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Long Term Disability / Life /
Accidental Death / ERISA

Our past years of representing insurance companies taught us a thing or two about how they work behind the scenes. Let our experience work for you.

Insurance Benefits Restrictions and Limitations in Texas

Whether you were diagnosed with a long-term illness or were severely injured, the thought of not being able to work for a long period of time can be a daunting one. Financial concerns may run rampant in your mind as you wonder how you will make ends meet.

If you are one of about 50 percent of employees in the United States with long term disability coverage, you may be breathing a sigh of relief. However, just having access to this coverage may be not enough. In order to obtain these benefits, you must prove to your insurance company that you have an impairment that will hinder you from doing your job.


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you have FREE OF CHARGE.

(866) 248-0580

Receiving a bill should never be the first step in getting help. Our firm knows that when dealing with an ERISA, long term disability or insurance claim, what you need is answers, and we are here to provide them free of charge.

Our firm welcomes telephone calls or the opportunity to visit with you in person to answer any questions you may have. We also provide FREE comprehensive case reviews. There is no obligation to hire us as your ERISA attorney.

Why I Love Our Mission Of
Helping People Like You…

Too much is at stake to guess about the best approach and strategy for fighting your denied insurance claim — years and years of financial security.

After spending years representing insurance companies, we don’t guess. We know their playbook and how they work behind the scenes. Using that knowledge, we’ve developed our own Clear Advantage Process for fighting claims.

It’s personally satisfying to use what I’ve learned as an insurance company insider, now for the good — helping families reverse unfair denials of insurance benefits they paid for, need and deserve.


About J. Price McNamara

Price McNamara began his law practice in 1990 representing insurance companies.

In 1995, Mr. McNamara founded McNamara Law Offices, where he represents people across the U.S. who are wrongfully denied long-term disability insurance, life insurance, and accidental death insurance benefits, with special focus on ERISA claims and lawsuits.

His is a member of the Louisiana and Texas Bars, with office locations by appointment only in Baton Rouge, Metairie, and Houston. He lives in Baton Rouge, Louisiana with his wife and their three children.

See How We Have Helped Others In Situations Just Like Yours.

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Proving this fact could be more challenging than it sounds, as the majority of Texas disability claims are denied on the first attempt. If insurance benefits restrictions and limitations in Texas are hindering you from obtaining the long term disability insurance benefits you have worked for, a seasoned ERISA attorney may be able to help you.

ERISA Federal Law

Employees who have welfare and pension benefits through a private employer or through a union have benefits that are most likely subject to the Employee Retirement Income Security Act, or ERISA. This set of federal laws was enacted in 1974 to set the standards for private insurance companies and to help protect the insured.

Protections provided under ERISA include requirements placed on plan administrators, providers, and beneficiaries for reporting and disclosure, participation, vesting, plan funding, and benefit accrual. Regulation of the responsibilities of plan fiduciaries and plan administration issues falls to the federal Department of Labor.


Our number-one goal is getting you and your family back to financial security as soon as possible.

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Baton Rouge Office

10455 Jefferson Hwy,
Suite 2B
Baton Rouge, LA 70809
Phone: (225) 201-8311
Fax: (225) 201-8313
(By Appointment)

New Orleans Office

4141 Veterans Memorial Blvd.
Suite 212
Metairie, LA 70002
Phone: (504) 458-8455
Fax: (225) 201-8313
(By Appointment)

Houston Office

363 N Sam Houston Pkwy E
Ste 1100 PMB, #114
Houston, TX 77060
Phone: (713) 439-0339
Fax: (225) 201-8313
(By Appointment)

Restrictions and Limitations on ERISA Benefits

ERISA long term disability insurance is often subject to approval based on the insurance carrier’s perception of the claimant’s functional impairment. The term “restrictions” refers to activities that the claimant cannot do, while the term “limitations” applies to activities that the claimant can still do but not at the same frequency, intensity, or duration that they could before becoming injured or ill.

However, physicians do not use this terminology in their daily practice. Instead, they are more likely to simply state that the claimant is disabled and cannot return to work at present. Without physicians using the right framework and terms for insurance benefits restrictions and limitations in Texas, an insurer will almost always deny the claim.

On the other hand, insurance companies may have difficulty connecting an injury or illness to a physical impairment. In fact, linking a medical condition to an impairment is usually a complex legal task. Either way, a qualified lawyer may be able to help a plan holder demonstrate their condition through the proper channels and terminology.

Learn More About Texas ERISA Restrictions and Limitations

An experienced attorney may be able to help bridge the gap between insurance terminology and physician language, increasing your chances of approval for disability. More specifically, they may be able to help your insurance company understand how your medical condition has led to an impairment that is not conducive to your line of work or, if applicable, any line of work. Call today to schedule a consultation and learn more about insurance benefits restrictions and limitations in Texas.

Attorney Advertising. This website is designed for general information only. The information presented at this site should not be construed to be formal legal advice nor the formation of a lawyer/client relationship. Testimonials are not a guarantee, warranty, or prediction of the outcome of your case. By providing certain contact information herein, you are expressly authorizing the recipient of this message to contact you via the methods of communication provided.

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