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Category Archives: Long Term Disability ERISA and Private Disability Insurance Claims

Irritable Bowel Syndrome and Your Rights to Long Term Disability Benefits

Irritable Bowel Syndrome long term disability

Long term disability carriers don’t make it easy for those who have Irritable Bowel Syndrome (IBS) to get the Long Term Disability Benefits they deserve.

Signs of Irritable Bowel Syndrome IBS are:Irritable Bowel Syndrome long term disability

1.) Abdominal pain,

2.) Bloating,

3.) Discomfort.

Other signs of IBS can include:

1.) Cramping in your abdomen,

2.) Diarrhea or constipation,

3.) Changes in how often you have bowel movements,

4.) Mucus in your stool.

Your colon has layers of muscles that tighten up and relax. That steady rhythm moves food and waste through your intestines. But, with IBS, the muscles in your colon do not contract like they should. Strong or weak contractions can cause cramping and bloating.

Your Rights to Long Term Disability benefits with Irritable Bowel Syndrome

The symptoms of pain, bloating, and discomfort can interfere with your ability to perform the essential duties of your occupation. It’s crucial those symptoms be developed in your medical records, if you want to be successful in your claim for Long Term Disability benefits.

Long Term Disability carriers do not always make it easy for IBS sufferers to get the disability benefits they deserve. Contact IBS Attorney Nancy Cavey, who can help you get the Long Term Disability benefits you deserve regardless of where you live in the United States. Call today for a complimentary consultation at 727-894-3188.

Celiac Disease and Your Rights to Long Term Disability Benefits.

celiac disease attorney disability

Celiac Disease is a permanent intolerance to wheat protein and related alcohol soluble proteins (prolamins) found in rye and barley.

celiac disease attorney disability

Celiac Disease can lead to an autoimmune disease, which can result in inflammation and malabsorption of critical vitamins, minerals and calories and eventually a long term disability.

Signs and Symptoms of Celiac Disease

These signs and symptoms can include:

1.) Diarrhea,

2.) Iron deficiency anemia,

3.) Lactose intolerance,

There are also “non classical” symptoms, like abdominal pain, The key to confirming the diagnosis is a small intestinal biopsy, and your response to a gluten free diet.

Because Celiac Disease is an autoimmune condition, you may have a long term disability permanent intestinal damage, unlike those who are simply allergic to wheat or gluten intolerance.

The long term disability benefits insurance company does not always make it easy for those with Celiac Disease to get Long Term Disability Benefits.

You can learn more about your rights to Long Term Disability if you have Celiac Disease by contacting Tampa Bay Celiac Disease Attorney Nancy Cavey who can help you get the Long Term Disability Benefits you deserve.

Osteoporosis and Your Right to Long Term Disability Benefits.

Osteoporosis disability lawyer

If you have purchased a Long Term Disability policy through your employer or on your own, you may be entitled to Long Term Disability Benefits, if your doctor has told you that you are unable to work as a result Osteoporosis disability lawyerof Osteoporosis.

How is Osteoporosis Diagnosed?

A Bone Density Test is the only test that can diagnose Osteoporosis before broken bones appear. It can also,

1.) Predict your chance of breaking bones in the future,

2.) See if your bone density is getting worse or staying the same,

Bone Density Tests

The National Osteoporosis Foundation recommends a Bone Density Test of the hip and spine using Central DXA machine Dual-Energy X-ray Absorptionetry, to diagnose Osteoporosis. Health care providers will measure bone density in hip and spine. People with Osteoporosis have a greater chance of fracturing those bones.

Broken bones in your hip or spine can cause serious problems which lead to an inability to work.

Completing the Social Security Disability Application can be a time consuming process. It’s important to explain your Osteoporosis symptoms and how the symptoms impact your functionality.

It’s also important that your doctors support your claim for Social Security Disability Benefits as a result of Osteoporosis. Ask your doctor if they’ll fill out a Residual Functional Capacity Form.

You can learn more about Osteoporosis and your right to Social Security Disability Benefits by contacting Osteoporosis Disability Attorney Nancy Cavey who can help you with your Social Security Disability Claim regardless of where you live in the Tampa Bay Area.

Physician Support for Your Long Term Disability Claims! Crucial!

If you have purchased a Long Term Disability policy through your employer or on your own, you may be entitled to Long Term Disability benefits if your physician has told you that you are unable to work.

Let’s be frank! A claim for disability benefits will never be approved without the support of your treating physician. Your doctor has to certify and document in your medical records you have restrictions and limitations that prevent you from working either in your occupation or any occupation.

Nancy Cavey, A Nation Wide Long Term Disability Attorney, thinks it’s crucial that you provide your doctor with an interval medical history of your symptoms and how those symptoms impact your function on a daily basis. Your doctor can properly document your medical records about your disabling condition with that crucial information.

Most doctors just don’t have the time to generate detailed medical records that documents the objective basis of your symptoms and how those symptoms impact your ability to function.

Most Long Term Disability carriers routinely deny a claim for Long Term Disability benefits based on insufficient support in your medical records. Worse yet, they’ll use Medical Disability Advisor, by Dr. Presley Reed, to determine just how long you should be disabled. (Not long!)

The Long Term Disability Claim system is rigged against unsuspecting disability policy holders.

Long Term Disability Attorney Nancy Cavey will review your medical records and work with you and your treating physician to obtain the right medical documentation to support your disability claim, she’ll help you get the benefits you and your family deserve.

You can learn more about the Long Term Disability claims application process and the games Long Term Disability carriers play with your medical records by contacting her today at (727)-894-3188 for a free no obligation consultation.

Continuing Disability Statements and Your Rights to Long Term Disability Benefits: The Introduction

You may have received a phone call or letter from your long term disability carrier advising that they want to take “a continuing disability statement”, they may even come to your house to attempt to take the statement which I strongly discourage. The introductory part of the continuing disability statement will include:

1. The agreement that the interview site is an agreeable location
2. Identify who is present and their relationship, if any, to you
3. The day’s date and time
4. Your acknowledgement that the interview is going to be recorded and your agreement to the same
5. Questions as to whether you are under the influence of any alcohol or drugs
6. Question about your prescription medication that would impair your ability to provide a statement
7. Any diagnoses of any mental or physical condition that would prevent you from understand or answering questions
8. Your agreement that you can provide a clear and coherent interview
9. Identification by you of the medical conditions that currently prevent you from working.

There are number of traps in this introduction but first and foremost is your agreement to give a statement at your home. The disability representative will be taking notes about what your yard looks like, what the interior of your house looks like, your ability to move in or around our house, greeting the representative, how you sit or move or about throughout the interview and what assistive devices you may be using.

Another trap involves your failure to record the interview. Interviews are a two way street and many times you keeping your own recording is way to keep the long term disability carrier “honest”.

If you are taking prescription medication, be prepared to identify any side effects that you are having as a side effect of those medications that will interfere with your ability to give a statement. For example, some medications can make you tired, dizzy, or cause slowed cognition, or slurred speech and your certainly don’t want to be giving a statement if you are under the influence of those medications.

Describing your medical condition can be a trap in that there might be multiple medical condition each of which individually cause you to be disabled, or when combined, cause you to be disabled. Many long term disability recipients simply don’t understand the combined impact of multiple medical conditions or multiple medications on their ability to work.

You should be thoroughly prepared, even for the introduction of a disability statement.

You can learn more by ordering long term disability ERISA attorney Nancy Cavey’s book The Smart Long Term Disability Consumer Guide for Preparing for Your Statement and Field Visit.

What Happens After your ERISA Lawsuit has been Filed?

erisa lawsuit

You purchased a long term disability policy to provide you with peace of mind. But, when you least can afford it, your disability carrier has denied your benefits and has rejected your appeal.

Your next and only recourse is to hire a long term disability attorney to sue your long term disability carrier. Your attorney will file what is called a complaint which outlines the facts of your case and why you are entitled to benefits. There generally is no activity for 60 to 90 days after a claim is filed. Why? The complaint is filed and then served on a defendant who, in turn, has to “answer” the complaint within 20 erisa lawsuitdays after the lawsuit is filed.

There “answer” is nothing more than the formal denial of the allegations of the complaint.

After the answer is filed, the court will issue a scheduling conference order directing the attorneys to confer about the scheduling of events in your case including, taking depositions, disclosing experts, filing motions, mediation, pretrial and trial.

The scheduling conference takes place about two to three months after the law suit is filed and establishes a time table for the parties to complete the discovery, conduct mediation and have a trial date.

Each court has there own local rules. These dates might vary depending on where you live. In any event, it may seem that nothing is happening until the scheduling conference. And, quite frankly, that’s incorrect. Many ERISA long term disability attorneys are drafting what’s called interrogatories and requests to produce which they can file as soon as the scheduling conference order is issued.

Need Help With Your ERISA Lawsuit?

You can learn more about the ERISA mediation process by contacting ERISA disability attorney Nancy Cavey who can help you with your claim regardless of where you live in the United States.

The Initial Application for Short Term or Long Term Disability Benefits Can Make or Break Your Case

long term short term disability cases

Completing your initial application without consulting a disability attorney is a setup for failure. You should formulate a plan of attack for winning your long term disability claim before you willy nilly complete an initial disability application with hopes that your carrier will Fedex a disability check to you.long term short term disability cases

Applications often contain vague questions that are misleading or will bait you into submitting incomplete information. Worse yet, having an irregular disability policy you don’t even know the standard proof you need to establish to show that your disabled as a result of your medical condition.

You will also be asked to have your physician complete an Attending Physicians Statement, or APS form, which will also have vague and misleading questions. As part of the initial disability application process it’s crucial that you discuss with your physician filling out the disability forms and the standard of a disability. You may be surprised that your physician wont fill out the disability agreement form or even support your claim for disability benefits.

Short and long term disability application attorney Nancy Cavey helps place you in the best position to secure your social security disability benefits. By:

1. Reviewing your policy;

2. Reviewing your medical records;

3. Creating a plan of attack and strategy for submitting a winning short and long term disability application;

4. If necessary consulting with your physician and helping them understand how to properly fill out the short or long term disability application;

5. Help you prepare and accurate description of your occupation;

6. Help accurately and fully complete your disability application.

Questions About The Initial Application For Short Term or Long Term Benefits?

If you have questions regarding the initial application for short or long term disability benefits or how to appeal a claim that’s been denied, you should immediately consult with Nancy Cavey. A severe medical condition makes it impossible for you to work, Nancy Cavey can help you cut through the red tape and fight for your benefits no matter where you live in the United States. Contact her today at 727.894.3188.

Tricks Long Term Disability Carriers Will Use to Deny Your Claim for Disability Benefits

long term disability carrier tricks

Many long term disability carriers will use a paper review of your file conducted by its internal medical personnel to determine whether or not there is:

1. An objective basis of your severe diagnosis.long term disability carrier tricks

2. An objective basis for the restriction of limitations that have been assigned.

3. A causal relationship between your diagnosis and or restrictions limitations in your inability to perform your own occupation.

It is not unusual for long term disability carrier’s medical personnel to determine your records do not indicate an inability to return to work.

Next weapon that long term disability carriers will use is a functional capacity evaluation to determine your restrictions and limitations. A long term disability carrier will select a bias FCE provider who will give the long term disability carrier exactly what they want- a reason to deny your claim either on the basis you didn’t fully cooperate with the FCE or that the restrictions and limitations indicate that you can engage in at least sedentary work.

It’s not uncommon for long term disability carriers to cherry pick the portions of the functional capacity evaluation to support their position to terminate benefits.

The third trick that long term disability carriers will use is to place you under video surveillance to justify a termination of the benefits. They’ll use it as a one two combination with your statement to show that you are exaggerating your complaints or functionality as compared to what is shown on the video tape.

Long term disability attorney Nancy Cavey will systematically attack long term disability carriers positions using their own evidence against them. She’ll also supplement your file with additional medical evidence to support your claim for disability benefits It is not unusual for long term disability appeal letter alone to be 65 pages long and, with additional medical and vocational support, to be hundreds of pages long.

If you suspect that your long term disability claim is being setup for a denial keep in mind those three tricks that long term disability carriers will use to justify their claims denial.

Long term disability carriers will go to any lengths to deny your benefits. Long term disability attorney Nancy Cavey handles long term disability claims throughout the United States and has represented claimants against every major long term disability carrier.

For a free consultation regarding your long term disability claim you can call 727.894.3188.

Do ERISA plans have to abide by Social Security Disability benefit award?

ERISA plans

No, the United States Supreme Court in MetLife vs. Glen, 554 US 105 (208), was troubled when MetLife encouraged Mr. Glen to apply for Social Security Disability benefits, reduced his long term disability benefits by the receipt of the Social Security benefits and then ignored the Social Security finding entirely in denying the long term disability benefits.

Many ERISA plans require claims to apply for Social Security Disability benefits and they even provide legal ERISA plansassistance to provide those benefits. Since the Glen decision, many long term disability insurance companies have been careful to reconcile the Social Security determination with their ultimate ERISA plan denial. In other words, they simply can’t ignore the decision but they are not bound by it.

Why?

The Social Security Administration has unique rules and procedures in making Social Security rules and determinations. As a result, courts do not view an award of Social Security benefits as the equivalent of disability on a ERISA disability policy.

As a result, ERISA long term disability insurance companies are now required to make a distinction between a Social Security Disability benefit decision and their denial. If they don’t, that can be grounds for appealing a denial of long term disability benefits.

If you have been awarded Social Security Disability benefits, and your carrier doesn’t discuss those benefits in it’s denial decision, you should contact disability attorney Nancy Cavey who can get the long term disability benefits that you deserve regardless of where you live in the United States.

Why Should I Appeal the Denial of my Disability Benefits?

You purchased a long term disability policy to provide you and your family peace of mind. Unfortunately, long term disability carriers are not in the business of paying disability benefits to their policy holders. They would rather collect the premium. So, what happens after you have submitted your claim and you have been denied? There are two reasons why you should appeal the denial of your disability benefits. Why?

1. Your appeal is your last chance to submit evidence of your disability.

You can actually get a copy of your file from your disability carrier which will help you determine the real reasons why your plan got denied. It isn’t uncommon for claim’s to be denied on the following basis: 1. No objective basis for diagnosis; 2. No objective basis of your restrictions and limitations; 3. No casual relationship between the diagnosis or restrictions and your inability to do your own or any occupation.

There is no trial in an ERISA case and, as a result, the court will decide your case entirely based on what was in the insurance companies claim file at the time of your last appeal.

That’s why it’s important that you secure the services of an experienced long term disability attorney.

Screwing up your appeal by handling it yourself only screws up the appeal but potentially screws up your lawsuit. There are many things that can and should be done to develop the medical and vocational evidence. This can include:

- Undergoing a functional capacity evaluation;
- Vocational evaluations;
- Statement from your physician addressing the reasons why your claim was denied;
- Statements of family, friends and even your employer.

2. If you fail to timely submit an appeal, you may be barred from suing your insurance company. This sounds weird but if you have fail to timely appeal the denial, the long term disability carrier may say that you fail to “exhaust your administrative remedies”. That appeal is your administrative remedy and if you do not use it, you can’t get back and fix it once the appeal deadline has passed. So, appealing the denial of benefits in time only gives you a chance to get your benefits reinstated but preserves your right to sue the disability insurance company.

To learn more about appealing the wrongful denial of your disability claim, contact long term disability attorney Nancy Cavey who can help you regardless of where you live in the United States.