ERISA and the 18 Mistakes That a Workers’ Compensation Claims Lawyer Can Make

Social Security Administration Recognizes a Need to Get Your Medical Records to Make a Timely Decision on Your Claim for Social Security Disability Benefits

When you apply for Social Security Disability benefits the Social Security Administration will obtain a copy of your medical records from your physician. The longer it takes to get those medical records, the longer it will take for the Social Security Administration to make a decision on your Social Security claim.

Social Security Commissioner Michael Astrue has reached an agreement with EHR Doctors to deliver electronic health records to the Social Security Administration so that they can quickly review Social Security Disability claims. Commissioner Astrue was quoted as saying that this technology “will improve our disability programs and provide better service to the public.  The use of Health IT will dramatically improve the speed, accuracy and efficiency of this process, reducing the cost of making a disability decision for both the medical community and the American Tax Payer.”

We, at Cavey and Barrett are glad the Social Security Administration has entered into a contract with the ERH Doctors and we hope that this critical technology will speed up the delivery of medical records to the Social Security Administration so that they can make a timely decision on Social Security Disability claims.

Inside Six Secrets to Getting the Right Long Term Disability Policy

Nancy Cavey, an ERISA long term disability attorney based in the Tampa Bay area has written the go to guide entitled Robbed of Your Peace of Mind, which helps explain some examples of getting the right long term disability policy.

While there are many policy terms you do not want to see in a long term disability policy there are six features that make for a great long term disability policy:

1. A policy that pays disability benefits if you are unable to do your specific job.

Many long term disability policies pay benefits based on a persons occupation not based on their job as it is performed with their specific employer. If, for example, you are a physician, you want a policy that protects you if you are unable to perform your sub- specialty, so your sub-specialty is protected. If, for example, you are a interventional cardiologist, you want to buy a policy that defines disability as being unable to perform your duties as an interventional cardiologist.

2. If you have to accept a long term disability policy that defines disability based on your occupation, pick the one that provides that benefits will be paid if you are unable to do any of your essential job duties.

If, for example, you are a surgeon and you can’t perform surgery than that is obviously an essential function of your job.

3. Have a waiting period that is financially right for you.

You should consider buying both a short term and long term disability policy plan. Short term disability insurance will cover you generally for a period of three to six months before your long term disability benefits start. If you have the financial resources to withstand three to six months of unemployment as a result of your disability, then you can go for a longer waiting period.

4. The longest possible benefit you can get.

Unfortunately, Nancy Cavey, St. Petersburg long term disability attorney, has seen long term disability policies pay benefits up to as short as two years. Remember, you are insuring your livelihood and as a result, you should have the longest possible benefit period in your long term disability policy- at least to age 65.

5. A waiver for Social Security offset.

Many long term disability policies will reduce your monthly disability income by the receipt of Social Security benefits. You don’t want to have your benefits reduced by the receipt of Social Security or even that of the Social Security benefits your children might receive on your behalf.

6. Buying a monthly benefit that meets your financial needs.

Most long term disability policies pay at least fifty to sixty percent of what you were making before you become disabled. Pass on any disability insurance policies that offer less. You might be able to get a total benefits of 60% or more, but you will have to buy more than one long term disability policy. Depending on your income, that may be just the thing that you need to do.

The most valuable asset you have is your ability to earn money and provide for you and your family. Disability insurance company insures that income and you want to make sure that you have the right long term disability  policy for you and your family.

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• WHAT NOT TO DO IF GETTING LONG TERM DISABILITY

Learn How Easily Carriers Like UNUM Have Denied Mental Illness Claims

UNUM has been the subject of a national lawsuit as a result of it’s claims handling which is ultimately settled. But unfortunately, UNUM continues to engage in questionable claims handling process.

Many UNUM policies have a provision that provides that the long term disability claims can be terminated under a mental nervous limitation. Most mental nervous limitations provide that benefits will be paid for two years at which time the benefits will be stopped.

While we understand that policy limitation, what happens if the UNUM policy holder has a herniated disc which causes depression or anxiety. Obviously it’s the physical condition that is causing these difficulties. UNUM has been using the mental nervous limitation to deny the payment of long term disability benefits after the conclusion of the two year mental limitation period. UNUM disability claims denied attorney Nancy Cavey, deplores UNUM use of the mental nervous limitation to deny the payment of disability benefits where UNUM policy holders have physical conditions like herniated discs causing depression or other psychological problems.

Nancy Cavey offers a free, consultation for any UNUM policyholder to learn more about their rights to disability benefits in the event of a mental illness claim. Be sure to consult with a lawyer that can help you with your UNUM Mental Illness claim today, call 727-894-3188.

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Shocking Attack on Social Security Disability Benefits by the Former Director of the Office of OMD

In a shocking editorial by Peter Orzak, the former White House director of OMD, Orzak has created the image of the “disability claimant” arguing that there are people who qualify for SSI that have, until now, avoided applying because they were able to find work. Now that they have lost their jobs or cannot find work, people who have qualified for SSI are now taking legal advantage of their rights to get SSI.

Orzak thinks that once you apply for Social Security Disability benefits you have “lost all the desire to work and just hang around in wheel chairs instead of being a productive citizen”.

Don’t let the people like Orzak get away with this sniveling dribble and use this as an excuse to cut the Social Security Disability’s safety net. If you are disabled and unable to work, you are legally entitled to Social Security benefits. After all, you have contributed to the Social Security Disability system, including deductions taken from your paycheck. You are legally entitled to Social Security Disability benefits and don’t let Peter Orzak discourage you from getting the Social Security Disability benefits you are entitled to.

How the 11th Circuit Court of Appeals Addresses Long Term Disability Carriers Right to Recover Social Security Offsets

The long term disability carriers right to recover for Social Security over payments is a complicated one.

In Popski vs. Parrott (Florida 61 f 3d 1367, 1369 (11^th Cir. 2006)), the 11^th Circuit which has jurisdiction over cases in Florida, Alabama and Georgia, compared two plans that had the language for reimbursement under ERISA section 503(a)(3). Interestingly enough, of the first plan payment, “any amount recovered by Covered Person whether or not designated as payment for medical expenses” and “clarify that the covered person had to repay the claim to benefits paid on their behalf while recovering from a third party or an insurer”(1373).

The 11^th Circuit found that this plain language allowed the plan to recover because the plan language addresses the findings in which recovery can be made (recovery from the third party or the insurer) and the portion due to the plan (benefits paid on behalf of the defendant). This plan sought to restore to the plan the funds in the plan holder’s possession.

The second plan didn’t have language that allowed for recovery because it didn’t even allow for the assertion of what’s called an equitable lien. The segregation of reimbursement provision allowed the plan the right to reimbursement “in full and in first priority” but didn’t specify the reimbursement having to be made out of any particular fund.

The court found that this was over broad because it failed to limit the recovery from the specific portion of the particular fund.

What does this all mean? What is means for the most part is that a long term disability carrier who overpays long term disability benefits when the policyholder gets a retroactive lump sum payment of Social Security benefits isn’t entitled to reimbursement of those funds. By law, the long term disability carrier isn’t allowed to “attach” your Social Security Disability benefits. The courts have found that it is not the Social Security benefits that need to be refunded, it’s the overpayment of the long term disability benefits which occurred when you got your lump sum overpayment. Regardless of what you call it, the reality is that if you have received a lump sum from the Social Security Disability Administration for retroactive payment, you have an overpayment of your long term disability benefits.

You, by contract, owe the long term disability carrier over payment as a result of the receipt of your Social Security benefits and, further, the long term disability carrier has the legal right to reduce your long term disability benefits by the receipt of Social Security Disability benefits even if you spent it, you are still going to be liable!

For example, in Herman vs. Metropolitan Life Insurance Company (2008 WL 5246319 (Middle District of Florida) December 16, 2008), the court found that Social Security funds were protected from execution level, attachment garnishment or other legal process. However, MetLife was still entitled to claim overpayment because it was seeking the amount of overpaid Ms. Herman in long term disability benefits rather than the Social Security funds.

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Can long term disability Carriers sue me for a refund of my long term disability benefits?

Can long term disability Carriers sue me for a refund of my long term disability benefits?

Unfortunately, one of the techniques that long term disability carriers seem to be using these days is to terminate long term disability benefits and then attempt to sue policy holders asking for a refund of benefits. Saying that they were “defrauded” This is just one of the many games that long term disability carriers will play to rob you of your peace of mind.

If the long term disability carrier is seeking a refund of all the long term disability benefits paid, contact long term disability attorney Nancy Cavey.

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Why You Should Have an Attorney if the Administrative Law Judge is going to Call a Vocational Expert

Why? The vocational experts testimony about your ability to do the lightest job you’ve held in the fifteen years, your transferable skills, and whether or not a job exists in the mythical national economy that you might be

Administrative Judge

capable of performing given your age, education, transferable skills is not for the faint of heart. You need to be able to identify quickly the elements of your illness and symptoms including pain and side effects of medication that might impact on your ability to work. Unfortunately, most Social Security Disability applicants are ill and really can’t focus their time or energy to properly preparing for a Social Security Disability hearing.

Even more complexes involve such things like a version of your occupation base, transferable skills and the residual functional capacity impact on your ability to work. Reddington Beach Social Security Disability attorney Sharon Barrett knows how to interact with the vocational evaluator and the Administrative Law Judge to develop the vocational aspects of your case so you are awarded to the Social Security Disability benefits that you are entitled to as a result of your disability. If you are facing these circumstances, give us a call today to discuss your claim.

One of the Reasons a Long Term Disability Carrier Can Deny Your Benefits Based on Your Facebook Account

Long term disability carriers will do anything they can to find a reason to deny your long term disability benefits.

They will often have you fill out an activity of daily living form, asking you what you can and cannot do on a daily basis. The long term disability carrier will then check social networking sites to see if there is any inconsistencies between what you put on your activity of daily living form and what your postings shows.

Anything that you’ve posted is going to end up in the hands of a long term disability carrier. Don’t destroy your long term disability claim with your Facebook and MySpace entries.

Nancy Cavey, long term disability denied attorney has written the book about the tricks the long term disability carriers use in having you complete activity of daily living forms and use surveillance entitled The Long Term Disability Guide for Your Statement and Field Visit. For you complementary copy click on the book image to the right of this page.

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What’s a Concurrent Social Security Disability Application?

What’s a Concurrent Social Security Disability Application?

Many times the Social Security Administration will take a Social Security Disability and SSI application. This is known as a “concurrent application”. It happens when a Social Security Disability applicant is covered and insured under Social Security Disability benefits but their projected Social Security Disability benefit amount is less that what you would get for SSI.

A concurrent application is taken to make sure that you receive a certain minimum monthly benefit. If you have any questions about your concurrent Social Security Disability application, give us a call today to discuss your claim.

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• CONCURRENT DISABILITY CLAIMS