ERISA benefit cases often look like they turn on medical records, policy language, or whether an insurance company “got it wrong.” In practice, one issue can shape nearly everything that follows: the standard of review.
That phrase sounds technical, but it affects how much deference a court gives to the plan administrator’s decision. In many cases, that difference can quietly influence what evidence matters, how arguments are framed, and whether a denial gets a fresh look or a more deferential one. The Supreme Court’s foundational ERISA decision, Firestone Tire & Rubber Co. v. Bruch, explained the starting point: courts generally apply de novo review unless the plan gives the administrator discretionary authority to determine eligibility or interpret plan terms. When discretion exists, courts often move into a more deferential framework, often described as abuse of discretion or arbitrary and capricious review, depending on the jurisdiction and context (Justia).
If you want a deeper primer on the basics before getting into the mistakes, it may help to start with this plain-English overview of how courts look at de novo and abuse-of-discretion review, and why plan wording can matter.
In this post, you’ll learn five standard-of-review mistakes that quietly undermine ERISA cases, why they matter, and how lawyers often think about them early—long before briefing starts.
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The standard of review is not just a legal label. It can affect:
Under Firestone, de novo review is the default unless the plan grants discretionary authority. The Court also noted that if the administrator has discretion and operates under a conflict of interest, that conflict is weighed as a factor in deciding whether there was an abuse of discretion (Justia). Later, in Metropolitan Life Insurance Co. v. Glenn, the Supreme Court reinforced that a structural conflict exists when the same entity both decides claims and pays benefits, and that conflict can matter more when the record shows signs of biased decision-making, such as selective reliance on favorable medical evidence or failure to account for a Social Security disability finding (Cornell LII).
That is why standard-of-review issues rarely sit off to the side. They often sit at the center of the case.
One of the quietest mistakes in ERISA litigation is waiting too long to identify the likely standard of review. By the time a complaint is filed—or worse, by the time summary judgment briefing begins—the record may already be locked, the wrong issues may have been emphasized on appeal, and key plan documents may still be missing.
In general terms, the standard-of-review analysis often begins with a few basic questions: