What Is ERISA?

When your employer provides you with a health or disability plan, it is governed by a federal law called The Employee Retirement
Income Security Act of 1974 (ERISA).  These benefit plans may be funded by insurance or by your employer.   Frequently, it is the
insurer that decides whether you get your benefits.  If the insurance company denies your claim, you have to try to convince it that you
are entitled to the benefit through an administrative appeal, also known as a request for review, before you can file a lawsuit.  

Who We Represent

Springer-Sullivan & Roberts LLP represents clients in all stages of benefit claims.  We can:

  • Help guide you through the process of applying for short- or long-term disability benefits.
  • Appeal your case to the insurance company by preparing and gathering all of the necessary supporting evidence if it denies your
    claim.
  • Litigate your case in federal court if the insurance company has wrongfully denied your claim for benefits and refuses to reverse its
    decision.
  • Represent you while your claim is in payment status to help ensure that it stays approved and to relieve you of the burden of
    communicating with the insurance company.  

Springer-Sullivan & Roberts LLP has represented individuals with many different disabling medical conditions, including AIDS/HIV,
Arthritis, Bipolar Disorder, Cancer, Carpal Tunnel Syndrome, Chemical Sensitivities, Chronic Fatigue Syndrome, Chronic Pain,
Depression, Degenerative Disc Disease, Diabetes, Ehlers-Danlos Syndrome, Fibromyalgia, Hypertension, Lou Gehrig’s, Lupus, Lyme
Disease, Multiple Sclerosis, Plantar Fasciitis, Polyostotic Fibrous Dysplasia, Post Traumatic Stress Disorder, Reflex Sympathetic
Dystrophy, and Repetitive Stress Syndrome.

When Do I Need a Lawyer, and Why?

ERISA is a complicated law with many nuanced regulations and procedures that limit the process of appealing a wrongful denial of your
claim.  

The best time to contact us is right after your claim for benefits has been denied.  This is because you may only have 180 days to appeal
the denial of your claim.  It is very important that you submit the best possible information supporting your claim before your time to
appeal expires.   If the insurer denies your appeal and you have to file a lawsuit, a court is usually limited in its ability to review additional
evidence that proves your disability.  In other words, when trying to prove your case, you may not be allowed to submit additional
evidence or testimony to prove your entitlement to benefits, even if that evidence would be helpful for a court to hear.  This is why you
should contact us to assist you in preparing your appeal to the insurance company.  

The bottom line:  The earlier you contact us to help get a benefit denial reversed, the better, because we know how to present the most
effective case for getting your benefits approved.
What we do for our clients
410 - 12th Street, Suite 325, Oakland, CA 94607   Tel: (510) 992-6130  Fax: (510) 280-7564
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