What is an examination under oath in a disability insurance case?

An examination under oath is a significantly more formal proceeding than a routine claim interview. You are sworn in, the session is recorded and transcribed, and the transcript becomes a permanent part of your claim file. In ERISA litigation, that transcript is part of the administrative record a federal court will review under the Firestone abuse-of-discretion standard.

Insurers typically request EUOs when they suspect misrepresentation, inconsistency between reported symptoms and observed activity (including surveillance), or when they are building a denial with record support. The questions will cover your medical history, daily activities, treatment history, prior employment, and functional limitations in granular detail. Inconsistencies between the EUO transcript and your medical records or prior statements will be used against you.

Whether you are required to submit to an EUO depends on your policy language. Most ERISA group plans do not explicitly require EUOs (they are more common in individual disability and property/casualty policies), but cooperation clauses can create an obligation. Refusing without legal basis can result in a denial on grounds of non-cooperation, which creates its own appeal issue.

If you receive a request for an EUO, consult with an ERISA attorney before appearing. Preparation — knowing what is in your medical record and claim file — is essential. You have 180 days under 29 CFR 2560.503-1 to appeal any resulting denial. We handle ERISA LTD cases on contingency. No fee unless we win.