How Substance Use Disorders Are Handled In Florida Long-Term Disability Determinations

Substance use disorders (SUDs) are medical conditions, not moral failings. Like other chronic health issues, they can severely impact a person’s ability to hold a job, maintain focus, or manage daily responsibilities.

For those struggling with addiction in Fort Lauderdale, employer-provided long-term disability (LTD) insurance can be a critical financial lifeline. Our experienced Jacksonville long-term disability lawyer explains how addiction-related claims are evaluated and what you can do to protect your rights.

Common Challenges in Filing a Florida LTD Claim for Substance Use Disorders

Substance abuse is a devastating problem, both locally and throughout the United States. According to Florida Health Charts, it claims the lives of over 7,000 people in the Sunshine State each year.

Many employer-provided long-term disability policies provide coverage for substance use disorders, but insurance companies often treat these claims with skepticism, resulting in denied benefits. Common issues you may face when filing an LTD claim for substance abuse in Florida include:

• Time-limited benefits: Some policies limit mental health and substance-related benefits to 12–24 months.
• Exclusions for self-inflicted harm: Policies may deny claims where substance use led directly to injury or death.
• Pre-existing condition clauses: If treatment occurred shortly before coverage began, the insurer may deny benefits under this clause.
• Failure to follow prescribed treatment: Not actively participating in rehabilitation or outpatient care may be used to terminate benefits.
• Insurer bias or surveillance: Insurance companies may question your credibility or use selective evidence to dispute your claim.

These challenges make it essential to approach this type of claim with strong medical documentation and legal support.

Protect Your Rights to LTD Benefits for Addiction-Related Disabilities

If you are unable to work due to substance use disorder, you still have legal rights under your policy, especially if your condition is being actively treated and documented. Insurers cannot automatically deny your claim based on the nature of your diagnosis. Here’s how to protect your rights and strengthen your claim:

• Seek a formal diagnosis from a licensed provider and comply with their treatment plan;
• Document all medical care, including inpatient rehab, therapy, and medication management;
• Keep records of missed work, workplace accommodations, or performance issues tied to your condition;
• Avoid discussing your condition on social media, as insurers may use it to dispute your claim;
• Consult an experienced LTD attorney early in the process to review policy language and assist with the application.

Denied LTD benefits for substance abuse in Florida? Under the Employee Retirement Income Security Act of 1974 (ERISA), you have the right to appeal the insurer’s decision.

Contact Our Experienced Florida Long-Term Disability Lawyer Today

Long-term disability claims involving substance use disorders are complex, and insurance companies may use any excuse to deny or limit your benefits. At Farrell Disability Law, we help clients fight back against unfair LTD denials and stand up for their right to financial support during recovery. To arrange a consultation in our Jacksonville or Orlando office,  call or contact our experienced Florida long-term disability lawyer online today.

Sources:

flhealthcharts.gov/ChartsDashboards/rdPage.aspx?rdReport=SubstanceUse.Overview

dol.gov/general/topic/health-plans/erisa#:~:text=The%20Employee%20Retirement%20Income%20Security,for%20individuals%20in%20these%20plans