For long-term disability claims governed by the Employee Retirement Income Security Act of 1974 (ERISA), an award of attorney fees is a possibility if you are denied long-term disability benefits and “win” against the insurance company in court. However, you need to understand that there is never a guarantee that a court will award you attorney fees in a suit related to long-term disability benefits.

ERISA permits an award of attorney fees in appeals of the denial of long-term disability benefits when the plaintiff is the prevailing party. For instance, the Ninth Circuit Federal Court, which ultimately hears appeals related to denied long-term disability claims in California, often awards attorney fees in this situation. Determining whether a plaintiff has prevailed, though, is not always so straightforward as it might seem.

Some courts have conditioned attorney fee awards on whether the plaintiff has been awarded a final judgment and a monetary award. Other courts have found an attorney fee award appropriate if the plaintiff has prevailed on any major issue in the court proceedings. Therefore, the exact definition of “prevail” remains an open question when it comes to attorney fees awards in long-term disability claim cases.

ERISA also limits attorney fee awards to “reasonable” attorney fees. This amount is normally calculated by multiplying a reasonable number of hours in pursuing a plaintiff’s claim for benefits by a reasonable hourly rate for attorneys who have similar experience in such cases.

If the plaintiff does not prevail on his or her long-term disability claim, courts normally do not award attorney fees to the insurance company or plan. However, if there is evidence that the plaintiff brought the claim in bad faith, then the court does have the discretion to order the plaintiff to pay attorney fees to the attorneys for the insurance company or plan. Attorney fees are only one of the many complex aspects involved in appealing the denial of long-term disability claims. As a result, you will need experienced legal representation and advice to pursue an ERISA-governed disability claim. Bonnici Law Group is a law firm focusing on ERISA long-term disability benefits in Southern California. When you need effective legal representation, contact Bonnici Law Group at 858-261-5454 or email us at help@bonnicilawgroup.com.