The ERISA Process: How To Navigate A Long-Term Disability Denial In Florida
You’ve done everything right. You paid into your employer’s long-term disability (LTD) plan, your doctor agrees you can’t work, and you filed your claim on time. Then the letter arrives: Denied.
For Florida workers with employer-provided LTD benefits, that denial likely falls under ERISA, the Employee Retirement Income Security Act. ERISA has strict, unforgiving rules for appealing LTD denials. And here’s the part many people don’t realize: you only get one chance to present your case.
That’s why navigating the ERISA process isn’t just about filing forms; it’s about strategy, deadlines, and putting every piece of evidence on the table from the start. Having our experienced Jacksonville long-term disability lawyer on your side can make the difference between a second denial and the benefits you’ve earned.
Long-Term Disability Benefits In Florida Denied? Why ERISA Appeals Are So Different
ERISA governs most group disability plans offered through private employers. While the law was created to protect workers, in practice, it gives insurers significant advantages during the appeal process.
Here’s what makes ERISA appeals so challenging:
- Short deadlines: You generally have 180 days to appeal after a denial.
- No new evidence later: Once the insurer closes the appeal, you can’t add new documents in court.
- Limited court review: A judge won’t hear witnesses or order a jury trial; they only review the existing file.
- Insurer advantage: In many cases, the insurance company both decides and pays claims, creating a conflict of interest.
That “one chance” to appeal isn’t just a saying. If you don’t submit everything during the administrative appeal, you’ve lost the chance to use it later.
Building a Strong ERISA Appeal in Florida
A denial isn’t the end of your claim, it’s the start of a different fight. To win, you have to treat your Florida long-term disability (LTD) benefit application like a trial case, even if you never actually step into a courtroom. The following steps can help in building a strong ERISA appeal:
- Get a copy of your claim file from the insurer to see evidence used in denying your claim.
- Get updated medical records and detailed statements from medical providers.
- Counter all insurer reasons for denying your claim.
- Consider getting expert opinions from vocational specialists about your inability to work.
- Work with a lawyer experienced in ERISA to ensure your appeal file is complete and strategically presented.
Insurers count on claimants making mistakes, missing deadlines, submitting incomplete files, or not challenging flawed reasoning.
For Help Navigating ERISA Appeals, Contact Our Experienced Jacksonville Long-Term Disability Lawyer
ERISA appeals are high-stakes, one-shot opportunities. If you’ve received an LTD denial in Florida, waiting or trying to handle it alone could cost you your benefits.
Farrell Disability Law helps clients in Jacksonville, Orlando, and across Florida take control of the ERISA process from day one. We gather the right evidence, meet every deadline, and fight to protect your income. To turn that denial letter into an approval, call or contact us online today to speak with our experienced Florida long-term disability lawyer.
Sources:
dol.gov/general/topic/retirement/erisa
dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/benefit-claims-procedure-regulation
