We Don’t Get Paid Until You Do
855.837.5333 Get Immediate Help

Fifth Circuit ERISA Lawyer

Serving Louisiana, Mississippi & Texas

The U.S. Court of Appeals for the Fifth Circuit handles ERISA litigation for Louisiana, Mississippi, and Texas. If you live or work in one of these states, or if your employer is based out of one of these areas, your claim may fall under the Fifth Circuit's jurisdiction. At ERISA Law Center, we understand how the Fifth Circuit approaches disability and life insurance litigation as governed by the Employee Retirement Income Security Act of 1974 (ERISA). An ERISA lawyer at our firm can provide the level of representation you need, tailored to this court's specific case law.

Statistically, most ERISA appeals to the Fifth Circuit result in judgment in favor of the plan or insurance company, but the Fifth Circuit is capable of rendering well-reasoned and comprehensive opinions in favor of claimants, and these decisions give claimants a roadmap to the types of arguments they need to make to succeed in the Fifth Circuit.

Conflicts of Interest and Disability Appeals

The Fifth Circuit, like the Tenth Circuit, has comprehensively addressed the question of discovery when the standard of review is for abuse of discretion and the claim administrator has a conflict of interest. The Fifth Circuit, like the Tenth Circuit, has expressly ruled that reasonable discovery tied to relevant evidence to explore conflict of interest should be permitted. By allowing claimants to delve into conflicts of interest, the Fifth Circuit allows claimants to demonstrate that decisions denying or terminating benefits are motivated by unfair or improper considerations.

You Pay Nothing Unless We Get You Benefits or a Settlement

Get in Touch Now

Enforcing ERISA Procedural Requirements

The Fifth Circuit has systemically addressed the requirement that claim administrators comply with ERISA regulatory rules, and the consequences when they do not do so. When a claim administrator fails to substantially comply with ERISA's procedural requirements, the Fifth Circuit remands the case to the claim administrator for a full, fair review.

Common procedural violations included:

  • The claim administrator raised new grounds for denial in court that were not raised to the administrative level;
  • The claim administrator did not identify the medical reviewer relied upon despite the claimant's request for this information;
  • The claim administrator relied upon the same medical reviewer for an opinion in the initial denial and in the administrative appeal; and
  • The claim administrator relied upon a medical reviewer who lacked the appropriate training and experience in the medical field involved and gave deference to the initial denial.

The Fifth Circuit is the only circuit which has explicitly recognized that when a review is for abuse of discretion, even when the claim administrator has substantial evidence to support its decision, that decision can be an abuse of discretion if there are sufficient procedural irregularities. Thus, the Court found that even though there was substantial evidence to support a denial of benefits, the denial of benefits was an abuse of discretion because of the severe procedural irregularities committed by the insurance company.

Even though the claimant was awarded benefits, however, the Fifth Circuit reversed the district court's award of attorney fees to the successful claimant, reasoning that "the legal questions in the case are much closer than the district court credited, and the district court, therefore, abused its discretion in assessing attorney fees against the insurance company." Again, this is a sign that despite its capability to make good law, its overall judicial temperament can be quite conservative.

Serving the Fifth Circuit

Our ERISA attorney serve the Fifth Circuit by representing claimants in the following states and cities: Louisiana: New Orleans, Baton Rouge, Shreveport, Metairie, Lafayette, Lake Charles, Kenner, Bossier City and Monroe; Mississippi: Jackson, Gulfport, Southaven, Hattiesburg, Biloxi, Meridian and Tupelo; and Texas: Houston, San Antonio, Dallas, Austin, Fort Worth, El Paso, Arlington, Corpus Christi and Plano.