Davies Insurance Attorney

By Frank N. Darras > Founding Partner, DarrasLaw | Nationally Recognized Disability Advocate > Last Updated: September 2026

With more than 30 years of experience and nearly $1 billion recovered for disabled policyholders, Frank Darras leads one of the nation’s foremost disability insurance law firms in representing claimants whose benefits have been delayed, denied, reduced, or terminated. Disability claims administered by Davies Life & Health or Disability Management Services (DMS) may involve complicated policy provisions, occupational disability definitions, medical and vocational reviews, continuing proof requirements, ERISA appeal deadlines, and disputes over whether a claimant remains unable to work.

Understanding Davies Life & Health and Disability Management Services

Davies Life & Health provides disability claims management and administrative services to insurers and benefit plans. Its disability operations include Disability Management Services, commonly referred to as DMS.

Because of corporate changes and administrative relationships, claimants may encounter several names in their documents. Older correspondence may refer to Disability Management Services or DMS, while more recent documents may use Davies Life & Health.

The company appearing on your claim correspondence is not necessarily the company that originally issued your disability insurance policy. Before filing a claim or appeal, review your policy, benefit booklet, denial letter, and other correspondence to determine:

• Which insurance company issued the policy;
• Whether Davies is acting as a third-party administrator;
• Who has authority to make benefit decisions;
• Where claim or appeal documents must be submitted;
• Whether the coverage is individual or employer-sponsored; and
• What deadlines and procedures apply to your claim.

These distinctions can affect the claim process, your appeal rights, and the legal remedies that may be available if benefits are denied.

What Does Davies Review in a Disability Claim?

A disability claim generally requires more than proof that you have been diagnosed with an illness or injury. The administrator will typically evaluate whether your condition prevents you from working as required by the specific definition of disability contained in your policy or benefit plan.

Depending on the claim, Davies may review:

• Medical records and treatment history;
• Diagnostic testing and laboratory results;
• Attending physician statements;
• Documented physical or cognitive restrictions and limitations;
• Your symptoms and reported functional abilities;
• The duties and demands of your occupation;
• Employment and earnings information;
• Independent medical or file reviews;
• Vocational assessments;
• Financial information for residual disability claims;
• Surveillance or other activity evidence; and
• Updated proof showing whether your disability continues.

The controlling definition of disability is found in the policy or employer benefit plan. Coverage terms can vary significantly, even when two claimants have similar medical conditions.

Own-Occupation and Any-Occupation Disability Standards

One of the most important provisions in a disability policy is the definition of disability.

Some policies determine whether you can perform the material and substantial duties of your regular or own occupation. Others use an any occupation standard or transition from own occupation to any occupation after benefits have been paid for a specified period.

An own-occupation analysis should involve more than comparing a diagnosis with a job title. It may require a detailed review of:

• The duties you actually performed before becoming disabled;
• The physical and cognitive requirements of those duties;
• The amount of time spent performing particular tasks;
• Which duties generated your income;
• Your supported medical restrictions and limitations; and
• Whether you can perform your occupation reliably and on a sustained basis.

Under an any-occupation standard, Davies or the insurer may evaluate whether you are capable of performing another occupation based on criteria contained in the policy. These criteria may include your education, training, experience, functional capacity, and potential earnings.

Disputes can arise when an administrator relies on generalized occupational descriptions or identifies alternative jobs that do not realistically account for the claimant’s medical restrictions or professional background.

Davies Disability Claims for Physicians and Other Professionals

Disability claims involving physicians, dentists, attorneys, executives, business owners, and other high-income professionals may require particularly detailed occupational and financial analysis.

For example, a physician’s ability to perform some administrative work does not necessarily establish an ability to perform surgery, procedures, examinations, patient care, or other duties that defined the physician’s specialty before disability.

Issues in professional disability claims may include:

• How the policy defines your occupation or specialty;
• Whether your occupation is evaluated nationally or based on your actual duties;
• Which occupational duties you can no longer perform;
• Whether you remain able to perform limited or incidental duties;
• Whether you qualify for residual or partial disability benefits;
• Whether your work hours have been reduced;
• Whether your income has declined because of your disability; and
• Whether you had multiple occupations or business interests before becoming disabled.

DarrasLaw has decades of experience reviewing complex individual disability policies and claims involving highly specialized occupations.

Common Reasons Davies Disability Claims May Be Denied or Terminated

A denial does not necessarily mean the claimant is capable of returning to work. It may reflect a disagreement over how the policy applies, whether sufficient evidence has been submitted, or whether the medical evidence adequately explains the claimant’s functional limitations.

Reasons that may appear in disability denial or termination letters include:

• Insufficient medical evidence of functional impairment;
• Normal or mild findings on imaging, laboratory testing, or examinations;
• A lack of clearly documented restrictions and limitations;
• Disagreement with the opinions of treating physicians;
• Failure to satisfy the policy’s definition of disability;
• Failure to establish the duties of the claimant’s occupation;
• Surveillance or reported activity allegedly inconsistent with claimed limitations;
• Missed treatment or gaps in medical care;
• Incomplete claim forms or delayed responses to requests for information;
• A change from an own-occupation to an any-occupation standard;
• Application of a policy limitation or exclusion;
• A pre-existing condition provision; or
• Failure to provide continuing proof of disability.

Each reason should be compared against the actual policy language and the evidence contained in the claim file. A strong appeal generally addresses each stated basis for denial rather than simply resubmitting the same medical records.

Medical Evidence That May Strengthen a Davies Disability Claim

Medical records are central to most disability claims, but records prepared primarily for treatment purposes may not fully explain why a patient cannot sustain the demands of full-time employment.

Your doctor may document a diagnosis, symptoms, medications, and treatment plan without addressing your ability to sit, stand, walk, concentrate, use your hands, perform procedures, remain on task, maintain attendance, or safely perform other occupational duties.

Depending on the medical condition and policy requirements, useful evidence may include:

• Detailed attending physician statements;
• Narrative reports explaining restrictions and limitations;
• Specialist evaluations;
• Longitudinal treatment records;
• Imaging and diagnostic testing;
• Operative reports;
• Neuropsychological or cognitive testing;
• Psychiatric or psychological evaluations;
• Functional capacity evaluations when medically appropriate;
• Medication histories and documentation of side effects;
• Statements from people with firsthand knowledge of your limitations; and
• Evidence connecting your medical condition to the specific duties of your occupation.

Not every disabling condition produces dramatic objective findings. Conditions involving chronic pain, fatigue, migraine disorders, cognitive symptoms, mental health impairments, and other illnesses may require careful documentation of symptom frequency, duration, severity, treatment response, and functional impact.

What To Do After Receiving a Davies Disability Denial Letter

Start by reading the denial or termination letter in full. It should identify the reasons for the decision and provide information about the available review or appeal procedure.

1. Confirm the appeal deadline. Do not assume telephone calls or informal discussions with a claim representative will extend it.
2. Obtain the policy or plan documents. Review the actual definition of disability and any exclusions, limitations, proof requirements, or appeal provisions.
3. Request the claim file when appropriate. The file may contain medical reviews, vocational reports, internal notes, correspondence, surveillance, or other materials considered during the claim review.
4. Identify every stated reason for the denial. Each medical, vocational, occupational, financial, and procedural issue should be addressed.
5. Review the occupational analysis. Determine whether Davies evaluated the correct occupation and accurately described its material duties.
6. Coordinate with your treating providers. Your physicians may need to explain not merely what your diagnosis is, but why your symptoms prevent you from reliably performing your occupational duties.
7. Avoid submitting a rushed appeal. A short letter stating that you disagree with the decision may fail to correct weaknesses in the evidence or preserve issues that could become important later.

ERISA Appeals for Employer-Sponsored Disability Benefits Administered by Davies

Many disability plans obtained through private employment are governed by the Employee Retirement Income Security Act of 1974, commonly called ERISA.

ERISA disability claims follow administrative procedures that differ significantly from disputes involving individually purchased disability insurance policies.

A claimant whose ERISA disability benefits are denied generally must be given at least 180 days to request review of an adverse benefit determination. The denial letter and governing plan should always be checked carefully because additional requirements may apply.

The administrative appeal is particularly important because a later lawsuit may depend heavily on the evidence submitted before the administrator issues its final claim decision.

An ERISA appeal may therefore need to include:

• Additional medical evidence;
• Treating physician opinions;
• Vocational evidence;
• Detailed occupational information;
• Responses to medical reviews;
• Responses to surveillance;
• Functional evidence; and
• Documentation addressing every reason given for the denial.

Missing a required appeal or submitting an incomplete administrative record can significantly affect a claimant’s ability to pursue benefits later.

Individual Disability Policies Are Different From ERISA Plans

An individually purchased disability insurance policy is generally governed by state insurance and contract law rather than ERISA.

These policies may provide rights and benefits that are different from those available under employer-sponsored plans, including provisions concerning:

• Own-occupation disability;
• Specialty-specific occupations;
• Residual or partial disability;
• Recovery benefits;
• Presumptive disability;
• Cost-of-living adjustments;
• Future increase options; and
• Lifetime or extended benefit provisions.

The policy should be carefully reviewed before accepting a denial, termination, benefit reduction, settlement proposal, rescission, or interpretation of the contract.

Can Davies Continue Reviewing a Claim After Benefits Are Approved?

Yes. Approval of disability benefits does not necessarily end the claims process.

Most disability policies and plans require continuing proof that the claimant remains eligible for benefits. Davies may periodically request updated:

• Medical records;
• Attending physician statements;
• Claimant questionnaires;
• Employment information;
• Financial records;
• Tax returns;
• Occupational information;
• Authorization forms; or
• Other documentation related to ongoing eligibility.

A claim may receive additional scrutiny when:

• The definition of disability is about to change;
• The claimant begins part-time work;
• The claimant reports earned income;
• Medical records indicate improvement;
• There are gaps or changes in treatment;
• A benefit limitation is approaching;
• New surveillance or online activity is reviewed; or
• The claimant reaches another policy milestone.

Claimants should respond accurately and on time to legitimate requests while keeping copies of everything submitted. Requests that appear unusually broad, repetitive, or unrelated to eligibility should be evaluated against the policy’s proof-of-loss and cooperation provisions.

How DarrasLaw Handles Davies Disability Claim Disputes

With more than 30 years of experience and nearly $1 billion recovered for disabled policyholders, Frank Darras leads a nationally recognized disability insurance law firm representing claimants nationwide in disputes involving major insurers and third-party disability claims administrators.

Depending on the status of your Davies or DMS claim, DarrasLaw may:

• Review the policy, plan documents, denial letter, and applicable deadlines;
• Determine whether ERISA or state insurance law applies;
• Analyze the administrative or insurer claim file;
• Evaluate medical and occupational evidence;
• Identify weaknesses or errors in medical and vocational reviews;
• Help document the material duties of your occupation;
• Coordinate evidence from treating providers;
• Develop an ERISA administrative appeal record;
• Address the termination of previously approved benefits; and
• Pursue litigation when a disability claim cannot be resolved through the administrative process.

No two disability claims are identical. The appropriate strategy depends on the policy language, the claimant’s occupation, medical condition, evidence already in the record, and whether the benefits arise from an individual policy or employer-sponsored plan.

Meet Our Disability Attorneys

Frank N. Darras, Founding Partner
Experience: For more than 30 years, Frank N. Darras has focused exclusively on long-term disability and insurance litigation, including high-stakes disputes against Lloyd’s of London syndicates.

Track Record: He and his firm have recovered nearly $1 billion in wrongfully delayed and denied insurance benefits for policyholders nationwide.

Recognition: Named to Lawdragon’s Top 500 Lawyers in America for 18 consecutive years and listed in Best Lawyers in America since 2006, Mr. Darras is widely regarded as a leading authority on ERISA and disability insurance law.

Susan B. Grabarsky, Senior Trial Attorney
Experience: Ms. Grabarsky represents both individual policyholders and employee groups in complex disability disputes. Her prior experience as an insurance cost-containment analyst provides unique insight into how carriers evaluate and deny claims.

Approach: She leverages her understanding of insurer review tactics to strategically challenge Lloyd’s denials and push for full payment of valid benefits.

Reputation: Known for meticulous preparation and assertive advocacy, she has built a strong record confronting unfair disability practices.

Heather Gardner, Senior Associate
Experience: Heather Gardner concentrates on ERISA-governed and individual disability appeals involving national and international carriers.

Role in Litigation: Working closely with Frank Darras, she helps develop comprehensive administrative records and appellate strategies designed to withstand federal court scrutiny.

Professional Strength: She is respected for her precision in analyzing policy language and dismantling complex denial rationales.

Phillip S. Bather, Associate Attorney
Experience: Phillip S. Bather focuses on ERISA litigation and insurance bad-faith disputes, assisting clients through intake, claim development, and administrative appeals.

Case Strategy: He works to assemble compelling evidentiary records aimed at reversing unjust denials and positioning cases for successful litigation when necessary.

Client Commitment: Recognized for his responsiveness and detail-oriented advocacy, he supports claimants facing aggressive insurer resistance.

Trusted Legal Credentials

• AV Preeminent® Rating – Martindale-Hubbell
• Best Lawyers in America – Disability Law
• Lawdragon 500 Leading Plaintiff Lawyers

Speak With a Davies Disability Claim Attorney

A denied or terminated disability claim can put your income and financial security at risk. Do not assume the administrator’s decision is final, and do not allow an appeal deadline to expire while attempting to resolve the matter through informal conversations.

DarrasLaw represents disabled policyholders nationwide in individual and employer-sponsored disability insurance matters. If Davies Life & Health or Disability Management Services is administering your claim, our attorneys can review your policy, medical evidence, occupational information, correspondence, and benefit decision.

Call (800) 898-7299 or complete our confidential online contact form to request a free disability policy and claim evaluation.

Frequently Asked Questions About Davies Disability Claims

Disclaimer: This page provides general information and is not legal advice. Insurance rights and deadlines depend on the language of the applicable policy or plan, the governing law, and the facts of the individual claim.