Tampa ERISA disability benefits include most private-sector employer-provided benefits for a short- or long-term disability. Since the Employee Retirement Income Security Act (ERISA) is a federal law, it often preempts state laws, which means that federal courts typically handle disputes without a jury trial.
If the plan administrator has denied your application for ERISA disability benefits or has unfairly terminated your payments, the Feldman Legal Group could help. Our experienced ERISA disability claims attorneys could assist with the complex paperwork and medical documentation necessary for a successful first-time claim and manage the critical period for filing an appeal after a denial.
What Do ERISA Disability Benefits Cover?
ERISA disability benefits can replace a portion of your regular income if you become unable to work due to a medical condition or injury. These employer-sponsored plans typically cover two main categories of benefits. The first covers short-term disability (STD) and provides temporary income replacement, typically covering anything from 40% to 70% of your salary. These benefits usually last between three and six months and begin after a brief elimination period of a few days to two weeks.
The second category covers long-term disability (LTD) and offers extended protection for serious or permanent conditions. It generally replaces 50% to 70% of your pre-disability income. Payments can last for several years or until you reach Social Security retirement age.
Since ERISA disability benefits in Tampa act as a wage replacement, the money is generally yours to use for essential expenses, including:
- Food
- Utilities
- transportation
- Rent or mortgage
- Wellness services
- Prescription drugs
- Out-of-pocket medical bills
Some LTD policies specifically include features for vocational rehabilitation or training to help you return to work. For the first two years, many plans require you to prove you cannot perform your job. After this period, they may require proof that you cannot perform any job in the national economy.
Additional Damages
ERISA claims also only allow for the recovery of actual benefits due under the plan, and you cannot seek additional damages for emotional distress or non-economic losses. Many LTD plans reduce your monthly payment if you receive other income, such as Social Security Disability Insurance, workers’ compensation, or other private insurance.
What Issues May Arise When Claiming ERISA Disability Benefits?
Claiming ERISA disability benefits in Tampa involves navigating complex federal regulations that often favor insurance companies over claimants. Several common issues frequently arise during the application and appeal process, which is why it is crucial to consult a legal advocate to help deal with any problems in your case.
Missing Deadlines
ERISA imposes rigid timelines for filing claims and appeals. Following the denial of your claim, you typically have only 180 days to file an administrative appeal. Missing even a single deadline can result in an automatic loss of your benefit rights. Courts generally only review the administrative record—the evidence submitted during the initial claim and appeal phase. This means that you cannot introduce new medical evidence if your case reaches the federal court. Many plans give the administrator discretionary authority, meaning a judge can only overturn a denial if it was arbitrary and capricious rather than just a simple disagreement.
Common Reasons for ERISA Disability Denials
A primary cause for denial is a lack of objective, comprehensive medical documentation. Insurers often disregard self-reported symptoms such as chronic pain or fatigue that lack supporting clinical findings. Many policies only cover your inability to perform your specific job for the first 24 months. After this period, the insurer may argue you are capable of working in another occupation as a means of avoiding a further payout, even if that job pays significantly less.
Insurance companies may hire private investigators or monitor your social media to find evidence of physical activities that contradict your claimed limitations. They may withhold benefits if you fail to follow your doctor’s prescribed treatment plan or miss regular medical appointments.
Contact an ERISA Disability Benefits Lawyer in Tampa For Help Today
Our legal team at Feldman Legal Group provides dedicated services to individuals facing challenges obtaining Tampa ERISA disability benefits. We provide aggressive advocacy to counter insurance companies, assist in collecting essential medical records, attend independent medical examinations, and build a compelling administrative record.
If administrative appeals are unsuccessful, our attorneys can file lawsuits in federal court to demand payment of benefits owed. We can provide a complimentary assessment of your insurance denial letter and claim file to determine the strength of your case. Contact Feldman Legal Group today to schedule your case consultation.
(877) 946-8293