Cavey and Barrett Blog

Social Security Disability and Veterans Disability Claims.

Are you a disabled veteran who has applied for Social Security Disability benefits? You can get both Social Security Disability and Veterans' benefits. There is nothing that stops you from getting two federal disability checks from two separate federal agencies. Think about it: medical records are the basis of your claim for both Social Security Disability and Veterans' benefits. Make sure that both the Disability Examiner or your VA and Social Security Disability Claims Examiner are aware of all of your medical treatment, including your military treatment, names of your doctors and addresses of your providers. That will make it easier for your records to be gathered by both the Social Security Administration and the Veterans Administration.

You can speed up the approval of both disability claims by making sure that both the Social Security Administration and the Veterans Administration are aware of all of the medical treatment you're receiving.

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.

No. 2 - My spouse is working. Will their income affect whether I'm entitled to Social Security Disability benefits?

If you're applying for SSI disability benefits and your spouse works, this may prevent you from getting SSI. If you get SSI, the amount earned by your spouse can potentially reduce the amount of your check.

However, if you're applying for Social Security Disability benefits (SSDI), then your spouse's earnings have no effect on your claim. It won't impact your eligibility to apply for disability benefits, to get disability benefits or have any impact on the amount of your benefits.

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.

No. 7 - Are you eligible for Social Security Disability?

To be eligible to file an application for Social Security Disability benefits you have to be insured. What? Now, I know that you haven't completed a disability application or paid a premium, so what do I mean by being insured?

The payroll deduction that your employer makes into the Social Security system is how you become insured. You have to be in the workforce for 20 out of 40 quarters to be insured.

If you have a gap in your work history because of illness, you may have lost your insured status for Social Security Disability, or you may simply have never worked.

If that's the case, the Social Security office will take an SSI disability application. What's that? SSI covers individuals who aren't eligible for Social Security Disability and don't have assets in excess of $2,000.

To be eligible for SSI, you must have a physical or mental impairment (or both) that:

(1) is considered severe;

(2) lasts for at least 12 months, or is anticipated to last that long based on your medical records;

(3) prevents you from working at the lightest job you held in the last 15 years;

(4) prevents you from performing suitable other work based on your age, education, work skills, and physical or mental limitations.

If you are not insured for Social Security Disability purposes, you may still be eligible for SSI.

At Cavey & Barrett we can help you determine whether or not you meet the criteria to be insured for Social Security Disability.

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.

No. 8 - I've been denied Social Security Disability benefits. What do I do next?

You have three choices: you can give up, file a brand new Social Security Disability application, or you can file an appeal.

I'm a fan of Winston Churchill, and my motto is "Never give up!"

You have to understand that most initial disability applications are denied and, in fact, are also denied a second time at the "request for reconsideration" stage.

Your chances of winning at the disability hearing stage level rise significantly, particularly if you have attorney representation.

We rarely contemplate having you start over with a new application and only suggest it if there is some technical reason for your denial. At Cavey & Barrett we can analyze the basis for the denial and help you decide whether or not you should appeal or file a new claim for disability application.

Of course, at Cavey & Barrett we find that the best course of action is normally to file a timely appeal. In fact, we suggest that you file it as soon as possible.

At Cavey & Barrett we can help you with the appeal process and, in particular, help you fill out the disability claim forms to make sure that you have properly explained your functional limitations and the difficulties that you have. Never give up on your claim!

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.

No. 9 - Should I file a new disability application with the Social Security Administration?

At Cavey & Barrett we find that most disability claimants who have been denied Social Security Disability should appeal their disability denial instead of filing a new disability application.

As we've explained, it's in a claimant's best interest to move your case to the disability hearing stage. Unfortunately, there are hoops that you have to jump through before you get to that administrative law judge. You first have to have your disability application denied, file a request for reconsideration, be denied, request a disability hearing, and finally (at long last) get in front of the administrative law judge where your chances of winning are significantly increased.

Every time you file a new disability application you start all over again and stop your progression through the disability appeal process.

This isn't to say that there aren't situations where you may want to start with a new application instead of appealing. For example, you may have been denied because you were still working or you've earned too much to be considered as being disabled. In that situation, it would make little sense to file a disability appeal but rather file a new application once you've stopped working.

At Cavey & Barrett we find that every situation is unique but that generally the best course of action is to file an appeal.

Sharon Barrett can provide you with expert legal advice on your Social Security denial and whether you should file a new application.

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.

No. 10 - I've been denied Social Security Disability benefits. Can I appeal?

Absolutely. Your notice of denial will provide you information regarding how you go about filing an appeal.

There are some things that you need to be aware of:

(1) The majority of Social Security Disability claims are denied. Nationally, about seven out of 10 initial claims are denied and eight out of 10 requests for reconsideration are denied. In Florida, the denial rate is approximately 64.9 percent;

(2) A large percentage of Social Security Disability claimants who are denied and who decide to appeal are eventually approved for benefits. Follow Winston Churchill's famous statement, "Never give up!"

(3) At each step of the disability evaluation process, you have the right to file an appeal if you've been denied. At Cavey & Barrett, we can assist you with filing the necessary paperwork and make sure that your appeal is timely filed;

(4) The disability appeal has to be filed within 60 days of the date of the denial. Unfortunately, Social Security Administration is rather strict about holding you to that 60-day timeline;

(5) The first appeal takes about 60 to 90 days, and you should expect to be denied;

(6) The request for reconsideration also takes about 60 to 90 days and you should expect to be denied once again;

(7) At the next stage, you can file a request for a hearing and, unfortunately, it will take 24 to 26 months to get a hearing. There are cases in which Cavey & Barrett may be able to get a request for a hearing put on a quicker basis if you qualify for a compassionate allowance.

Remember to appeal, appeal, appeal. Your best chances of obtaining Social Security Disability benefits are before the administrative law judge.

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.

No. 11 - My condition is improving. Should I still proceed on my Social Security Disability claim?

Yes! Many Social Security Disability applicants have medical conditions that get worse, get better, get worse, get better... This cycle can keep on repeating itself and is found in situations like fibromyalgia, back problems, lupus, MS, and depression.

Because your condition may get better and worse, some disability applicants should really think twice about giving up their claim, even when it seems their condition might be improving.

If your condition is improving and you choose not to file an appeal on a claim within the 60-day appeal period, you'll be forced to start over with a brand new application, which will cause you to start all over again, getting back in line.

Because it takes so long to get a hearing in front of an administrative law judge, we rarely recommend that Social Security Disability applicants stop pursuing their Social Security Disability claim. You never know what your physical or mental condition might be like by the time you get in front of the administrative law judge.

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.

No. 12 - Help! My claim for disability benefits has been denied. What should I do next?

The second step in the Social Security Disability evaluation process is filing a request for reconsideration. There are some secrets that you need to know:

(1) when you file your request for reconsideration, provide updated information regarding any visits you've made to doctors, hospitals, and clinics since you filed your initial application together with the addresses of those medical providers;

(2) If you have the most recent medical records, submit them with your request for reconsideration. Why? Your request for reconsideration can be held up while the office of disability determinations waits for your updated medical records. However, keep a copy of your request for reconsideration and the medical records that you have submitted. Send this information to the Social Security Administration by certified mail, return receipt requested;

(3) Keep a copy of your original disability application and review it when you submit your request for reconsideration. Why? Unfortunately, Social Security Disability applicants will sometimes leave off the names and addresses of medical providers or even forget physical or mental conditions for which they have been treated. If you have forgotten something, you want to include that information on your reconsideration appeal;

(4) Consult with Cavey & Barrett before you turn in your request for reconsideration. You have sixty (60) days to file your request for reconsideration, and every day you wait adds more time to the process. Schedule an appointment with Cavey & Barrett so they can review your initial Social Security Disability application, the denial letter you received from the Social Security Administration, and help you properly prepare and timely submit your request for reconsideration.

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.

No. 14 - When should I get a Social Security Disability attorney?

The answer depends on you and your needs. We find that some claimants benefit from having representation at Cavey & Barrett from the very beginning, so that they understand the Social Security Disability claims process and get assistance in filling out their initial application. Others find that Cavey & Barrett assists them in avoiding missed deadlines and having to avoid the stress of dealing with the Social Security Administration.

More often than not, Social Security Disability applicants come to Cavey & Barrett after their initial application has been denied. While we are more than happy to represent you at any stage in the Social Security proceedings; we think that getting an attorney after the first denial is crucial in advancing your claim to the hearing stage.

At Cavey & Barrett, we think that waiting to get representation until just before your Social Security hearing is tempting fate. Why? During the course of your claim, Cavey & Barrett make sure that the Social Security Administration receives your ongoing medical records and is kept up to date with your medical treatment. We prepare a brief for the court prior to the hearing, setting forth the reasons why your claim should be accepted and, of course, if we have to go to a hearing, we prepare your court hearing. Waiting untill the last minute doesn't help anyone prepare for your big day in front of the administrative law judge.

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.

No. 15 - Can I work while I am getting Social Security Disability benefits?

People who apply for Social Security Disability benefits are in a different position from those who are already getting Social Security Disability benefits. If you are receiving Social Security Disability benefits and are working on a trial work period, you can only work nine (9) months in a 5-year period and earn $960 per month.

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.

No. 1 - Is the long-term disability carrier entitled to repayment because I got Social Security Disability benefits?

Have you read your long-term disability policy? Does it provide that future benefits can be withheld to recover any overpayment arising from a retroactive payment of benefits such as Social Security Disability benefits?

In the case of White v. Coca Cola Corporation, the United States District Court for the Northern District of Georgia upheld a provision in Coca Cola's long-term disability plan that allowed Coca Cola to withhold future benefits to recover a retroactive payment of Social Security benefits in the amount of $38,124.90 that Mr. White received.

They reduced Mr. White's payments for 60 months to recover the overpayment, and he appealed. The court agreed with Coca Cola and found that they were entitled to reduce future long-term disability benefits because of the lump sum payment of Social Security benefits.

At Cavey & Barrett we can assist you in reviewing your long-term disability policy to determine whether or not your long-term disability carrier is entitled to recoup any overpayment for Social Security benefits.

No. 2 - Long-term disability benefits and my healthcare coverage through COBRA

At Cavey & Barrett it's not uncommon for long-term disability applicants to come to our office with a letter from their employer about continuing their healthcare coverage through COBRA.

Federal law requires employers with 20 or more employees to provide COBRA healthcare continuation coverage, and there are specific time limits for choosing this coverage.

Unfortunately, many long-term disability applicants are also applying for Social Security Disability benefits and are in need of medical treatment. They have not become Medicare eligible and are facing a gap in their health insurance coverage.

While there is no one-size-fits-all answer, there are considerations that each long-term disability applicant should consider in making the difficult decision about continued COBRA coverage or alternative coverage:

1. Are you eligible for COBRA?

2. Do you have any dependents who have medical problems which require ongoing medical treatment?

3. Do you have coverage available to you under a spouse's employer?

4. Where are you with the Social Security Disability process? COBRA generally allows you and your dependants to keep group health coverage for 18 months after your employment ends. 

There is an additional 11-month extension available when qualified beneficiaries are determined by the Social Security Administration to be disabled. This would provide 29 months of healthcare coverage. 

You become eligible for Medicare 24 months from the SSA determined date of award.

5. Have you been awarded SSDI, and do you have dependants? If all of the qualified beneficiaries in your family are disabled and meet the SSDI eligibility requirements, all the qualified beneficiaries in the family are entitled to an 11-month extension of the general 18-month COBRA coverage. This will provide 29 months of COBRA coverage.

6. What will your COBRA coverage cost? You will have to talk to your Human Resources Department to determine how much COBRA coverage will cost. 

Generally the first 18 months of coverage can cost as much as 102 percent of the cost of the plan of those who are still employed.

7. What do you anticipate your medical needs to be in the next 18 months? 

At Cavey & Barrett we suggest that you estimate what medical treatment you are going to require in the next 18 months and what it would cost without insurance? Look at your deductibles and estimate the cost of medication, diagnostic testing, and hospitalization. 

If you are facing significant medical treatment, it may be wiser to pay the higher COBRA premium so that you can get the medical treatment you need.

8. What would be the cost of any COBRA premium increases? If you get the 11-month disability extension, the premium for those 11 months may go up to 150 percent of the plan's total cost.

9. Have you priced any individual health plans?

You have 60 days to make the COBRA election.

At Cavey & Barrett we provide our long-term disability/ERISA clients with advice as to their COBRA and insurance options. We will help you determine your insurance costs under COBRA, the medical benefits you might require in the future and alternative medical care sources.

At Cavey & Barrett we can also refer you to lower cost healthcare options such as Drug Company and state pharmaceutical assistance programs, various government programs such as Medicaid, Veterans' Assistance and State and Local Health Services.

The decision that you make regarding your medical care is not only financial but one that will impact your health as you are trying to deal with your disabling condition and recover.

Cavey & Barrett can provide you with assistance.

No. 3 - Long-term disability and financial planning.

At Cavey & Barrett we assist our Long-Term Disability/ERISA clients in dealing with the challenges they confront in the disability claims process.

These questions include:

(1) What are my benefits when I'm going to start working?

(2) How do I file for Social Security?

(3) Should I COBRA my health coverage?

(4) Do I have alternative sources of healthcare?

(5) How do I make the health insurance gap between my Medicare eligibility and the loss of my healthcare?

For assistance with these questions and your long-term disability or Social Security Disability application, contact Cavey & Barrett, your Social Security Disability and Long-term Disability experts.

No. 4 - The 2008 economy and the payment of long-term disability benefits.

At Cavey & Barrett we are seeing a "slow pace strategy" by long-term disability carriers. We have found that carriers aren't "receiving paperwork," asking for the same information over and over, suggesting that they need information, indicating that there is a delay in getting information from physicians. These are all delay tactics that the carriers are using to delay payment to you.

With stock prices down and a lack of investment income earnings, disability insurance companies are taking longer to determine disability claims and to pay long-term disability benefits.

If you are experiencing any of these problems with your long-term disability or ERISA carrier, immediately contact Nancy Cavey at Cavey & Barrett to assist you in your long-term disability claim. There are things that can be done to expedite the handling of your long-term disability or ERISA claim. Remember, long-term disability insurance companies think that they can outlast long-term disability claimants. Our advice and counsel help you understand what your carrier is doing and help you prepare yourself financially. 

No. 5 - What every medical professional needs to know about ERISA.

It is important that medical professionals understand their long-term disability policy so they can prevent the disaster of being disabled and being unable to recover the benefits they deserve.

Did you know that there are three types of disability policies? Do you know which kind you have?

The first is an individual disability policy, which you may have purchased directly from a carrier and which provides you long-term disability benefits in the event of sickness or injury.

Do you know that there are two types of individual policies? The first is a general policy that insures you against being disabled and being able to perform all work, while an "occupational" policy provides you disability benefits if you can't perform the material and substantial duties of your own occupation. Obviously, an occupational policy will provide greater coverage to a medical professional who would be entitled to these benefits even if they were able to engage in another occupation.

The second type of long-term disability policy is a group policy which is made payable to the participants of professional associations or medical practices. Group policies provide benefits based on a percentage of your base salary. These benefits normally pay 50-75 percent of the base salary and limit the maximum amount of benefits you are entitled to per month, regardless of your base income. It is not uncommon for these group policies to reduce benefits when you receive income from other sources such as Social Security Disability, Workers' Compensation, or even a 401K distribution.

Employer sponsored disability policies are typically the least expensive policies and provide employees with disability insurance based upon a percentage of the base salary as part of the employer's overall benefit package.

Unfortunately, group and employer sponsored policies are governed by the Employer Retirement Income Security Act of 1974 (ERISA). For a lot of ERISA attorneys, that acronym is named: "Everything Ridiculous Since Adam." ERISA deprives medical professionals the right to a trial by jury, the possibility of punitive damages, and it significantly affects your administrative and litigation rights.

The most an aggrieved medical professional can recover in an ERISA lawsuit is the amount of the benefits due, the interest cost and a discretionary award of fees.

There have been rulings by the court that disability claims brought by business partners or even sole shareholders of organizations who purchased individual insurance coverage, the owner of the business is covered by ERISA.

Unfortunately, at the time disability policies are sold to organizations, one of the primary factors is whether the applicant is interested in tax savings or coverage. Unfortunately, most organizations will opt for the least expensive policy that is taxable rather than for expanded coverage.

ERISA policies have a number of disadvantages. These will require you to have an administrative appeal before you can sue. If the plan provides the administrator with the discretion to determine the claim, courts generally overturn that decision if the administrator has acted arbitrarily and capriciously. So long as the record reflects a rational basis for the decision despite overwhelming evidence, the court will uphold the decision.

Unfortunately, the court is limited to reviewing the evidence that was in the file at the time the administrator made the decision. As a result, you can't offer additional documentation or even testify in front of a judge.

Despite these disadvantages, medical professionals are not doomed to having their claims denied. It is important that a medical professional consult with an attorney before filing a claim so that you understand the definition of disability, or if what is covered under base earnings can provide you with an opportunity to get your medical and financial house in order, develop supporting medical evidence before you file your claim for disability benefits.

Disability insurance companies do target high-end policies issued to medical professionals for denial or termination with the hope that ERISA will limit their exposure.

Don't make yourself a target for claims denial. Contact the law office of Cavey & Barrett to assist you in reviewing your disability policy, to assist you in your pre-claim filing preparation, and to assist you in reversing denials of disability claims.

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.

No. 6 - The Long-term Disability Carrier is trying to talk with my treating physician behind my back. What should I do?

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.

The seven things long-term disability policy holders should do.

Nancy Cavey, Hillsboro and Pinelas Counties disability insurance company lawyer, suggests that longer-term disability applicants call and:

(1) get a copy of their policy;

(2) read the policy and the directions for filing their claim and follow every step;

(3) make a copy of everything you send to the disability carrier;

(4) send everything to the long-term disability carrier with return receipt request to prove that you sent the material;

(5) if you speak with the adjuster, which Nancy Cavey does not suggest you do, document every telephone conversation;

(6) if you have a high monthly benefit policy, be prepared for surveillance. The disability insurance company will hire an investigator to videotape you;

(7) consider consulting Nancy Cavey to assist you through the disability claims application process. Nancy can assist you before you file, during and after the claim has been filed;

(8) remember that disability insurance companies review files on an ongoing basis. Simply being paid does not mean that your benefits will continue. If your checks start coming late or stop, contact Cavey & Barrett for assistance in protecting your rights to the long-term disability benefits you paid for to protect your family.

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.

No. 10 - Can I refuse to attend a neuropsychological exam at a long-term disability carrier?

If a long-term disability carrier is scheduling you for a neuropsychological exam, I strongly suggest that you contact an attorney like Nancy Cavey immediately! Nancy Cavey is familiar with the neuropsychologists routinely used by long-term disability carriers.

We won't ever refuse an exam, but there are a number of things that can be done to protect your interests. These include:

(1) obtaining your own neuropsychological exam before attending the long-term disability carrier's neuropsychological exam;

(2) videotaping the independent medical examination;

(3) limit the carrier's neuropsychological review to the raw data of your examination.

To discuss this, and any other issues you have with your long-term disability claim, or for assistance in filing your long-term disability/ERISA claim, contact Nancy Cavey at www.caveylaw.com.

Nancy's new book on the mistakes that you can make in dealing with the insurance company will soon be published and will be made available at her website at Caveylaw.com .

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.

Dental disability insurance is essential.

If you become disabled and are unable to work, dental disability insurance is essential to help you maintain your current practice. According to a recent survey, nearly half of one million people who filed for bankruptcy in the United States did so because of an illness or an injury. If you're involved in a car accident, suffered a sports injury, or have any other painful condition, you may be unable to continue your practice and be forced to close or even sell your practice.

It's essential that you find a disability plan that meets your occupational needs. Determining which policy is right for you is crucial. There are two types of disability policies. The first is a group policy that can be purchased from your employer or with pre-tax dollars. Remember, group plans have limited coverage, can be taxed, and any benefits you receive from Social Security, Workers' Compensation or income from other sources can be used to reduce your group disability coverage.

This is not true of the second type of disability policy, an individual policy which can be customizable. 

Additionally, you should consider having an overhead disability expense policy that will pay your employees and even the rent when you are recovering from your disability. Without having overhead expense coverage, a temporary disability like a tennis injury to your shoulder could force you to lay off your staff and shut your practice.

Getting the correct dental disability coverage is essential, and you should contact your local disability agent to find reliable and multifaceted disability insurance that meets your particular needs.

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.

Shopping for a physician and dental disability insurance.

Physicians and dental disability insurance can help protect medical providers and their families in the case of injuries or unexpected circumstances. You and your family rely on your paycheck to pay bills, feed and clothe your family, and to provide a home and a lifestyle that have come to expect.

There are a number of things that you should consider before choosing a disability insurance policy. At Cavey & Barrett, we recommend that physicians and dentists purchase private disability insurance policies instead of a policy through a group plan. You should consider the following:

1. Quality. This disability plan will be the main source of your monthly income if you're disabled and are unable to work. The amount of the monthly income that you will be paid has to be high enough to cover all the bills that you need paid every month. Therefore, the plan that you select should cover your monthly expenses.

2. You should also have a guaranteed renewable feature, which means that as long as the premiums are paid the insurance company can't make any changes in your policy. A disability policy can't be cancelled for any kind of reason, including changes in your health. So long as you continue to pay the premiums, you have disability insurance coverage.

3. Company rating and status. Insurance companies should be financially sound to provide you with security, and you want to enroll in a plan that has a rating of A+ or better. However, company ratings aren't the most important factor. At Cavey & Barrett we find that many disability insurance companies that have high ratings have lousy track records in paying disability claims. Be sure that you ask your disability insurance agent about the claims paying and denial history of the company that they are recommending.

4. Benefits. When deciding on a disability insurance policy, you should consider the amount of the monthly benefits and how long you must wait before you get those benefits. Many disability insurance companies will offer to only pay 50 to 60 percent of your income, and it is rare that you will find a disability insurance plan that will pay 100 percent of your income.

5. How will you make up the difference? Many long-term disability policyholders mistakenly believe that Social Security Disability benefits can assist them in making up the difference. In some areas it will take over two years to get a Social Security Disability claim approved. More importantly, many group disability policies will have a provision that reduces the amount of your disability benefits by the receipt of your Social Security benefits.

6. Another important factor is what is called the elimination period of benefits. Most insurance companies will pay claims within 60 to 90 days after the disability period begins. How long can you go without a paycheck?

7. Coverage. When shopping for a disability insurance company, make sure that your specific occupation is listed, instead of a general occupational listing. In other words, if you are an interventional cardiologist, you want to make sure that you are covered for your loss of ability to work as an interventional cardiologist. Similarly, if you are a cosmetic dentist, you want to make sure that your specific occupation is listed instead of being listed as a general dentist.

8. Shopping for physician and dental disability insurance companies can be confusing especially if you don't know what you are looking for. In Nancy Cavey's experience, getting a "medical, specialist or a broker" who can advise you on the best insurance company for your situation is helpful, but it is not the only solution.

9. Many medical providers have complex financial considerations that need to be evaluated in selecting the right disability insurance policy. These will be discussed in future postings.

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.

Long-term disability carriers' Independent Medical Examiners.

Unfortunately, it's not uncommon for long-term disability carriers to use "independent" medical examiners to evaluate your entitlement to continuing long-term disability benefits. This is particularly true in the case of psychiatric or psychological conditions such as depression or anxiety.

One of the most common "tricks" is to have a long-term disability carrier schedule an independent medical examination with a psychiatrist or a psychologist who will have you sit in a room with a computer and answer hundreds of questions on the computer.

This is known as psychological or psychiatric testing. What you will find is most of the questions don't apply to you but you will be instructed to answer them anyway. 

Most questions are totally irrelevant and even ridiculous. 

More often than not, simply because you sit in a room and answer the questions, the independent medical evaluating physician will conclude that you have the ability to concentrate, that you are not functionally impaired, and that you have the pace and stamina necessary to work.

Even though you may complain that you are depressed and anxious, the independent medical examiner will determine that you are not "functionally impaired."

Of course, this will be used by the long-term disability carrier to cut off your benefits. When you appeal, the long-term disability carrier will reaffirm their denial based on the results of the independent medical evaluation.

If you are scheduled for any type of independent medical examination by a long-term disability carrier, understand that this is the prelude to having your long-term disability benefits cut off. Contact Cavey & Barrett, your Florida based long-term disability claimant attorneys who can help you with this frightening turn of events.

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.

Three things that claimants must do before filing a disability claim.

It is crucial that any long-term disability policyholder who is about to file a claim for immediate disability benefits do the following:

1. Get a copy of the original policy.

2. a. Read the policy so that you understand whether or not your disabling condition is, in fact, covered under the terms of the policy and for how long benefits will be paid. You also need to understand whether there will be any reduction from your disability benefits for income such as Workers' Compensation, Social Security, or even 401K deductions.

2. b. You should also read the policy for the directions required for the filing of a claim and follow every step. Make sure that your claim is filed timely.

3. Make a copy of everything you send to the long-term disability insurance company and send everything with a return receipt to prove that it was sent.

Remember, help is available to assist you before you file the claim and during your claim's process. Consult Cavey & Barrett for assistance in filing your long-term disability application.

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.

Policy provisions.

Each long-term disability policy is different. Unfortunately, there is no uniform long-term disability policy in the United States. Each policy has different provisions. You should understand what the definition of disability is under your long-term disability policy, what conditions are excluded, when you have to file a claim, how much you are entitled to in benefits, whether or not there are offsets or reductions against benefits, and how long the claim process takes.

Group disability coverage is designed to limit coverage and benefits. That's why long-term disability policies cost significantly less than a quality individual private disability insurance policy.

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.

ERISA

ERISA stands for "Employer Retirement Income Security Act." It was passed in 1974 for the purpose of protecting employee benefits for group plan participants. Unfortunately, disability insurance policies are subject to the ERISA regulations, which long-term disability carriers refer to as "Everything Ridiculous in the World Since Adam."

ERISA, which is a federal statute, pre-empts state law. That means that there are no state law causes of action, including bad-faith claims handling.

I am sure that your HR manager thought that having a group LTD policy would be a great benefit to the employees and is part of a benefits package that most employees are quite happy to have. These policies are cheaper, easier to sell, and are probably more profitable for the long-term disability insurance companies. How does it become profitable? ERISA procedures set up an administrative process, and you must read your policy closely to understand that process. There are specific time periods in which you must report your claim, submit information in support of your claim, and time periods in which the insurance companies or claims administrator must deny your claim.

There may even be an internal appeals process in the event that your claim has been denied.

Unfortunately, you must follow this claims process to the letter until you "exhaust your administrative remedies."

Long-term disability lawyers such as Cavey & Barrett more often find that the claimant has been exhausted by the administrative remedies as opposed to getting a favorable decision.

You should also remember that there is no such thing as a treating physician rule that gives deference to the opinions of your treating physicians. The long-term disability carrier can and many times ignores what your physician has to say about you and your ability to work.

These ERISA procedures are used to sabotage your claim. Under ERISA, the long-term disability carrier has to provide you with an explanation for its decision as well as documentation that it relied on in making the denial. Allegedly, this give you multiple opportunities to cure the defect.

In reality, the long-term disability insurance company will have your file reviewed by a peer review physician or have you evaluated by a physician of their choosing. The insurance company's claims denial is almost perfunctory and the insurance company will simply be happy to take a defensive posture, sitting back and taking apart your claim.

Since there is no treating physician rule, so long as the long-term disability carrier follows the ERISA regulations by having its team of internal medical consultants and experts address your medical documentation, it can be difficult to overturn the group carrier's decision to deny your claim or terminate your benefits.

It is crucial that you have an experienced long-term disability attorney help you even before you file your claim for long-term disability benefits. Nancy Cavey, who is highly experienced in representing long-term disability applicants, can assist you in understanding your long-term disability policy, assist you in perfecting your claim, and providing the long-term disability carrier with documentation to defeat every company's strategy that will be employed to deny your claim.

Group long-term disability policy language, the internal ERISA claims process, and your burden of proof to establish your entitlement to long-term disability benefits, can place significant hurdles in your path. If you have a choice, Cavey & Barrett strongly recommend that you purchase a private long-term disability policy that is tailored to your specific needs and will let you quickly go into state court to seek the long-term disability benefits that are due and owing to you.

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.

What every medical professional should look for in a disability insurance policy.

For medical providers just out of school, buying a disability insurance policy probably ranks last on their list of things to do. After all, you have just finished your training. You're young and healthy. What are the odds that you're going to become disabled? You may not think that a broken arm, a problem pregnancy, or a car accident may be disabling, but anyone of them could keep you out of work.

According to the Health Insurance Association of America, over 30 percent of Americans ages 35 to 65 will suffer a disability that lasts at least 90 days sometime during their career.

Without disability insurance coverage, an unexpected injury or illness can drive out to financial ruin.

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.