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

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Category Archives: Blog

What Every Prostate Cancer Sufferer Needs To Know About Social Security Disability Benefits

prostate cancer social security disability

Prostate cancer is a form of cancer that develops in the prostate and is normally a slow growing tumor. However, once the prostate cancer spreads, it is dangerous and aggressive and can reach your bones, lymph nodes and lungs.

prostate cancer social security disability

Symptoms of Prostate Cancer

Unfortunately, during the early stages of prostate cancer there are no symptoms and that’s why annual prostate cancer testing is critically important.

Serious prostate symptoms can include:

• Pain in the genital and pelvic area;
• Blood in the urine or seamen;
• Frequent urinary tract infections;
• Unexpected weight loss;
• Pain in the lower back or pelvic area;
• Anemia; and
• Fatigue.

Many of the prostate cancer symptoms are similar to prostatitis, erectile dysfunction or an overactive bladder. If you have any of these symptoms, you should contact your physician immediately.

What Should I Do If I’ve Been Diagnosed With Prostate Cancer?

If your physician has diagnosed prostate cancer and told you that you’re unable to work, you should immediately apply for Social Security Disability benefits. The Social Security Administration doesn’t always make it easy for those with prostate cancer to get the disability benefits they deserve, even in more progressive cases. However, the Compassionate Allowance Program may be the right answer for getting you your Social Security Disability benefits.

To learn more about your rights to Social Security Disability benefits for prostate cancer, contact Tampa Bay Social Security Disability attorney Nancy Cavey at 727-894-3188.

What You Need To Know About The Appeals Council If Your Social Security Disability Claim Is Denied

social security disability appeals council

If your Social Security Disability claim is denied by the Administrative Law Judge you have a difficult decision to make. The Social Security Administration will give you 30 days to appeal to the Appeals Council or file a new Social Security Disability claim asking for benefits from the date of the Administrative Law Judge’s denial forward.

By filing a new claim for Social Security Disability benefits you give up the back benefits from the time of your initial application until the time of the Administrative Law Judge’s decision. That can be a significant amount of Social Security benefits.

On the other hand, the Appeals Council is just not a friendly place for Social Security Disability applicants whose claims have been denied.

social security disability appeals council

Statistics About the Appeals Council in 2013

The appeals council processed 176,251 requests for review and the average time for the Appeals Council to make a decision was 364 days.

The Appeals Council will not take new testimony and simply reviews the Administrative Law Judge’s decision and the record to determine whether the Judge has made an error of law.

According to the statistics, over 76.87% of Administrative Law Judge’s denials were upheld and only 17.11% were remanded to the Administrative Law Judge. Less than 1.45% of decisions were found to be fully favorable.

These are awful statistics!

Making a difficult decision

If your claim for Social Security Disability has been denied, you’ll have to make a difficult decision about whether you want to appeal to the Appeals Council or start all over. Certainly, these statistics don’t bode well if you choose to appeal to the Appeals Council.

You should contact experienced Appeals Council attorney Nancy Cavey for advise as to how to proceed if your claim for Social Security Disability benefits is denied by the Administrative Law Judge. Give us a call today at 727-894-3188 to discuss your options!

Can I Work And Still Receive Social Security Disability Benefits?

work while on social security disability benefits

Maybe! It is possible to work part-time and not lose your Social Security Disability benefits but the answer depends on how much you earn and what kind of disability benefits you are receiving.

If you’re receiving Supplemental Security Income (SSI) and go to work, your SSI benefits will be reduced by $1.00 for every $2.00 you earn after the first $65.00 or ($85.00) if you have no other income. That means that you could earn so much working part-time but your SSI benefits would stop.

work while on social security disability benefits

Social Security Disability Benefits and Working (SSD)

If you’re receiving Social Security Disability benefits and your earnings are below what the Social Security Administration calls the annual “Substantial Gainful Activity Amount,” your benefits will neither stop or be reduced because of your earnings. You continue to get your full Social Security Disability benefits while you work part-time. It’s also possible to earn more than “SGA” amount and still receive your full benefits during the 9-month trial work period.

How much can I earn per month and still receive my Social Security Disability benefits?

The amount that you can earn up to “substantial gainful activity” (SGA) changes on an annual basis and, as of 2014, is $1,070 per month. The SGA amount is the absolute cut-off point.

If your earnings are more than the substantial gainful activity amount your benefits will stop after you’ve used up your 9-month trial work (on a grace period of 3 months), no matter how disabled you are.

If you want to work part-time, it’s best to keep your income well below the substantial gainful activity amount. Remember, there is no trial work for SSI.

How long is the trial work period for SSD?

That trial work period allows you to earn any amount for 9 months and still receive your full disability benefits. You can test your ability to return to work full-time without having your monthly disability benefits stopped. Most people often use up their trial work period by working part-time. A trial work month here, and a trial work period there, still counts as long as all 9 months are used in a 5-year period of time. Once you use up your 9-month trial work period, it’s gone!

You’ll probably be able to get your disability benefits back if you start working within 3 years after you’ve used up your 9-month trial work period. If you’ve worked again at SGA for more than 3 years after your trial work period, you’re going to have to start the Social Security Disability Claims process all over.

The SGA number is based on gross wages which is not averaged over the months worked.

Don’t use up your trial work period

It’s best not to use your trial work period until you are ready to return to work full-time. Don’t waste it on part-time employment.

If you are receiving Social Security Disability benefits, you are required to report your work promptly. We suggest that if you telephone the Social Security Administration to report you’ve begun to work, ask when you need to provide income documentation. Be sure to get the name and location of the name of the person you speak with and follow up with a letter to your local office keeping a copy of the letter for your files.

Call us at 727-894-3188 to discuss your options when it comes to hiring an Social Security Disability Attorney in the Tampa St. Petersburg area to help!

 

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.