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

Employer-provided long-term disability benefits in Florida protect you if you cannot work for a year or longer due to an injury or illness. The Employee Retirement Income Security Act (ERISA) governs the claims administration and appeals process. Our Jacksonville long-term disability lawyer explains what you need to know about ERISA and how it impacts your rights to benefits.

How ERISA Protects Your Rights To Long-Term Disability Benefits In Florida

ERISA is a complex federal law that governs and sets minimum standards for the administration of employer-provided retirement plans, health and wellness programs, and insurance policies. In dictating how disputes involving benefits are resolved, ERISA trumps all state and local laws.

The Bureau of Labor Statistics states that over half of private-sector workers have employer-provided long-term disability (LTD) insurance coverage available. LTD benefits reimburse up to two-thirds of your lost income if you cannot work for a year or more due to an injury or illness. Ways in which ERISA protects your rights:

• ERISA requires employers to provide copies of policy documents: You may request copies of all LTD policy documents free of charge. We typically encourage this as the first step in filing a claim.
• ERISA requires the insurance company to act in your best interests: Under ERISA, LTD insurance providers have a fiduciary duty. They must act prudently and in your best interests, providing a full and fair review of any claims filed.
• ERISA sets time limits on the LTD claims review process: ERISA gives insurers up to 45 days to review your claim and issue either an approval or denial. However, insurers may request up to two 30-day extensions if they can show exceptional circumstances.

How ERISA Governs The Appeals Process When Florida Long-Term Disability ClaimsAre Denied

Long-term disability benefits that are available through your employer can provide a safety net, ensuring you can continue to provide for yourself and your family in the event you are unable to work. However, long-term disability claims in Florida are often denied for one reason or another. ERISA protects your rights in this situation and governs the appeals process:

• Requires insurers to provide detailed reasons for denying claims and the information used in making their decision;
• Requires them to provide employees with a full copy of their claim file within 30 days of their request;
• Provides employees up to 180 days to file a long-term disability claim appeal;
• Requires a clear process for handling appeals, which usually involves appearing at administrative hearings;
• Provides guidelines for filing a lawsuit against the insurer if benefits are wrongfully denied.

Schedule A Consultation With Our Florida Long-Term Disability Lawyer

LTD benefits in Florida provide a safety net if you are unable to work, but insurers frequently deny claims. At Farrell Disability Law, we guide you through the appeals process and help you get the maximum benefits you deserve. Call or contact our Florida long-term disability lawyer online and schedule a consultation in our Jacksonville or Orlando 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#:~:text=Short%2Dterm%20disability%20insurance%20was,benefits%20varies%20by%20wage%20group.