ERISA Appeals For Denied Long-Term Disability Benefits: What Florida Claimants Need To Know

If your employer-provided long-term disability (LTD) benefits were denied, you’re likely frustrated and overwhelmed, and understandably so. These policies are subject to the Employee Retirement Income Security Act of 1974 (ERISA). This is a federal law that provides important protections. However, it also imposes strict deadlines and procedures that can make winning an appeal difficult without the right support.

Our Jacksonville long-term disability lawyer guides clients through the ERISA appeals process and helps them avoid costly mistakes. If you get denied benefits, the following explains what you need to know.

How ERISA Limits and Shapes the Long-Term Disability Appeals Process

The Florida Chamber Foundation reports that more than 1.2 million residents between the ages of 18 to 64 (the ages people are most likely to be in the workforce) are disabled. More than half have long-term disability insurance available through an employer-provided policy.

ERISA was designed to protect employee benefits, but in practice, it often favors insurance companies. Unlike private or individual disability policies, ERISA-controlled claims must follow a rigid process. Here’s how ERISA affects your long-term disability appeal:

• You typically have 180 days to file an administrative appeal after a denial.
• No new evidence can be added once the appeal process is complete.
• Court reviews are limited to the information already in the administrative record.
• There is no jury trial. Instead, a judge decides your case, often giving deference to the insurer’s decision.

In short, the appeal you submit is your only opportunity to create a persuasive case for why you qualify for long-term disability benefits. If your appeal is weak or incomplete, you may lose the chance to correct it later.

How to Build a Strong ERISA Appeal for Florida Long-Term Disability Benefits

Winning an ERISA appeal requires proving you are disabled, using medical, vocational, and personal evidence that’s impossible to ignore. Since the court won’t consider new evidence later, it is important to submit all relevant information during this stage. To build a strong appeal, follow these key steps:

• Request and review your complete claim file from the insurance company.
• Submit updated medical records, doctor opinions, and test results.
• Include a statement describing how your condition affects your daily life and ability to work.
• Get a vocational expert report to explain why you cannot work.
• Work with a lawyer familiar with ERISA to ensure your appeal includes everything the court might need.

Insurance companies count on claimants not understanding the rules. Working with a knowledgeable long-term disability lawyer can make the difference between approval and denial.

Farrell Disability Law Helps You Fight Back After An LTD Claim Denial

When employer-provided long-term disability benefits in Florida are denied, ERISA governs the appeals process. At Farrell Disability Law, we help clients across Jacksonville and Orlando file strong, timely ERISA appeals that give them the best possible chance at approval.

Take the next step toward getting the disability benefits you need and have earned. Call or contact our office online today for a consultation with our Florida long-term disability lawyer.

Sources:

dol.gov/general/topic/health-plans/erisa

flchamber.com/wp-content/uploads/2019/01/Employment-of-Floridians-with-a-Disability_2019.pdf