Florida is the most populous state in the southeast and the fourth most populous state in the country. It is one of the fastest-growing states in the country. Many people who live in Florida today come from the northeast, eager to leave the cold climate behind and live in a warm tropical state where they can enjoy outdoor activities like golf, boating, and fishing all year long.
The Law Office of Justin Frankel represents many Florida long-term disability insurance claimants whose claims have been denied, delayed, or terminated. If you have any Florida disability claims, you don’t have to fight your long term disability case battle alone. The attorneys at the Law Office of Justin Frankel can be reached at 888-583-4959. Call today to schedule your free case evaluation and get started with your case.
While Florida is known as a tourist destination, that is only a part of the state’s economy. Several key commercial centers in Florida — Miami, Jacksonville, Orlando, and the state capital, Tallahassee — are busy with international trade and finance. Major hospitals can be found in these cities as well. The state has an extensive state university system, and several colleges draw professors and college students from across the county. Retirees from the entire Eastern seaboard and Canada come to Florida, and a large economy has sprung up around their special needs: housing, entertainment, medical care, etc.
The Employee Retirement Income Security Act, or ERISA, is a federal law applicable to group disability insurance policies, though ERISA does not govern individual disability private insurance plans. While it was created to protect employee benefits from employers, insurance companies often use ERISA against claimants in several different ways. For example, a jury trial is not possible in ERISA cases. Rather, a Federal judge will decide on your claim. This is a significant departure from ordinary court proceedings and could put you in a much more difficult position, as Courts sit as the jury.
ERISA cases must follow a specific process, which can make claimants’ lives more difficult when trying to fight for their benefits. Even appealing a denial or termination is complicated, so it is in your interest to get the help of an experienced long-term disability lawyer before you make any kind of filing, no matter how much insurance companies tell you that a disability insurance attorney is unnecessary or try to move you quickly through the appeal process.
The statute of limitations for a long-term disability claim in Florida depends on the details of your insurance policy. Some policies are more restrictive than others, necessitating that you check the details of your specific policy to make sure you do not miss any deadlines, as that could negate your ability to fight for your benefits.
Quite a few different medical conditions could qualify you for disability in the state of Florida. There are a wide range of qualifying conditions, and they vary from policy to policy. Put simply, if a condition is preventing you from being able to work, you may be eligible for disability benefits.
Our law firm has worked on cases involving a large range of conditions, so our decades of experience are as varied as the conditions themselves. We have represented clients in Florida with long-term conditions.
The long-term disability claim application process in Florida is challenging, but it is important to understand the steps before any kind of filing. We recommend talking with a long-term disability insurance attorney before filing a claim, so your claim can be prepared to withstand the many challenges facing it. If you’ve already filed a claim and the insurance company has denied the claim or is asking for an extensive amount of information, your next step should be to contact an experienced long-term disability insurance attorney.
If your claim is denied, you will be provided with the reason it was rejected.
An independent medical examination (IME) is a standard request by an insurance company policy provision included in almost every long-term disability insurance policy. It often seems excessive when the same disability insurance claims adjuster who has gathered extensive medical records then requests that the claimant go for an IME. It would seem that the disability insurance company already has all of the information that it might need. However, by virtue of its inclusion in the contract, the insurance company does have a right to ask for an IME.
What most individuals making a claim do not understand is that there is nothing “independent” about an IME. The doctor conducting the examination of the patient is paid a very generous sum of money by the disability insurance company to perform the exam. There are entire medical practices that don’t practice medicine on people – – all they do is IMEs for insurance companies. It is important to understand this so that when you go for an IME, you know why you are there and what the doctor is looking for.
Many people fall into the trap of trying to minimize their pain or their illness because they do not want the doctor, an authority figure in a white lab coat, to dislike them or judge them to be a malinger. This is a natural tendency which the doctor and the insurance company take advantage of.
When you are told to go for an IME, go with a friend or family member who can take notes. Do not volunteer information to the doctor; rather, just answer the questions you are asked. Be honest about what hurts and any limitations that you have because of your illness or injury. If you can, videotape or audiotape the examination. Remember that the doctor wants to keep their client — the insurance company — happy. Their allegiance is not to you, even if they are a medical professional who has sworn to help people. If you have questions about an IME, please call our office today to learn how representation from a skilled Florida long-term disability insurance attorney can help protect you and your family.
Disability claims are most often denied for the following reasons:
Medical evidence that demonstrates the validity of your disability is a crucial part of your disability claim. The exact details can vary based on your condition, but you will need evidence that shows how your condition prevents you from being able to do the tasks and duties of your job.
The definition of disability is not always consistent, so you must know exactly how your insurer defines it. Your particular policy will include a list of conditions that meet the definition of disability. Your claim must meet the definition of disability listed in your policy to qualify for disability insurance benefits.
If you can work at all with your disability, your claim may be denied. This can be a problem when you are unable to work at the capacity you are used to, and the only available work after the onset of your disability pays much less. You could still have a case, but insurers often use this as an excuse for denial.
Depending on your policy, after the initial period of coverage in which you cannot do your job (“own occupation”) due to your disability, your policy may only continue to pay if your disability prevents you from doing any job (“any occupation”) you are capable of doing. If your insurance carrier denies your disability claim, you can file an appeal. Depending upon the type of policy you have, if that does not work, you can proceed with a private lawsuit. If it is a policy governed by ERISA, other requirements must be met prior to filing a lawsuit.
If you are able to do some work, with severe limitations, and if your long-term disability insurance policy has certain provisions, you may be able to file for partial disability benefits. An experienced long-term disability insurance law firm will be able to review your policy and consider if this applies to your unique situation.
While they are always on high alert for it, insurance providers tend to be a bit overzealous when it comes to throwing out accusations of fraud. To combat any accusations of fraud, gather all the proper evidence for your claim and hire a Florida disability claims attorney to handle all communications with the insurance company.
The deadlines regarding Florida disability claims tend to be quite strict, so you must file everything on time. If you miss a deadline, your case can be dismissed.
The appeal process for claim denials can be quite complicated, and the details will vary based on the reason you were denied in the first place.
If your initial appeal does not succeed, you may have to resort to taking the issue to federal court. A trial will take much longer, potentially lasting years, but the benefits are still well worth the effort in many cases. A disability insurance lawyer will be able to evaluate your situation and explain your legal options.
At the Law Office of Justin Frankel, we strive to give our clients the chance of a productive future despite whatever disability they may be living with. People with disabilities deserve the insurance benefits for which they pay, and we are happy to fight this battle for you so you can focus on improving your well-being. We will fight for you at every step of the process and offer you the same level of service we have offered to many others who have successfully challenged their insurance company. We will never pass your case to a junior lawyer — you will always work with Justin Frankel.
Here is what a few of our clients had to say in testimonials about our long-term disability attorneys.
“Justin and his team, including Christina, are outstanding. The insurance companies make it difficult for the disabled. However, they are no match for Justin and his experienced team. My case was extremely difficult, and I personally had lost hope, but Justin kept me positive. He stacked my case with medical evidence, scientific backup, and vocational expert support. I am very fortunate that I found his firm. Justin cares about the individual, and not only did he win my case but he negotiated a very beneficial deal on my behalf. He is an amazing, experienced attorney that will do everything possible to win your case. Don’t hesitate and make sure he is on your side!” — Gigi
When you work with our legal team, you get to work alongside our experienced partners who will take a personal interest in your case with committed legal representation for Florida residents. Take the first step toward claiming your or a loved one’s long-term disability benefits with a free consultation and case evaluation by contacting our disability law firm via our online contact form or by calling our phone number at 888-583-4959.