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Five Strategies For A Successful Florida Long-Term Disability ERISA Appeal

ERISA

Long-term disability benefits available through your employer can help make up for a portion of your lost wages in the event an injury, illness, or chronic health condition prevents you from working for a year or more. However, these benefits are provided through insurance companies, which look for reasons to deny claims.

ERISA is a complex federal law that applies in these cases. Our Orlando long-term disability lawyer explains more about ERISA and offers five strategies for filing a successful appeal.

What Is ERISA And How Does It Impact Florida Long-Term Disability Benefits?

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that governs employer-provided health and wellness programs. It does not require employers to provide benefits, but it does set minimum standards for how they are administered.

ERISA impacts long-term disability benefits in Florida by mandating the following:

  • That benefit program participants be provided with copies of all benefit-related documents;
  • That those who manage these plans act in the best interests of their employees;
  • In the event of a claims denial, provides clear guidelines for filing an appeal;
  • In the event plans are mismanaged or benefits continue to be denied on appeal, gives plan participants the right to sue.

Five Strategies For Filing An ERISA Appeal

The Bureau of Labor Statistics (BLS) reports that over a third of all workers receive long-term disability benefits through their employer. These can provide payments for up to two-thirds of your lost wages in the event you are unable to work for a year or more.

While insurers are notorious for denying long-term disability (LTD) claims, ERISA protects your rights. Follow these strategies for filing a successful ERISA appeal:

  1. Carefully review the reasons for your denial. Insurers are required to notify you of a denial within 45 days of filing your claim, though they may request extensions. They are also required to specify the reasons your claim was denied.
  2. Review the terms of your long-term disability policy. Pay close attention to eligibility requirements, covered conditions, and any policy exclusions.
  3. Pay attention to appeals deadlines. While you have up to 180 days to file an appeal, this time can go quickly and should be used to gather evidence in support of your claim.
  4. Continue undergoing treatment for your condition. It is important to follow all doctor instructions regarding ongoing care, testing, treatment, and medications. Failing to do so could result in denied benefits.
  5. Get legal help. ERISA is a complex law, and navigating the appeals process is challenging. To protect your rights, get our Florida long-term disability benefits lawyer on your side.

Request A Consultation With Our Florida Long-Term Disability Lawyer Today

If you have been denied long-term disability or encounter other problems in filing a claim, contact Farrell Disability Law. We provide the trusted legal guidance and professional legal representation you need to get the benefits you are entitled to. Request a consultation in our Orlando or Jacksonville office today.

Sources:

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

bls.gov/opub/ted/2020/short-term-and-long-term-disability-insurance-for-civilian-workers-in-2020.htm

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