Bridget Hardt’s medical troubles started a decade ago, when the Chesapeake, Va., woman was working as an executive assistant at Dan River Inc., a textile company. She suffered from neck and shoulder pain and, after being diagnosed with carpal tunnel syndrome, had surgery on both her wrists—but the pain didn’t go away.
Hardt applied for long-term disability benefits, and Reliance Standard Life Insurance Co., which handled Dan River’s insurance plan, agreed to pay her disability for two years. During that time, her condition worsened and Hardt was awarded Social Security disability benefits.
“I went to the doctor’s when this all started, and I’m still going to the doctor’s,” says Hardt, now 65. “Some of the pain I’m going to have for the rest of my life.” But at the end of the agreed two years, Reliance terminated her benefits, saying she wasn’t “totally disabled.”
Hardt went to court, charging that Reliance had wrongfully denied her claim and violated the Employee Retirement Income Security Act (ERISA), the federal law that governs the administration of most private health, pension and other employee benefit plans. A court sent her case back to the insurer with instructions to review her medical record and said that if Hardt’s claim wasn’t reconsidered within 30 days, it would rule in her favor. Reliance then declared Hardt eligible for long-term disability coverage and paid her the past benefits she was owed.
An ERISA provision allows individuals who win such cases to have their legal costs paid by their opponent, and a court ordered Reliance to pay Hardt almost $40,000 in attorneys’ fees. But an appeals court ruled that the ERISA provision did not apply because the decision came from the insurance company rather than a courtroom, and Reliance was not required to pay her attorneys’ fees.
The U.S. Supreme Court sided with Hardt on May 24, ruling that the appeals court had misread the law and she was eligible to collect attorneys’ fees. But the unanimous opinion, written by Justice Clarence Thomas, also raises new questions about the standards that judges should use for determining when people with such claims should have their attorneys’ fees paid by their opponents, leaving analysts uncertain about the ruling’s ultimate impact.
A triumph for advocates
By any measure, the high court’s decision in Hardt’s case marks a victory for advocates for older Americans, the disabled and others. Those public interest activists worried that a decision in favor of the insurance company would have made it more difficult for people with relatively low-value claims like Hardt’s to find attorneys willing to represent them.
AARP wrote in a friend-of-the-court brief filed on Hardt’s behalf that most participants in employee benefit plans “have limited means, and thus are unable to retain a qualified attorney.” That’s because the benefits in dispute are typically modest amounts, which makes lawyers unwilling to rely on contingency fee agreements. AARP argued that a ruling that agreed with the appeals court, and sided with Reliance, would have done more to dissuade attorneys from taking on these cases.
It’s a calculation that Hardt knows firsthand. The past-due benefits she finally collected were $55,250. She told the court that her attorneys’ fees and costs totaled $58,920.73, even more than she collected in back benefits.
“It’s hard enough to find an attorney who can represent you in an ERISA case,” says Hardt. But if you can’t recoup their fees, she says, it would be nearly impossible.