The Long-term Disability Carrier is trying to talk with my treating physician behind my back. What should I do?

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Unfortunately, it’s not uncommon for the long-term disability insurance company to use the medical release which you signed to communicate directly with your treating physicians without notice to you. They will also tell your treating physician their version of your medical condition and your policy terms in an attempt to get the physician to release you to some form of employment.

In the case of Safon v. Wells Fargo & Company, Long-term Disability Plan, 522 F.3d 863 (9th Cir. 2008), The court noted that the ERISA regulations call for a “meaningful dialogue” between the claims administrator and the beneficiary. The court held that direct contact with a treating physician without informing the long-term disability claimant was a direct violation of the ERISA fiduciary duty to communicate.

The court noted that Met Life seemed to have “disregarded this responsibility in various ways – the opacity of its communications with Safon, the fact they communicated directly with her doctors without advising her of the communication, and the fact that it took various of her doctors’ statements out of context or otherwise distorted them in an apparent effort to support a denial of benefits.”

The Safon court imposed a rule that if a claims administrator communicates with a treating physician, it must disclose that fact “to the patient at a meaningful time.”

At Cavey & Barrett, we routinely advise long-term disability carriers that the medical releases that they have obtained from you are now void. And we also contact the treating physicians and advise them under no circumstances to speak with or communicate with your long-term disability carrier. For these very reasons, we want all communications with you and your treating physician to come through our office so that we can make sure that the information that is being provided to the long-term disability carrier support your claim and that it is accurate.

Nancy Cavey, an experienced long-term disability/ERISA attorney based in Pinelas and Hillsboro counties, Florida, helps you navigate the long-term disability maze.

Answering these broad-based questions isn’t easy. Help is a phone call away. You can contact Nancy Cavey, an experienced long-term disability attorney at 727-894-3188.

If You Don’t Understand Your Rights to Social Security Disability Benefits as a Result of Obesity, You Will Hate Yourself Later

Did you know that obesity is linked to many health problems such as diabetes, heart disease, hypertension, cardiovascular disease, stroke and cancer?

Did you know that one in five adults is obese and suffers from at least one chronic medical condition as a result of that added weight?

If you suffer from diabetes, heart disease, hypertension, cardiovascular disease, or cancer you may entitled to Social Security Disability benefits if your physician tells you that you are unable to work. We specialize in Social Security Disability claims and obesity, give us a call today at 727-894-3188.

Breast Cancer and Your Rights to Social Security Disability Benefits

We were all recently moved by Elizabeth Edwards posting before her untimely death that was a result of breast cancer.Social Security Disability Breast Cancer

If you have been recently diagnosed as having breast cancer, you may not be able to continue with your normal work activities. If your physician believes that you will be out of work for at least a year, you should immediately apply for Social Security Disability benefits.

Facing the diagnosis of breast cancer can be devastating and your attention is, rightfully, focused on getting the right treatment for you. However, it is important that you also apply for Social Security Disability benefits for breast cancer. One of the most important benefits of receiving Social Security Disability benefits is your entitlement to medical benefits.

Improved treatment can make the difference in the recovery from breast cancer.

Contact Social Security Disability breast cancer attorney Sharon Barrett for more information regarding your rights to Social Security Disability benefits and medical treatment under the auspices of Medicare and Medicaid. Call 727-894-3188 today.

USA Today Reports Yoga Improves Symptoms of Fibromyalgia

A study of women who suffer from fibromyalgia reveals that women who took a yoga class that met once a week for eight weeks reported that the two hour yoga class resulted in:

  • Decreased pain
  • Decreased fatigue
  • Decreased tenderness
  • Improved Anxiety
  • Better sleep
  • Beet mood

If you are a fibromyalgia sufferer you might consider enrolling in a yoga class.

Cavey and Barrett specialize in representing fibromyalgia sufferers in their Long Term Disability claim. Contact us today for more information about your fibromyalgia claim.

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8 Million Disabled United States Workers

Did you know that in 2010, there were more than 8 million disabled American workers. A 20 year old has a 30% chance of being disabled by retirement age.

What is Past Relevant Work in A Social Security Disability Claim?

Past relevant work and your Social Security Disability claim. Past relevant work is a term of art in the Social Security Disability world. What it means is that the work that you have done for the fifteen years prior to your application. If you can return to the lightest job you have held in the last fifteen years, your Social Security Disability claim will be denied! See how easily you can screw up your Social Security Disability application.

You can make many mistakes in the initial Social Security Disability application but one of the most crucial involves your responses to questions about your past work.

To be eligible for Social Security Disability benefits the Social Security Administration will look at the kind of work you have done in the fifteen years prior to your application. If you can return to the lightest job that you have help in the last fifteen years, the Social Security Administration will deny your claim on the basis that you can return to your “past relevant work”.

The Social Security Administration will also ask whether or not there is a job that exists in the national economy based on your age, education and work history. And the level of physical functioning you are capable of doing.

Many people just screw up their Social Security Disability application because they don’t understand the importance of past relevant work.

What do I mean?

The Social Security Disability application will ask you about the past relevant that you have done by asking you what your “title” was and your job duties.

Many people try to embellish and make their job sound more important than it really was.

So for example, if you were a garbage man to embellish the job you might say you were a “sanitation engineer”. While they may actually be the same jobs, the titles are different and the Social Security Administration will use a book called the Dictionary of Occupation Titles to look up the various job duties. Obviously, an “engineer” is one in which would have many skills that would be transferable to all sorts of different occupations. You’d be able to calculate things, organize things, do drawings. On the other hand, a garbage collector gets on and off his garbage truck, picks up garbage cans and disposes the garbage and returns them to the street. There is a world of difference between those two jobs.

So, one of the first and foremost mistakes you can make is embellishing your job title. That can come back and bite you because the Social Security Administration will find if you have been an engineer, that you have transferable skills and that alone is grounds to deny your claim for Social Security Disability benefits.

At Cavey and Barrett, your Tampa Social Security Disability attorneys, we urge you to be honest. Honest with what your job title was and your job duties. Accurately describe your job duties, your supervisor responsibilities, if any, and the physical requirements of your job.

Don’t make yourself out to be superman. An inaccurate description of your past relevant work will be kryptonite to your Social Security Disability claim.

Best Social Security Disability Advocates in The Tampa Bay Area

There are many disability advocates and representative throughout the United States, but some have labeled themselves “Best Social Security Disability advocates” like Binder and Binder. Did you know however, that many Social Security Disability attorneys are not legally allowed to make that post because Bar Associations prevent them from describing themselves as “the best” or “aggressive” or even give statistics about their winning numbers. Companies like Binder and Binder, are Social Security Disability representatives, they are not attorneys! They are allowed to say whatever they want to say about their skills and abilities and aren’t subject to regulation like Social Security Disability attorneys.

Don’t be fooled by advertisements.

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If You Do Not Understand What is Going to Happen During Your Social Security Disability Medical Exam, You’ll Hate Yourself Later When Your Social Security Disability Claim is Denied

The Social Security Administration may ask you to go for what is called a “consultative exam” to determine whether or not your medical condition effects your ability to work.

If you don’t understand what is going to happen during the Social Security Disability medical exam, you may make crucial mistakes.

Here are five tips on what you should expect at your Social Security Disability medical exam:

1. The physician who performs the Social Security Disability medical exam is paid by the Social Security Administration. That physician is supposed to be an independent physician, but unfortunately, it is not uncommon to see the same physician being referred to cases over and over. One has to wonder how “independent” they are.

2. Regardless, you must be respectful of the Social Security Disability examiner as they can destroy your claim if you are rude or abusive.

3. The purpose of the medical exam is to help gather evidence for your Social Security Disability claim because the claims examiner doesn’t think that there is enough medical evidence to determine whether you are entitled to Social Security Disability benefits. As a result, what happens at the examine will depend on the nature of the medical problem. You may have a physical examination, x-rays, or even blood work drawn.

4. The Social Security medical examiner is not going to be providing you with treatment but rather, is going to be performing an exam and doing any diagnostic studies that will help that position evaluate your physical restriction and limitations.

5. The Social Security Disability exam is going to be a rocket examination lasting maybe only fifteen to twenty minutes.

Social Security medical examiner is not going to determine whether or not you are entitled to benefits. Their job is to determine performance in physical examination, document the objective findings on examinations and render an opinion about your physical abilities.

Regardless, you must be respectful of the Social Security Disability examiner as they can destroy your claim if you are rude or abusive.

You should be very careful during the physical examination as if you tell the doctor you have difficulty bending and then pick your socks off the floor to put them on, you’ve just demonstrated that you have the ability to bend.

If you have been scheduled for a Social Security Disability consultative exam, you should consult with a Social Security Disability attorney such as Pinellas Park Social Security Disability attorney Sharon Barrett who can prepare you for this crucial examination.

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Do You Know What Clues the Social Security Administration Left in the Notice of Denial Letter you Have Just Received?

Your physician told you that you are unable to work and you applied for Social Security Disability benefits thinking that, in your heart of hearts, the Social Security Administration would know that you are unable to work and grant you your benefits. Just imagine how you feel standing at the mailbox with a “Notice of Decision Letter” denying your claim for Social Security Disability benefits. Did you know that there are clues in that decision letter that will tell you why your claim was denied?

Sharon Barrett, an experienced Social Security Disability attorney and former staff attorney in Tampa, knows what those clues are.

They can include particular language indicating that your medical condition is “not severe”, that you “don’t meet a listing”, that you can return to your “past relevant work”, or that there is work that exists in the national economy given your “age, education, transferable skills”. That may seem like gibberish to you but those are all clues about why your Social Security Disability benefits were denied.

If you have received such a letter, you have 60 days in which to appeal and you shouldn’t delay! Why? If you do not timely file your request for reconsideration after your initial application has been denied, you get to start all over and get back in line.

If you have received a “Notice of Decision” denial letter, you would be wise to immediately contact an experienced Social Security Disability attorney who can help explain to you the clues that the Social Security Administration has left in the Social Security denial letter.

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What Social Security Disability Claim’s Examiners Want to See in Social Security Disability File Before They Will Grant Your Claim

In a recent report commissioned by the Social Security Administration, documents that the Office of Disability Determinations, who reviews the initial and request for reconsideration of every Social Security Disability claim routinely denies claims at this stage. In fact, statistics show that almost 2/3rd of initial applications are denied.

Why does this happen? To answer that question, you first must understand the five step sequential evaluation that is used in every Social Security Disability case. The Social Security rules require that:Social Security Examiner Disability File

  • You have not engaged in substantial gainful activity;
  • You have a severe impairment;
  • You meet a medical listing;
  • That you cannot return to your past relevant work;
  • That you can’t engage in any work based on your age, education, or transferable skills.

The starting point for evaluating every Social Security Disability claim is your disability application. Why? That disability claims application has material information.

It includes a list of all your medical providers and one of the first things that the disability claims examiner will do is to write a letter to all your medical providers asking for a copy of your medical chart. If you haven’t listed all your medical providers, you are short changing yourself because, ultimately, the disability claims examiners will be reviewing your medical records and determining whether or not you have:

  • A severe impairment
  • Whether you meet a listing
  • And if not, determining whether you can return to your past relevant work or return to other work based on your age, education, work exertional level and your prior skill level.

This analysis requires that the disability claims examiner understand medical conditions, their diagnosis, restrictions and limitations and also to be a bit of a vocational rehabilitation counselor to determine whether you meet the criteria at step four and five.

The reality is that examiners simply aren’t trained to understand this documentation and, worse yet, if your doctors’ don’t fully explain what your restrictions and limitations are, the claims examiner is going to pass your case off to a medical consultant.

DDS also have medical consultants on their staff who review the medical records to try to determine what your physical abilities are, more often than not they will determine that you are capable of doing at least light work based on their review of your medical records and that will result in the denial of your claim.

It’s important that every Social Security Disability applicant obtain and review their medical records so that they have a full understanding of whether their physician supports the claim, whether there is documentation that would help the DDS examiner make the right decision.

If your initial claim has been denied, you need to file a request for reconsideration within 60 days. Having attorney representation at the request for reconsideration stage can make the difference between getting your Social Security Disability benefits or being denied yet a second time. That means if you are denied at the request for reconsideration stage you get to get in line once again- this time a line for a hearing in front of the Administrative Law Judge.

Developing the medical evidence in your claim at the initial and request for reconsideration stage is crucial to support your Social Security Disability claim.

The five step sequential evaluation is hard to understand and, even worse yet, it is hard for a Social Security Disability applicant to develop the necessary medical and vocational evidence to win their claim.

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We represent clients all over Florida including: Tampa, St. Petersburg, Sarasota, Bradenton, Venice, Ft. Myers, Naples, Orlando, Lakeland, Gainesville, Daytona, West Palm Beach, Ft. Lauderdale, Miami, Miami Beach, Jacksonville, Tallahassee, New Port Richey, Hudson, Safety Harbor, Largo, Palm Harbor, Port Richey, Clearwater, Indian Rocks Beach, Dunedin, Spring Hill, Brooksville, and all other cities in Florida.

If you or someone you know has been effected by a hour and wage claim, disability or social security claim in Florida, do not hesitate to Contact Us before you speak with an insurance company. There is no obligation to hire a lawyer and the consultation is FREE.

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