ERISA Appeal Attorney in Fort Lauderdale

Group Disability Claim Denied? Your Appeal Starts Here.

When a group disability claim is denied, most employees don’t realize they’re standing at the most consequential moment in the entire process. At Martin J. Sperry, P.A., we handle ERISA appeals for employees throughout Fort Lauderdale and South Florida whose group disability benefits have been wrongfully denied. With more than 45 years of experience in disability insurance law and millions of dollars recovered for clients, we know what a strong appeal requires, and we build it from the first day of your case.

Most private employer-sponsored disability policies are governed by the Employee Retirement Income Security Act of 1974 (ERISA), a federal law that gives you the right to appeal a denial before pursuing a lawsuit. That appeal isn’t optional procedure. It’s a legal requirement, and it’s the last chance to build the evidence record your case will rest on. We don’t handle Social Security Disability claims. Our practice centers on disability insurance and ERISA, which means every case benefits from focused attention in this specific area of law.

If you’ve received a denial, contact Martin J. Sperry, P.A. today at (954) 324-2340 for a free consultation by phone, in person, or via Zoom. There’s no fee unless we recover benefits for you.

The ERISA Appeals Process After a Denial

After your claim is denied, the insurer is generally required to send a written denial letter identifying the specific reasons for the denial, the policy terms it relied on, and instructions for filing an appeal. Read that letter carefully. Under federal regulations, you generally have 180 days from the date you receive it to file a written administrative appeal with the insurance company. Missing that deadline can permanently forfeit both your right to appeal and your ability to file a lawsuit.

During the appeal window, you have the right to request your complete claim file from the insurer at no charge. That file reveals what evidence the insurer used and, critically, what it ignored. You may then submit additional medical records, treating physician statements, physician evaluations, and functional capacity assessments to strengthen the record. Once the appeal is submitted, the insurer generally has 45 days to issue a decision, with one possible 45-day extension for special circumstances, and the reviewer must be someone not involved in the original denial.

The Stakes of Getting the Appeal Right

If the administrative appeal is denied, the path leads to federal district court. At that stage, the federal judge typically reviews only the administrative record compiled during the claim and appeal. No new medical records, reports, or testimony can generally be introduced. The quality of the appeal you file today is the foundation of any federal case tomorrow. An incomplete or disorganized appeal doesn’t just hurt the appeal; it can permanently limit what you can argue in court.

A phone call or informal communication doesn’t constitute a valid ERISA appeal. The submission must be written, follow the plan’s stated procedures, and arrive within the deadline. Some plan documents also impose deadlines shorter than the 180-day federal default for certain claim types, making it essential to review plan documents immediately after a denial.

Don’t let the 180-day deadline slip. Call Martin J. Sperry, P.A. at (954) 324-2340 to review your denial letter and discuss your appeal options at no cost and no obligation.