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  • Long Term Disability Guide

    Robbed of Your Peace of Mind? Your Guide to Long Term Disability Benefits

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  • Hiring a Great Long Term Disability Attorney

    The Key To Hiring The Right Long Term Disability Attorney

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    The Smart Long Term Disability Guide For Preparing Your Statement and Field Visit

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  • Social Security Disability Guide

    Your Rights To Social Security Disability Benefits - Your Guide to Getting Benefits Now

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Category Archives: Blog

NOSSCR Commentary Article About SSDI Misconceptions

the hill ssdi article

In a recent commentary article by NOSSCR, found here: http://thehill.com/blogs/congress-blog/healthcare/215601-ssdi-the-truth-behind-media-and-political-mischaracterizations shows some misconceptions that the media may put out about SSDI. What are your thoughts about the article and the real truth behind it?

Do you need help with your SSDI or have a question? SSDI Attorney Nancy Cavey has been practicing disability law for over 30 years. Give us a call today 727-894-3188.

Stomach Cancer And Your Rights To Long Term Disability Benefits

stomach cancer long term disability attorney

Did you know that stomach cancer is the 4th most common cancer worldwide and the 2nd leading causes of cancer deaths in the world?

More than 10,000 American suffer from stomach cancer and 1 in every 114 men and women are at risk of this deadly disease!

However, if you are diagnosed with stomach cancer, you should immediately apply for long term disability benefits.

stomach cancer long term disability attorney

Stomach cancer signs and symptoms

Early stage stomach cancer rarely causes symptoms and, as a result, detection is difficult. However, signs and symptoms of stomach cancer can include:

1. Indigestion, heartburn or ulcer-type symptoms;
2. Difficulty swallowing;
3. Abdominal pain or vague discomfort in the abdomen, usually above the navel;
4. Nausea and vomiting and/or bloating after meals;
5. Vomiting blood, or blood in the stool;
6. Diarrhea or constipation;
7. Loss of appetite;
8. Unexplained weight loss;
9. Weakness and fatigue;
10. Sense of fullness after eating small amounts of food (also called early satiety); and
11. Symptoms may mimic other conditions, such as GERD, gastritis or peptic ulcer.

These signs and symptoms shouldn’t be ignored and you should immediately consult with your physician. These symptoms can sometimes also be caused by things other than stomach cancer and you want to have a peace of mind and have your physician determine the cause of your problem.
It may be hereditary and strikes young adults in their 20′s, 30′s, and 40′s. It’s typically diagnosed in the late stages and, unfortunately, there is a 5 year survival rate.

What should I do if I’ve been diagnosed with stomach cancer?

You may be entitled to long term disability benefits if you purchased a long term disability policy through your employer or bought your own disability policy. You should immediately contact Long Term Disability lawyer Nancy Cavey who can help you get the long term disability benefits you deserve for stomach cancer. It’s crucial that you get these benefits as quickly as possible so that you can get the medical care that you desperately need. Give us a call today at 727-894-3188 to setup your free consultation.

Cognitive Dysfunction And Your Claim For Long Term Disability Benefits

Cognitive Dysfunction

Long term disability carriers don’t make it easy for those who are disabled to get the long term disability benefits that they deserve. Long term disability carriers deny claims on the basis of:

A. Lack of diagnostic criteria;

B. No clinical connection with disabling medical condition; and

C. No objective medical or self-reported symptoms and limitations.

Cognitive Dysfunction

Cognitive Dysfunction

Cognitive dysfunction is present in a number of medical conditions, including tinnitis, hearing loss, headaches and vertigo.

Cognitive dysfunction isn’t evidence of a disability but it’s an important factor to consider in determining the disability. Courts require that long term disability carriers give attention to subjective complaints, assign weight to those subjective complaints or provide specific reasons for its decisions to discount those subjective complaints.

Carriers simply can’t point to a lack of objective evidence in denying a claim. The carrier has to identify any objective findings and consider the cognitive symptoms that would reasonably be expected to see as a result of the medical condition. Carriers can’t just rely on the lack of objective evidence to deny a claim unless there is a subjective, self-reported symptoms and limitations clause in the policy.

What you should do if you have cognitive dysfunction

If you’re filing a long term disability claim as a result of cognitive dysfunction, you should obtain a copy of your medical records and review those records closely. Will your physician document the medical evidence for your cognitive dysfunction or clinical correlation between the complaints and your diagnosis? Has your physician performed any objective testing? Has your physician explained how your cognitive difficulties are manifestations of the symptoms of your medical condition? If not, you may claim may be denied right out of the box because of the lack of medical evidence that supports your cognitive dysfunction.

What should I do if I’ve been denied benefits as a result of cognitive disorder?

Contact Long Term Disability lawyer Nancy Cavey within 180 days of receipt of your denial letter so she can obtain the carrier’s file, conference with your doctor and obtain the necessary medical evidence to establish objective basis of your cognitive disorder and help you get the benefits you deserve. Contact her today at 727-894-3188.

What Every Erisa Plan Holder Needs To Know About Plan Amendments

erisa law lawyer disability tampa

If you employer offered you a disability policy, you may be covered by the Employer Retirement Income Security Act (ERISA). ERISA governs both pension benefit plans and long term disability benefits. ERISA long term disability plans are amended for one reason or another. Amendments can be classified into two categories, substantive and procedural.

Substantive and Procedural Plan Amendments

If a benefit is changing or ending, this would be considered to be a substantive. However, if only appeal procedures such as deadlines for submitting an appeal or for decision-makers to make the final decision on a claim, that’s probably a procedural amendment.

The general rule is that procedural amendments are generally not retroactive. However, substantive amendments will affect you if you’ve vested in your benefits.

How Plan Amendments Must Be Made

Plan sponsors have to follow the ERISA statute to make sure that the amendment has been made properly. The reality is the plan amendments can be made into effect whether it is good or bad.

Learn more about your policy

You can learn more about your disability policy by ordering a free, no obligation copy of our ERISA disability book , Robbed of Your Peace of Mind, today by visiting this link: http://www.caveylaw.com/get-disability-book/ to understand more about ERISA disability and your options.

Why Discovery Is Limited In Erisa Cases

discovery erisa disability limited

If you purchased a long term disability policy through your employer, your long term disability policy may be governed by the Employer Retirement Income Security Act (ERISA).

If you’re a long term disability policy holder whose benefits have been denied, you can challenge that denial in a federal court. However, you or your lawyer’s rights to conduct discovery and take the deposition of a claims adjuster, peer review doctors or others is generally limited.

discovery erisa disability limited

Why’s Discovery limited?

The fundamental goal of ERISA is to provide a “method for workers and beneficiaries to resolve disputes over benefits inexpensively and expeditiously.” Accord Semien v. Life Ins. Co. of N. Am., 436 F.3d 805, 815 (7th Cir. 2006). Consequently, discovery is often limited in an ERISA case. Discovery beyond the administrative record (the carrier’s file) is generally inappropriate depending on the court’s applicable standard of review.

What’s the standard of review?

A denial of ERISA benefits is reviewed under a de novo standard unless the benefit plan gives the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe the terms of the plan. Firestone Tire & Rubber Co. V. Bruch, 489 U.S. 101, 115 (1989).

However, when the challenged plan grants the administrator discretionary authority under the applicable standard of review is “arbitrary and capricious.” An administrator’s interpretation of the plan “won’t be disturbed” if reasonable. As a result, a long term disability carrier has the power to review the medical and come to its own determination as to entitlement to benefits.

That’s not good for you! What are examples of discretionary language? Some examples include the following:

“_______X_______carrier shall possess the authority, in its sole discretion, to construe the terms of this policy and to determine benefit eligibility hereunder. _______X______’s decisions regarding construction of the terms of this policy and benefit eligibility shall be conclusive and binding.”

Therefore, based on the language and controlling law, the federal court would have to apply the “arbitrary and capricious” standard of review which results in a limited review of the administrative record and even more limited ability to conduct discovery.

What should I do if my claim for disability benefits has been denied?

If your claim for disability benefits has been denied, please give us a call immediately to look over your denial. You may need a lawyer to get the disability benefits you deserve! 727-894-3188

Group Health Insurance Benefits For Those On Long Term Disability Insurance

group health insurance long term disability attorney

When you became disabled you, unfortunately, most likely lost your job and your group insurance benefits. The lack of health insurance can have a devastating impact on your medical and financial future.

group health insurance long term disability attorney

Websites for help with insurance

Did you know that there are a number of websites that can help you find an affordable insurance program? These include the following:

• Heathcare.gov: The official site for the Health Insurance Marketplace (a.k.a. Obamacare);

• FinancialHelpforHealth.org: A new site from the Robert Wood Johnson Foundation to help consumers learn about credits and subsidies for health insurance;

• AARP.org: Solid information on both Medicare and the Health Insurance Marketplace

• Florida SHINE.org: The online home of Serving Health Insurance Needs of Elders (toll-free 1-800-963-5337); and

• Medicare.gov: The official site for Medicare information.

Don’t delay! If you need insurance, help is available today.

If your Long Term Disability claim or Social Security Disability claim has been denied, contact attorney Nancy Cavey who can help you get the benefits you deserve.

Discretionary Clauses And Your Long Term Disability Claim

Discretionary Clauses long term disability claims

Get out your long term disability policy and look for something called the “Discretionary Clause”. It’s a clause that lets the long term disability carrier make the decision and requires that the court defer to its decision. It’s what I call a “get out of jail free card.”

Fortunately, there are some states that prohibit discretionary clauses in long term disability policies. These states include:

California;
Colorado;
Illinois;
Michigan; and
Washington.

You can determine whether the discretionary clause is applicable to you by looking at your disability policy and what state your policy was issued.

What other terms don’t you want to see in your long term disability policy?

Long Term Disability lawyer Nancy Cavey has written a go-to guide, “Everything You Need to Know About Your Long Term Disability Claim” that talks about all of the terms that you don’t want to see in your long term disability policy. You can order a free, no obligation copy of her book by contacting Long Term Disability lawyer Nancy Cavey at 727-894-3188.

Making The Decision To Hire An Attorney To Get Your Long Term Disability Benefits If Your Claim Has Been Denied

hiring a long term disability attorney

You bought your long term disability policy to provide you and your family peace of mind if you were unable to work. You’ve even made the difficult decision to apply for disability benefits knowing that your physician and employer have supported your claim. Yet, you’ve gotten a denial from the long term disability carrier.

No matter how angry or upset you are, don’t walk away from your long term disability claim. As a disability attorney, I know that very few people look forward to protracted litigation but there are times in life when the only right course of action is to pursue your claim.

hiring a long term disability attorney

What you should do if your claim has been improperly denied

If your insurance company improperly denied or treated your claim with a total lack of regard, it’s time to get a long term disability attorney involved.

When you’re forced in that position, you want to make sure that you’ve hired the right long term disability attorney for you.

You can order your free, no obligation copy of my book, “Hiring the Right Long Term Disability Attorney for You” by contacting my office at 727-894-3188 for a free, no obligation consultation.

Only an experienced disability attorney can understand the terms and conditions of your policy, the reasons for your initial denial and outline and implement a strategy for getting the long term disability benefits you deserve. After all, you purchased your disability policy to provide you and your family peace of mind. Don’t let the long term disability carrier rob you blind! Call us today to discuss your options – 727-894-3188.

The Five Things Long Term Disability Carriers Try To Do To Complicate And Even Deny Your Long Term Disability Benefits

5 things long term disability insurance carriers do

I’m sure that you purchased your long term disability policy to provide peace of mind if you became disabled. You may have every intention of returning to work but simply continue to be disabled while you’re recovering.

5 things long term disability insurance carriers do

Don’t think that the long term disability carrier is sitting idly by while you’re collecting disability benefits. There are five things that long term disability carriers can do to delay or even deny your long term disability benefits. These include:

1. Obtaining an Independent Medical Evaluation (IME) by a physician who has been paid to say that you are not disabled;

2. Having a field investigator knock on your door, unannounced, for the purposes of taking a statement about your Activities of Daily Living;

3. Seeing strange vehicles in your neighborhood following you to and from doctor’s offices, the grocery store or even to the children’s school and securing surveillance of your activities;

4. Contacting your neighbors and even your co-workers about your hobbies and daily activities;

5. Having the long term disability carrier’s peer reviewer or consulting doctors call your attending physician in an effort to convince your doctor that you’re capable of engaging in part-time employment.

What you should do to protect yourself

One of the quickest ways to provide yourself with peace of mind is to secure the services of an experienced long term disability attorney who can:

1. Help you complete the Activity of Daily Living forms submitted to you by the disability carrier;

2. Provide advise on what to expect and how to handle field representatives, surveillance and vocational evaluations used by disability insurance companies to deny claims;

3. Provide disability advice on what to expect and how to handle an independent medical evaluation (IME) or a Functional Capacity Evaluation (FCE);

4. Advice on how you should communicate with your physician about your occupation and how to fill out the disability forms;

Getting the go-to book

You should also order the no obligation copy of my book, “The Smart Long Term Disability Consumer Guide For Preparing For Your Statement and Field Visit – See more at: http://www.caveylaw.com/the-smart-long-term-disability-consumer-guide-for-preparing-for-your-statement-and-field-visit/” that explains to you the games that long term disability carriers play in disability claims.

Be prepared and be forewarned. You should be ready to take on insurance companies so that you can get the disability benefits you deserve. Call today at 727-894-3188 for a complimentary consultation.