San Francisco ERISA Disability Lawyer

Trusted disability insurance attorneys serving San Francisco and the surrounding area, with more than 30 years of experience holding insurers accountable.

If your long-term disability claim has been denied under a plan you get through your employer, the path to payment runs through a federal appeal process, not a standard lawsuit. Our San Francisco, CA ERISA disability lawyer at The Law Office of Bennett M. Cohen can review what the insurer decided, find the gaps in its reasoning, and assemble the evidence your claim needs before any deadline passes. We offer a free consultation to talk through where your claim stands, so contact us today.

ERISA Disability Lawyer San Francisco, CA

What does an ERISA disability lawyer do? ERISA (the Employee Retirement Income Security Act of 1974) is the federal law that governs most long-term disability plans offered through an employer, and it controls how a claim is filed, denied, and appealed. When an insurer denies your claim under an employer-sponsored plan, you are not dealing with a standard insurance dispute under California law. You are operating inside a federal system with its own procedures, its own deadlines, and its own strict limits on what a court will consider.

An attorney handling these matters reviews the plan language, the denial letter, and the medical file, then works to fix the problems before the case reaches a courtroom. Much of the result is decided during the administrative appeal, because federal judges generally limit their review to the record built at that stage. What goes into the appeal record is what the court will see, which is why having experienced counsel before that window closes can shape everything that follows.

We work with claimants in San Francisco and across California to build that record correctly from the start. That means gathering updated medical documentation, securing detailed statements from treating physicians that tie a diagnosis to specific functional limitations, and identifying the gaps in the insurer’s own reasoning. The Law Office of Bennett M. Cohen has represented people against some of the largest disability insurers in the country for more than 30 years, and we understand how to effectively build a case to support our clients.

Types of ERISA Disability Cases We Handle in San Francisco

Disability denials come in many forms, and the reason an insurer puts in writing rarely tells the whole story. We represent San Francisco claimants across a range of conditions and policy types, including employer plans governed by ERISA and individual policies governed by California law. The matters below are the ones we handle most often.

• Long-term disability denials. Group long-term disability is where ERISA most often applies. We review the plan’s definition of disability, the insurer’s internal medical reviews, and the common insurer tactics used to justify a denial.
• Disability appeals. Most plans require an administrative appeal before you can sue. Because courts generally review only the appeal record, we treat this stage as the place to add the medical and vocational evidence the insurer left out.
• Disability insurance claim denials. We challenge denials issued at the first review, whether the insurer says your condition is not severe or that you can perform some other job. Each stated reason gets answered with records.
• Individual disability claims. Policies bought outside of work are governed by California law rather than ERISA, which can open the door to a bad faith insurance claim when an insurer acts unreasonably.
• Chronic pain and fibromyalgia claims. Insurers often deny conditions that lack a clear test result. We document how chronic pain limits your daily function and connect it to your work restrictions.
• Mental health condition claims. Depression, anxiety, and similar diagnoses are frequently subject to shorter benefit periods and heightened scrutiny. We gather treatment records and provider statements that support the limitation.
• Surveillance and exam-based denials. Some insurers rely on surveillance footage or a one-time medical exam to argue you can work. We show the full picture instead of a single afternoon.
• Disability buyout offers. When an insurer proposes a lump sum to close your file, the number is rarely the value of your future benefits. We weigh the offer before you decide on taking a buyout.

Why Choose The Law Office of Bennett M. Cohen as my ERISA Disability Lawyer in San Francisco, CA?

Experience Against Major Insurers

Our founder, Bennett M. Cohen, has represented plaintiffs against some of the most powerful corporate defendants in the country, including national life and disability insurers. He earned his undergraduate degree from Oberlin College and his law degree from the University of San Francisco School of Law. With more than 30 years of practice, he understands how these companies assemble a denial and how to take it apart.

Results and a Focus on Disability Claims

We have reversed insurance denials, secured payment of all past-due benefits, and won jury awards in disability bad faith matters. A disability benefits lawyer from The Law Office of Bennett M. Cohen can take a claim from the first filing through federal court. We offer a free consultation to review your denial and tell you where things stand.

San Francisco ERISA Disability Infographic

Understanding ERISA Disability Cases

Benefits, Denials, and Appeals in ERISA Disability Cases

A handful of terms come up in almost every case. Knowing them helps you read your own paperwork.

• Disability. Plans usually define it as the inability to perform your own occupation, then later, any occupation. The wording controls what you must prove.
• The administrative record. This is the file the insurer compiles. In court, it is often the only evidence a judge will consider.
• The appeal. A required step after a denial, and in most cases the last chance to add evidence.
• Standard of review. Plan language can decide whether a judge looks at your claim fresh or defers to the insurer’s standard of review.
• Remedies. When ERISA applies, recovery is generally limited to the benefits owed, unlike a claim brought under state law.

What Are Important Aspects of an ERISA Disability Case?

The strength of an ERISA claim usually comes down to the record and the deadlines. A few aspects carry more weight than the rest.

• Medical proof that ties your diagnosis to specific work restrictions, supported by objective medical evidence where it exists.
• A clear account of your job duties, since the insurer must measure your limits against real demands.
• A written denial that states each reason, because the insurer generally cannot explain its denial with new rationales later in court.
• Attention to every appeal deadline, because a missed date can end the claim for good.

What Is The ERISA Disability Case Timeline?

Every plan runs on its own schedule, but the sequence stays consistent. Here is the general path a claim follows:

• You file the claim and submit your medical support.
• The insurer reviews the claim and issues a written decision.
• If it is denied, you file an administrative appeal within the plan’s window.
• The insurer reviews the appeal and either pays the benefits or upholds the denial.
• If the denial stands, the next step is a lawsuit in federal court.

What Should You Bring to Your ERISA Disability Consultation?

Bring whatever the insurer has sent you, along with your medical history. These documents let us assess the claim quickly and accurately.

• Your denial letter and any appeal deadlines stated in it.
• The plan documents or summary plan description.
• Recent medical records and your treating providers’ contact information.
• Pay stubs or employment records that describe your job duties.

During the consultation, we review where the claim stands and explain the options in plain terms. There is no cost for this first meeting.

What Are Important California Legal Resources for ERISA Disability Cases?

ERISA is a federal law, so many of the rules that decide a disability appeal come from federal agencies rather than the state. The resources below are starting points for reading the rules that may apply to your situation.

• The U.S. Department of Labor explains the claim and appeal rights that apply to employer-sponsored disability plans.
• The Social Security Administration covers disability benefits that are separate from a private long-term disability claim.
• The California Department of Insurance handles complaints about individual policies and other insurance the state regulates.

Reach Out to The Law Office of Bennett M. Cohen to Schedule a Consultation

If a disability insurer has denied your claim, contact us to schedule a free consultation with our San Francisco ERISA disability attorney. Denials can feel final, but in most cases they are the beginning of a process, not the end of one. We will look at the denial letter, walk through your options, and give you an honest read on whether an appeal is worth pursuing. If the insurer relied on a paper review, a surveillance report, or a definition of disability that does not match your actual condition, we will identify it and flag any approaching deadlines so nothing is lost to a missed date.