Don't Stop at a Denial:
Get the Long-Term Disability Benefits You Deserve
When a serious illness or injury leaves you unable to work, the long-term disability (“LTD”) coverage you earned through your job is designed to support you. Far too often, insurance companies delay, dispute, and deny long term disability claims—and hardworking Floridians are forced to navigate a lengthy appeals process. These tactics to delay and dispute often start from the very first filing of your claim, which is why it is important to bring in an experienced LTD attorney as early as possible–even before you file your initial application for benefits.
If you are struggling to work or keep a full-time job because of a long-term physical or mental health condition, and you have long-term disability (LTD) coverage, you should apply for disability benefits. LTD insurance is designed to supplement your income if you become unable to work. Many policies provide short-term disability benefits (for an initial period of time) followed by LTD benefits. Generally, LTD coverage will pay around 60% of your income should you become disabled long-term and can no longer perform your job or a similar job. Be aware, however, that your claim will likely be initially denied. The good news is that is usually not the final answer. You purchased LTD insurance for one reason: to provide you with financial assistance if you became disabled long-term and were unable to work. If your claim for LTD benefits has now been denied because your LTD insurance company is claiming you are not disabled, disputing your inability to work, or just treating you unfairly, you have rights. Here is what you need to know about your LTD benefits and why you need a disability attorney fighting for your rights.
TWWHB: Experienced Long Term Disability Lawyers serving Florida
Taylor, Warren, Weidner, Hancock & Barnes represents policyholders across Pensacola, Escambia and Santa Rosa Counties, and the Gulf Coast who have been wrongfully cut off from the long term disability benefits to which they were entitled. If you are unable to work because of a medical condition, and have had your disability insurance claim denied, TWWHB is here to help.
Our talented team has spent decades protecting long term disability benefits on behalf of Gulf Coast families. From our office on West Main Street in Pensacola, we serve clients throughout Escambia and Santa Rosa Counties and along the I-10 and U.S. 98 corridors. Our attorneys have earned recognition, including the National Trial Lawyers Top 100 and membership in the Multi-Million Dollar Advocates Forum.
Speak with a Florida Long Term Disability Lawyer
What you need to know:
You don't know the rules and they can be used against you. A LTD insurance policy is meant to provide you with a portion of your income when you are no longer able to work due to a long-term injury or illness. But your LTD insurance company is in the business of making a profit and they have incentive to try to pay you less than you are entitled on your claim for LTD benefits. Your insurance company may try to deny your claim based on loopholes in your policy that you were never even aware of. They may try to gather evidence from you in the form of statements, records, even medical examinations that can be used to downplay your injuries or your claimed inability to work and deny your claim. There are also often many types of insurance involved in a long-term disability situation Social Security Disability, Supplemental Security Income, health insurance, life insurance, etc.—which all have to be coordinated together, some even subrogated (offset) against one another, and your LTD insurance company may take advantage of your lack of knowledge of the policy, the law, and the rules at play to try to pay less on your LTD claim.
You don't know the value of your LTD benefits claim.The value of your claim for long-term disability benefits is often governed by many factors, including settlements from previous cases and federal law. Unless you are familiar with these different factors and the applicable law, it is very difficult to assess what you should expect from your LTD claim. If you do not know the law and how to properly calculate the LTD benefits that you are entitled to under your policy, you may unknowingly accept less benefits than you deserve.
You don't need any more stress. Coping with the stress that comes along with an accident or illness that causes you to become disabled long-term and unable to work the way that you did before is emotionally and mentally draining. Adding onto that the stress of dealing with an insurance company that is trained, equipped and motivated to exhaust you during the claims investigation process will only increase your frustration and focus your energies away from adapting to your new way of life in the best, most healthy way possible. At Taylor, Warren, Weidner, Hancock & Barnes, we are experienced and skilled at battling the insurance company to get the benefits you deserve. Let us take the burden of fighting your LTD insurance company off your hands so you can focus on coping and moving forward.
Why You Should Contact a LTD Attorney BEFORE a Denial
Most people filing a long-term disability claim believe their claim–or their appeal if their initial claim was denied–will be given the proper consideration it deserves and will not be denied because it is legitimate.
However, this is what most people do not know or understand:
Many legitimate claims are initially denied, and it can often make it harder for an attorney to assist after a denial.
This is what we would like most people to know and understand:
Bringing an experienced LTD attorney in before you initially file your claim has no downside and will vastly improve your chances of getting paid what you deserve.
You may be wondering why this is. It's because LTD insurance companies often hire doctors, adjusters, and attorneys whose job it is to find every excuse to pay you less. If you do not know the game or how it is played, you are at a severe disadvantage.
But you don't have to go it alone. Our long-term disability attorneys build the other side of the record. We gather medical documentation, legal evidence, and vocational proof to show how your medical conditions prevent you from working. We then apply the language of your policy to the letter of the law, giving your insurer no option but to pay the full value of your claim.
We handle disability insurance claims, including Employee Retirement Income Security Act (ERISA) claims, from the first application through every stage of the appeals process. When necessary, we will take your case to federal court. Whether your claim is still pending or you're staring at your third denial letter, we're here to help. The sooner you speak with one of our experienced disability insurance attorneys, the stronger your position will be. Call us at (850) 438-4899 to begin the process.
How Long Term Disability Claims Get Denied - AND WHEN (at the outset of the claim)
Long term disability claims rarely fail because a person isn't truly disabled. They fail because of how the claim was built and presented. We regularly see insurers argue that your medical documentation doesn't “objectively” prove you are unable to work, relying on their own paid doctors instead of the medical professionals who actually treat you. They may even use surveillance and your social media posts to challenge your claim. These tactics often begin upon your filing of the initial application, putting you at a great disadvantage right out of the gate.
Through the complications, false claims and paperwork, it can be easy to let your claim-filing deadline run out. The system is designed to make the filing process feel complicated and overwhelming so policyholders give up or don't fight for the full amount to which they are entitled. This situation is not your fault—but it is your responsibility to protect your claim before it is too late. Call TWWHB as soon as possible–even before you file your initial application if that is the stage you are at–to protect your claim.
Read More from TWWHB: Three Long-Term Disability Claim Mistakes Physicians Should Avoid
ERISA: The Federal Law That Changes Everything
If your policy came through your employer
The Employee Retirement Income Security Act of 1974, better known as ERISA, is a comprehensive federal statute enacted to govern employee benefit plans, including the group disability coverage most workers receive through employment. While the Retirement Income Security Act was designed to protect employees, its procedural rules are unforgiving; a single misstep in the claim process can easily invalidate a claim.
If your long-term disability policy came through your employer, your claim is almost certainly governed by ERISA. This is a critical component of any LTD case; ERISA is a complex federal law that rewrites the ordinary rules of disability law, and often tilts them in the insurer's favor. If you don't know the rules, they can be used against you.
Here is what you need to know about how ERISA will affect your LTD claim:
You usually must appeal to the insurer before you can sue.
Under ERISA, a denial must be appealed directly to the insurance company before any lawsuit is filed. Skipping this step means you may forfeit your right to refile.
Time may be running out to file a claim.
The deadline to appeal an ERISA denial can be as little as 180 days from your denial letter.
The administrative record is often frozen.
In most ERISA cases, the court reviews only the evidence already in the insurer's file: the same paper trail assembled to downplay your medical conditions. What you submit during the appeals process may be your only chance to put your medical evidence in front of a judge.
The remedies are limited.
ERISA moves cases into federal court, eliminates jury trials, and strips away the extra damages available in ordinary contract disputes. This is why having a long term disability attorney is critical.
Put simply: ERISA is complicated by design. Expect the appeals process to be long, costly, and skewed in the insurer's favor. Having a law firm that knows how to handle the ERISA framework can mean the difference between a wrongful denial and a lifetime enjoying the financial benefits you deserve.
Meet TWWHB: Florida's Long Term Disability Lawyers
The talented legal team at TWWHB has decades of experience representing Floridians seeking long term disability benefits. We handle long-term disability and ERISA matters on a contingency basis, and we never charge a fee or cost for an initial consultation to explain your rights. We believe that every person is entitled to full, fair compensation under Florida law, and in accordance with their employment contract.
We start by establishing the medical evidence that connects your medical conditions to the specific job duties you can no longer perform. We coordinate with your treating physicians, retain vocational specialists, and make sure every requirement of the ERISA claim process is met on time and in full. If the insurer has already sent a denial letter, we respond with a comprehensive administrative appeal.
If your long term disability benefits have been denied, reduced, or delayed, don't wait for the deadline to pass before filing your claim. Contact Taylor, Warren, Weidner, Hancock & Barnes to speak with a long-term disability attorney who understands both the law and what you're going through. Your initial consultation is always free.
Frequently Asked Questions About Long-Term Disability Claims
Do I need a long term disability attorney?
You are not required to hire an attorney, but filing without an experienced LTD attorney will put you at a disadvantage, especially if your policy came through your employer and is governed by ERISA. The insurance company has doctors, claims specialists, and lawyers whose job is to find reasons to pay you less. A long-term disability attorney levels that playing field, making sure your file contains the medical evidence and vocational proof needed to win and that every deadline is met.
At Taylor, Warren, Weidner, Hancock & Barnes, we never charge a fee or cost for an initial consultation, so there's no risk in simply learning where you stand. Call (850) 438-4899 to speak with an attorney and learn more about how we can help.
What is ERISA, and why does it matter with regard to filing a long term disability claim?
ERISA is a federal law, enacted in 1974, that rewrites the ordinary rules of a disability claim. Under ERISA, you generally must appeal a denial to the insurance company before you can file suit, the deadline to appeal can be as short as 180 days. A court will often review only the evidence already in the insurer's file; your appeal may be your only chance to put your case in front of a judge. These policies can make it more difficult to file a successful long term disability claim.
The insurance company sent me a denial letter. Is my claim over?
Not necessarily. An insurance claim denial is not the end of the road, but it is the start of the appeals process. Your denial letter tells us exactly what gaps to fill; the long term disability attorneys at TWWHB will use your denial as a roadmap to build a comprehensive administrative appeal. We may add medical documentation, treating-physician support, and/or expert opinions the insurer overlooked or ignored. We encourage you to act quickly to protect the actionability of your claim.
If your claim was initially denied, hire an attorney before filing your appeal. If you did receive a denial of your initial claim, we highly recommend you hire an experienced LTD attorney to assist you in preparing the appeal. This is a crucial phase in the claims process, and you will benefit from experienced guidance before filing your appeal.
How long do I have to appeal a denial?
Depending on your policy and plan, the window can be as little as 180 days from your denial date. That may sound like a lot of time, but building a strong appeal requires gathering updated records, obtaining supportive letters from your doctors, and sometimes arranging expert evaluations: a process that can take weeks, if not months. Missing the deadline can end your claim entirely, with no ability to refile. If you've been denied, the safest step is to contact a long-term disability attorney as soon as possible.
My doctor says I'm disabled but my insurer says I'm not. What now?
In these cases, we recommend hiring an attorney to make the best possible case in your favor. We work with your treating providers to translate your medical conditions into clear, objective terms that connect your symptoms and limitations to the specific job duties you can no longer perform. The stronger and more specific that medical evidence, the harder it is for the insurer to brush aside. Call us to explore your legal options.
I appealed my disability claim. Will my insurance company surveil me?
Often, yes. Insurers are allowed to use surveillance, review your social media, and request “independent” medical examinations in the hope of finding something that appears inconsistent with your claim. This isn't a reason to panic, but it is a reason to be careful and honest. Live within your restrictions, be consistent in what you report to your doctors and the insurer, and let your attorney handle communications with the carrier.
What kinds of conditions qualify for long-term disability benefits?
Your insurance policy's definition of disability will vary based on your coverage. What matters is whether your condition prevents you from working under the definition of disability in your specific policy. Some pay if you can't perform your “own occupation,” while others use a stricter “any occupation” standard. We handle claims involving a wide range of both physical and mental health conditions.
How much does it cost to hire your firm?
TWWHB handles long-term disability and ERISA claims on a contingency basis, and your initial consultation is always free. There is no fee, no cost, and no obligation to sit down with us and review your situation. Our goal is to make experienced representation accessible to the Gulf Coast families who need it most. Call us at (850) 438-4899 to learn how we can help.
Why should I choose Taylor, Warren, Weidner, Hancock & Barnes?
We're a trusted Florida law firm that has spent decades standing up to insurance companies on behalf of policyholders. We serve clients throughout Escambia and Santa Rosa Counties and across the Gulf Coast. Our attorneys have earned recognition including the National Trial Lawyers Top 100 and membership in the Multi-Million Dollar Advocates Forum. When you hire us, your problem becomes our problem — and we'll fight to recover the long-term disability benefits you earned.
Have a question we didn't answer? Call (850) 438-4899 or contact us online for a free consultation. You may also wish to visit our FAQ page on Long-Term Disability Insurance Claims.
Helpful Links and Resources
Helpful article from the Florida Department of Health on disability determinations.
Learn about Florida's insurance regulations and requirements governing long-term care insurance.
Helpful article from the University of Florida's Human Resources department “Demystifying Disability Insurance.”
Read Florida law on long-term care insurance policies.
Florida Department of Management Services' guide to State Group Disability Income.
The National Association of Insurance Commissioners' guide to Navigating Long-Term Care Insurance.
Read about the Federal Long-Term Care Insurance Program.
The disability attorneys at Taylor, Warren, Weidner, Hancock & Barnes, P.A. know the complicated ins and outs of disability law and know how to handle your LTD claim to make sure you get all of the disability benefits you are entitled to. Don't let your lack of knowledge of the law and the pitfalls hinder your ability to collect everything you are entitled to. If you have questions about your rights regarding an LTD claim, give us a call at (850) 438-4899. We will never charge you any fee or cost to inform you of your legal rights.
We offer free confidential consultations to analyze your unique conditions and circumstances. Do not give up.
