and efficient way to get started. Thank you for writing this book, Mr. Riemer. It is truly a lighthouse in the fog.”

— Roadside Attraction | Silver Spring, MD

An Attorney’s Guide to ERISA Disability Claims is an essential resource that gives you the specialized knowledge you need to thoroughly prepare ERISA disability claims through both the initial application process and the insurance company’s appeal process. Filled with practical strategies, and helpful forms and templates, this guide teaches you how to assemble a compelling case so that your client meets the policy’s standard of disability. You will learn:

• How to guide your client, your client’s doctor, and your client’s employer to avoid traps when completing the claim application forms.
• How to prove your client is disabled.
• How insurers cherry pick doctors’ treatment notes and what to do about it.
• What to include in a Residual Functional Capacity Questionnaire.
• What to ask a doctor to include in a narrative report.
• How to prep your client for an insurer interview.
• How to handle a claim when the policy’s occupational standard shifts from “own occupation” to “any occupation.”
• What information to gather for the client’s vocational affidavit.
• What actual demands of your client’s occupation insurers’ will overlook.
• How to get your client’s claim file and what to look for when you get it.
• How to analyze the denial letter so that you can respond to all of the insurer’s concerns.
• When to send your client for a functional capacity evaluation and how to overcome an unfavorable one.
• What’s required for valid neuropsychological testing.
• When to get a vocational expert evaluation and what information is in one.
• How to discredit an insurer’s surveillance videotape of your client.
• 15 arguments you can make to the insurer for reversing its original denial.

ABBREVIATED TABLE OF CONTENTS

CHAPTER 1 STRATEGY
CHAPTER 2 APPLYING FOR BENEFITS
CHAPTER 3 PROVING DISABILITY
CHAPTER 4 APPEALING A DENIAL OR DISCONTINUATION
CHAPTER 5 REQUESTING THE POST APPEAL CLAIM FILE
CHAPTER 6 ADDITIONAL APPEALS
CHAPTER 7 CONCLUSION
APPENDIX: SAMPLE DOCUMENTS

ABOUT THE AUTHOR

Scott M. Riemer, for more than 25 years, has continually distinguished himself as one of the country’s premier ERISA and long-term disability attorneys. Today, he is the principal of Riemer & Associates LLC, a nationwide leader in long-term disability claims, appeals and litigation, with headquarters in New York City.

Mr. Riemer has successfully represented hundreds of clients, including complex class action claims against leading insurance companies. He has obtained tens of millions of dollars in benefits, settlements and judgments. He approaches every case with an unwavering focus on integrity, transparency, compassion and protecting the rights of his clients.

As a nationally renowned expert on ERISA and disability topics, Mr. Riemer is regularly called upon by the media and his peers within the legal industry to provide his unique insight and perspective. His articles have appeared in the New York Law Journal, The New York Employee Advocate, CFIDS Chronicle and many other publications. He has been quoted as an ERISA litigation authority in Newsday, Lawyers USA and Consumers Digest, and has lectured and presented on a variety of topics in forums such as the American Conference Institute, the Pension Rights Center, the American Bar Association, the New York State Bar Association, and the International Lyme and Associated Diseases Society.

Throughout his career, Mr. Riemer has fought to protect and advance the rights of the disabled. Recently, he received the Public Education Award from the New York City Chapter of the National Multiple Sclerosis Society for volunteer services and pro bono efforts to make the procedures used for long-term disability insurance more equitable for those with multiple sclerosis. In addition, one of Mr. Riemer’s cases was awarded the Courageous Plaintiff Award by the National Employment Lawyers Association of New York.

Mr. Riemer graduated from the University of Michigan Law School in 1983. He is an attorney in good standing admitted to practice in the State of New York, the Southern District of New York, the Eastern District of New York, the District of Connecticut, the Court of Appeals for the Second Circuit and the United States Supreme Court. To learn more about him and his firm, visit www.riemerlawfirm.com.