How Pre-Existing Conditions Affect Long-Term Disability Claims In Florida
Long-term disability (LTD) insurance protects your finances when injuries or illnesses prevent you from working. However, in cases involving pre-existing conditions, Florida insurers are quick to deny claims.
If this has happened to you, our Jacksonville long-term disability lawyer is here to help. Find out how pre-existing clauses in Florida LTD policies work and what you can do if your claim is denied.
How Do Pre-Existing Condition Clauses In Florida LTD Policies Work?
When injuries or illnesses prevent you from working for a year or more, long-term disability insurance can help offset your losses. Employers often provide this type of coverage, but many policies contain pre-existing condition exclusions.
The Florida Office of Insurance Regulation (FLOIR) allows insurers to include these clauses, but they must follow strict rules. They will typically review your medical history for a certain period before coverage starts (the ‘look-back period’), which can range from three to 12 months.
Evidence of pre-existing conditions that insurers often use to deny LTD benefits in Florida claims include:
- Medical records showing a prior diagnosis or treatment during the look-back period;
- Use of prescribed medications taken for pre-existing conditions;
- Overlapping symptoms related to a pre-existing condition, even if your symptoms have worsened since then;
- Not disclosing your full medical history when applying for LTD coverage through your employer.
Appealing Denied LTD Benefits In Florida Due to a Pre-Existing Condition
If your long-term disability claim is denied based on a pre-existing condition exclusion, don’t give up. Many applicants successfully appeal and receive benefits. Follow these steps to strengthen your case:
- Request a copy of your LTD policy: Review the insurer’s definition of a pre-existing condition and the look-back period they applied.
- Obtain detailed medical records: Your doctor can clarify that your current disability is not directly related to a pre-existing medical condition.
- Get statements from your physician: A letter from your treating provider explaining why your condition is new or unrelated can help counter the insurer’s claims.
- Provide evidence of a significant change in health: If your condition worsened unexpectedly, medical documentation can prove it’s not a pre-existing issue.
- Consult our Florida LTD lawyer: An experienced Florida LTD lawyer can challenge wrongful denials, ensuring your appeal follows ERISA guidelines and includes the strongest evidence.
If your appeal continues to be denied, you may have grounds to file an LTD lawsuit against the insurance company under federal ERISA laws.
Pre-Existing Conditions Standing In The Way Of Your Benefits? Contact Our Florida Long-Term Disability Lawyer
Being denied long-term disability benefits in Florida due to pre-existing conditions jeopardizes your financial security. Insurers look for reasons to deny or downplay disability claims, but you have the right to fight back. Farrell Law acts as a strong legal ally on your side.
We have decades of experience helping local clients get benefits and appealing denied LTD claims. We can review your case, advise you on your legal rights, and fight to get the total amount you deserve. Contact our Florida long-term disability lawyer and request a consultation today in our Orlando or Jacksonville office.
Source:
dol.gov/general/topic/health-plans/erisa#:~:text=The%20Employee%20Retirement%20Income%20Security,for%20individuals%20in%20these%20plans.
