Wondering what it takes to write a Long Term Disability appeal in Florida? We’re sharing the details with you below.
Recently, many new clients come to us after being receiving a claim denial for Long Term Disability benefits and explain that the claim representative told them to appeal the decision by completing a form provided to them. The form commonly has only a few lines in which to state the reasoning for the claimant’s disagreement with the adverse determination. This is a preposterous proposal. The idea that a claimant would be able to state the reasons which they are unable to work and their lack of functional capacity in such a small amount of space is untenable. Furthermore, many of these clients tell us during an initial consultation or later in our representation that the claims representative handling their claim told them that they would only need to state something along the lines of, “I appeal.” in the space provided. It is hard to imagine an action more damaging to the outcome of the next level appeal, and perhaps final appeal in a claim for Long Term Disability benefits.
An appeal following a Long Term Disability denial is an opportunity to let the insurance company know how they may have misconstrued the medical evidence and your treating physician’s opinions. It is important to collect the medical records pertinent to your disability and ensure that they are in the claim file before the claim representative making a determination in your claim. Further, a claimant would be remiss to if he or she does not obtain an affirmative statement of some form or other from their treating physicians outlining their functional capacity and restrictions and limitations. Often, medical records do not give the kind of information that claims representatives need in order to understand your limited functional capacity.
The reason the above is so important is that once your Long Term Disability appeal in Florida is exhausted and the time finally comes that a claimant is able to file a lawsuit with an insurance company that is not budging in their denial of your Long Term Disability claim, the evidence has closed. Your only opportunity to put the evidence you need to win your claim is during the appeal process. You are not allowed by governing regulations to gather further evidence of your disability after that time. As a result, the appeal process is of utmost importance in order to win your claim for Long Term Disability benefits.
Our law firm navigates the complicated issues which are presented in ERISA claims for Short and Long Term Disability related to chronic back pain. If you have any questions about your Short Term disability or Long Term disability appeal in Florida, please give Herbert M. Hill, P.A. a call and we would be glad to answer any questions you may have. We are available at 407-839-0005 or, toll free, 844-454-59995, If you would like, after discussing your case, we can set a conference. In most circumstances, that conference would be free of charge but in no circumstance would you be under any obligation to hire me nor would you feel any pressure from me to do so.
Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida. While the vast majority of cases handled are for disability insurance benefits, areas of practice include employee benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (“ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.