Cavey and Barrett Blog

Overpayment of Long Term Disability Benefits and that Call from the Carrier Asking for the Money Back

Overpayment of Long Term Disability Benefits and that Call from the Carrier Asking for the Money Back

Assembling a Paper Trail and Your Long Term Disability Carrier

Assembling a Paper Trail and Your Long Term Disability Carrier

Long Term Disability Insurance Check Up

Long term disability attorney Nancy Cavey suggests that you review your insurance policy.

Airplane Pilot Loses License Because of Restrictions and is Still Denied Long Term Disability

Airplane Pilot Loses License Because of Restrictions and is Still Denied Long Term Disability Benefits

Fatigue and Your Disability Claim

If you have MS we here at Cavey and Barrett know you're going to have trouble getting out of bed, much less working. We will work our hardest to make sure that you get the benefits you deserve.

Long Term Disability Benefits and Lyme Disease

Have you been diagnosed with lyme disease and had your claim for Long Term Disability benefits has been denied? Contact lyme disease Long Term Disability attorney Nancy Cavey, for a free, no obligation consultation at 727-894-3188.

Federal Judge Allows Deposition in Standard Insurance Company Claim’s Denial of Disabled Attorney

Long Term Disability attorney Nancy Cavey was successful in securing the reinstatement of Long Term Disability benefits wrongfully denied by Standard Insurance company in claims involving Piper Rudnick's Long Term Disability policies.

Fibromyalgia and Your Long Term Disability Claim

Do you suffer from Fibromyalgia and are you thinking about filing a claim for Long Term Disability benefits or has your claim for Long Term Disability benefits been denied? If so contact Long Term Disability attorney Nancy Cavey, who can assist you with your Fibromyalgia Long Term Disability claim by calling 727-894-3188.

What Every Long Term Disability Policy Holder Needs to Know About Social Security Disability

Most long term disability policy holders are surprised to learn that their long term disability policy requires they apply for Social Security Disability benefits and, if granted, allows the Long Term disability carrier to reduce your long term disability benefits by the receipt of Social Security benefits. Wow! That will reduce the amount of your long term disability benefits.

On the up-side, there are some benefits to receiving Social Security Disability benefits that most long term disability applicants aren’t aware of:

1.    Cost of living increases.
2.    Taxability of your benefits.
3.    Medicare coverage.

1. Cost of Living Increases:

Long Term disability policies generally don’t have a cost of living adjustment factor and, as a result, your long term disability benefit remains the same.

However, most years, the Social Security Administration grants cost of living adjustments to deal with the impact of inflation.

2. Taxability of Your Benefits:

Long term disability benefits may be taxable if you paid your long term disability insurance premium with pre-taxed dollars. Social Security benefits can be taxable.

3. Medicare Coverage:

When you are unable to work, your employer will offer you continuing health insurance benefits through COBRA. This is a very costly option. If you leave your company you are eligible to purchase eighteen months of health coverage. However, if you are receiving Social Security Disability benefits, you can purchase an additional eleven months of coverage.

At Cavey and Barrett we explain, in detail, that it takes almost two years for you to get Social Security Disability benefits. You don’t become Medicare eligible until you’ve been on those benefits for two years.

As you can see, it is important to maintain your health insurance coverage, not only for treatment, but to prove your entitlement to Long Term disability and Social Security. You may need those eighteen months of health coverage to win both cases.

Contact Nancy Cavey, who has experience with Social Security Disability and Long Term Disability cases and she will take the time to explain the interaction between both cases and how you can maximize your benefits. Call at 727-894-3188 for a free no obligation legal consultation.

Mental Nervous Disorders Used as To Deny Multiple Sclerosis to a Long Term Disability Claimant

In Dunn v. Reliance Standard, US District Court (C.D. Cal) Mr. Dunn was employed by UBS Railroad as a financial advisor and had a Long Term Disability policy through his employer, which was administered by Reliance.

Mr. Dunn was diagnosed with having multiple sclerosis and understandably, developed depression. He was referred to a psychiatrist for evaluation and treatment as his treating physician opined that his mental condition was caused by multiple sclerosis.

One physician also opined that Mr. Dunn was completely disabled by both the psychological and MS conditions.

Reliance in an effort to deny Mr. Dunn benefits had a independent medical evaluation by a Dr. Orfuss who knew that Mr. Dunn had a history of depression prior to the diagnosis of MS.

Without explanation to denote this preexisting history, Dr. Orfuss concluded that Mr. Dunn was temporarily and total disabled as a result of his psychiatric problems explaining his conclusions by applying Mr. Dunn’s case to other MS patients who continued to work: “to certify disability of Mr. Dunn is due to Multiple sclerosis at this time, serves as a great injustice of those thousands of patients with MS with far more grief and exacerbations and far more frequents symptoms than he manifests, that continue working all with the motivation to remain as productive as possible for as long as possible.”

Based on this opinion, Reliance denied the claim for Long Term Disability benefits based on MS and then in the appeal providing documentation from a treating physician reporting that Mr. Dunn was totally disabled as a result of a multiple sclerosis including his cognitive dysfunction and fatigue which are most related.

Reliance requested another review using a well-known insurance favored peer reviewed doctor, Dr. William Halpman who has been criticized in the past for  “obvious bias and favorable objecting a claimant for LTD benefits.”

As expected Dr. Halpman agreed with Dr. Orfuss and maintained his denial of Mr. Dunn’s claim.

Mr. Dunn then filed a lawsuit in district court and the federal court reviewed the mental nervous limitation in the policy which stated that the limitation applied to “periods of disability caused by or contributed to by mental and nervous disorders.”

The court found that the phrase “due to” was ambiguous and was susceptible of at least two meanings, one of which could mean the inability to work was solely the result of the depression. But the court however noted that the phrase could be “read more broadly” and the limitation would not apply to neither physical and mental disorder as “the sole cause of the inability to work but rather it would apply a physical ailment and the mental disorder together to create the inability to work.”

The court concluded that the policy language was in conflict of the plan description of limitation and construed the ambiguity in favor of Mr. Dunn finding the 24 month limitation didn’t apply to inability to work unless his inability to work was “solely at trivial to the depression.”

The court also noted that despite other district courts criticism of Dr. Halpman’s use of Dr. Orfuss’ in regard to practices in respect of fighting analysis, the court noted that Reliance has used the services of Dr. Halpman 267 times in 2003 and 110 in 2004.

The court noted that: “Dr. Halpman appears to be a man with a mission- to find a way to justify denials.” And in this case, the Federal District Court found that Reliance continued, to back self-interest in deciding and determining (Long Term Disability benefits) by the use of Dr. Halpman.

If you are an MS sufferer who’s Long Term Disability plan has been denied or suspended based on a mental nervous limitation or the use of insurance doctors such as Dr. Halpman, you need the assistance of Nancy Cavey a Long Term Disability attorney who practices in nationwide and assists MS sufferers with their claims for benefits.

What Should I Do I’ve Been Scheduled for an Independent Medical Evaluation for my Long Term Disability Claim?

Nancy Cavey, a Florida based Long Term Disability ERISA attorney suggests that you immediately consult with a Long Term Disability attorney. Why? There are a number of things that can be done to protect you. One of the things that can be done is to send a letter to the Long Term Disability carrier asking for:

Fibromyalgia and Your Long Term Disability Claim

Over 6 million Americans suffer from Fibromyalgia in the United States. Unfortunately, Long Term Disability carriers treat Fibromyalgia as a made up condition and routinely deny claims for Long Term Disability benefits for Fibromyalgia.

Important Fibromyalgia Information Online

If you are a Fibromyalgia sufferer who is applying for Long Term Disability benefits here are some important websites that you will help you with your Fibromyalgia:

Federal Judge Allows Deposition in Standard Insurance Company Claim’s Denial of Disabled Attorney

Congratulations to David Bryant and Megan Galor, disability attorney’s who represent J. Kevin Garvey in his Long Term Disability claim against his former employer Piper Rudnick and their Long Term Disability carrier Standard Insurance Company.

Vocational Mistakes Long Term Disability Carriers Use to Deny Your Long Term Disability Benefits/ Sarasota Long Term Disability Benefit Lawyer Nancy Cavey

Long Term Disability carriers will routinely use a vocational assessment to determine your residual functional capacity and the skills, interests, aptitudes you have so that they can determine whether you are capable of going back to your past work or other work available in the national economy.

Long Term Disability and the Receipt of Social Security Benefits

If you’ve purchased your Long Term Disability policy through your employer you will most likely find: Any Social Security Disability benefits received will be subtracted from your Long Term Disability benefits and that tou have you “repay” the Long Term Disability carrier any lump sum that you’ve received for past-due Social Security Disability benefits.

Tax Lawyer Denied Long Term Disability Benefits by Provident Life: An Accident Insurance Company, Provident Life Long Term Disability Benefits Denied Attorney Nancy Cavey

Patricia Galvan, who was a 54 year old tax attorney, was involved in two automobile accidents in 2000 and 2001 and was treated extensively for neck pain, thoracic outlet syndrome, herniated discs, radiculopathy and shoulder impingement syndrome. Ms. Galvan attempted to battle through her pain but by mid-January 2004 she could not work any further.

Disability Policies and the Term “Occupation”

Let me give you an example, pull out your disability policy and take a close look at it. Does it define “occupation”? Does the “occupation” refer to only the job you held at the time your disabled? Does it mean the “inability to engage in your occupation” at the time of your disabling condition? Or should it be interpreted to include any work requiring similar skills or producing a similar end point?

Activities of Daily Living Form

The Long Term Disability carrier has asked you to complete an Activities of Daily Living form in which you are asked to document what you are physically capable of doing. In that form, or even in a statement, you might tell the Long Term Disability insurance company that you “always use a cane” or that you always “limp.” If surveillance shows that you are walking without a cane or without a limp you are in trouble! While walking without a cane or a limp doesn’t mean you can work, it does destroy your credibility.

Long Term Disability Attorney Richard Johnson Discusses ERISA’s Effects On Clients

Long Term Disability Attorney Richard Johnson appeared on Nicole Sandlers talk show on Air America discussing the effects that ERISA has on our clients. Nancy Cavey, a Florida based ERISA Long Term Disability attorney who handles cases in Florida, Georgia and Alabama suggests that you listen to this talk.

Are Long Term Disability Policies Purchased Through My Medical Society Covered Under ERISA?

Nancy Cavey, ERISA Long Term Disability attorney who practices nation wide, knows that groups like dental hygienists or doctors are professional organizations who may offer disability policies to their members. Questions do arise about whether or not a disability policy offered through a professional association that offers a group discount are individual policies not subject to ERISA.

My Long Term Disability Claim was denied because I Can Be a Video Surveillance Monitor: What Does That Have to Do With My Claim?

Long Term Disability policies normally say that after the payment of two years of benefits, you must prove that you are unable to do the material and substantial duties of any occupation by which you are experienced as a result of your age, education and transferable skills.

Closely Reading Guidelines and Your Claim for Long Term Disability Benefits

Closely read, “return to work guidelines.” Long Term Disability carriers will routinely use these to deny Long Term Disability claims. What are the guidelines? Quite frankly, these guidelines are at best estimated return to work dates created by a former Long Term Disability medical claims consultant, obviously you can tell that any of these guidelines will provide for an early return to work and are not favorable to Long Term Disability claims applicants.

Have Predictions by Your Doctor of Improvement Led to the Long Term Disability Carrier Denying Your Benefits?

Long Term Disability insurance companies, including UNUM, have a habit of selectively reviewing medical records looking for statements to take out of context to justify a claims denial. For example in Pelchat v. UNUM Life Insurance Company of America, 2003 US District Lexis 8095 (N.D. March 2003), the Long Term Disability policy holders physician initially released her to return to work with restrictions but “shortly thereafter determined that she remained disabled.”

What Does the Phrase Regular Occupation Mean in My Long Term Disability Policy?

Many Long Term Disability policies say that you if are unable to perform your regular occupation you may be entitled to Long Term Disability benefits. But what does regular occupation mean? Regular occupation means the occupation you are in at the time that you became disabled. In Dionida v. Reliance Standard Life Insurance 50.fsupp2d.934 (N.D. CA 1999), the court held that regular occupation means “a position of the same general character as the insurers previous job, or similar duties and training requirements.”