We focus on ERISA disability benefit claims.

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When you contact Evergreen Disability Law for any type of case, you work with a disability benefits attorney – not every law firm can say the same. We believe the focus on a particular practice area makes a world of difference.

ERISA Long Term disability

This is our primary focus, helping people apply for, appeal denials of, and litigate cases involving long term disability insurance that was provided by their employers. When a benefit comes from an employee benefit plan, it is generally governed by the federal employee benefits law called ERISA, which stands for the Employee Retirement Income Security Act.  Unlike Social Security, which uses the same rules on every claim, the benefits under ERISA Long Term Disability plans are not always the same, so it is important to review your particular plan documents to determine the particular terms.  If all of your appeals are denied, you have the option to bring a lawsuit in federal court challenging the denial.

There are very few attorneys who focus on these claims specifically, and even fewer who are willing to fight them not only with the insurer, but in federal court. Attorney Jeremy Bordelon has been working on these claims since 2004 as a paralegal, and since 2009 as an attorney. He has been involved in hundreds of claims, and taken dozens of cases to judgment in federal district courts and the federal courts of appeals. We would be proud to put this experience to work for you.

ERISA Life insurance / Accidental death BENEFITS

The ERISA law applies not only to disability benefits, but to any type of benefit someone obtains at work, such as employee life insurance, dependent life insurance, and accidental death insurance. We have helped clients challenge denials of these benefits for a number of reasons, including the following:

  • Employer errors with enrollment, premium collection, or benefits sign-ups

  • Life insurance waiver of premiums claims when an employee becomes disabled

  • Life insurance conversions to private coverage when an employee leaves work

  • Accidental death claim denials due to “related medical conditions”

  • Accidental death claim denials due to misconduct, substance abuse or alleged suicide

ERISA Health insurance BENEFITS

Health insurance obtained through work is also governed by ERISA, and we have been able to help a number of clients with these claims, as well. Past claims have included autism-related speech and language treatments for an employee’s child, a case involving a large unexpected bill for a cardiac surgery after the employee had called the insurer for an estimate, and a case involving purported “experimental” treatment for prostate cancer. If you have are facing a denial of pre-service authorization or a large bill for care your have already received, please contact us for a free consultation.

Please note that ERISA pension claims are not our specialty, so we may not be able to assist with those types of claims, but we would do our best to evaluate your issue and provide an appropriate referral to another attorney, if we can.

PRIVATE DISABILITY INSURANCE

When people get disability insurance not through work, but through a private insurance agent, those claims do not fall under the ERISA employee benefit laws.  Usually this is a good thing, because remedies under ERISA are very limited - there is usually no possibility of punitive damages or even a jury to hear your case fairly.  In private disability insurance claims, however, you have more rights.

We focus primarily on claims in Oregon and Washington, since our practice is based in Portland. In Oregon, the traditional thinking has been that “bad faith” or punitive-type damages for an insurance denial were not available, even in a non-ERISA case. That thinking has been changing recently, however, with the recent Oregon Court of Appeals case of Moody v. Oregon Community Credit Union, 317 Or. App. 233 (2022). In certain cases where the insurer committed particularly bad acts, there may now be a way in Oregon to pursue damages beyond just the benefits that were due in the first place. This law is still developing, but we are watching these developments carefully in order to best serve our clients.

In Washington State, the availability of “extra-contractual” damages in first party (non-ERISA) insurance cases is better established, based on common-law good faith requirements, as well as the Washington Insurance Fair Claims Act and the Washington Consumer Protection Act. So if you have a private policy governed by Washington State law, and the insurer fails to act in “good faith” or violates the requirements of one of these consumer protection laws, there could be extra damages available to you in court. While our practice is based in Portland, our attorney is licensed and admitted to practice in all state and federal courts in Washington.

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Social Security Disability

Evergreen Disability Law is no longer accepting new Social Security Disability claims. Attorney Jeremy Bordelon has an extensive background in these claims, having handled hundreds of claims both with the Social Security Administration and in further appeals to federal court, and was formerly certified as a Social Security Specialist by the National Board of Social Security Disability Advocacy. However, we have chosen not to accept new clients in this area in order to focus on the benefit claims described above. Jeremy’s experience with and knowledge of Social Security’s processes and claim files is still very useful in private disability insurance claims, since these processes often go hand-in-hand. We are often able to refer our private disability insurance clients to trusted Social Security Disability attorneys for representation on those claims, and continue to work closely with those attorneys when our clients have both types of claims at once, which is often the case.