In a case of Orange County v. Wilder, the 1st District Court of Appeals has ruled that viral cardiomyopathy constitutes heart and “heart disease” as the term is used in Section Florida Statute 112.18. If a presumption applies, a first responder is under no obligation to establish occupational causation and the employer has the burden to prove that they did not get the virus at work.
Are you a first responder and have a question about this issue? We represent all over the state of Florida First Responders who need help just like in this situation. Give us a call 727-894-3188 to talk to an attorney that can help.
Article noted from FEBRUARY 1, 2013 FLORIDA LAW WEEKLY
The 1st District Court of Appeal recently ruled that there is no requirement that an Employer/Carrier provide injured law enforcement officers information regarding the statutory presumption.
Officer Guevara was employed by the City of North Bay Village and was placed on light duty on March 15, 2007 after a physical revealed his blood pressure was elevated. His supervisor completed a Notice of Injury and the City of North Bay Village, through Florida Municipal Insurance Trust/Florida League of Cities, sent Officer Guevara an initial claim packet which included an informational brochure approved by the Department of Financial Services.
The packet did not enclose any information about a statutory presumption for injuries sustained by law enforcement officers. Unfortunately, Officer Guevara filed his Petition for Benefits seeking Worker’s Compensation benefits late.
The employer/carrier denied the claim on the basis that the statute of limitations defense had run and the Judge disagreed finding that the packet was so generic that it didn’t provide any meaningful information to Officer Guevara about the statutory presumption of causation afforded law enforcement officers under Section 112.18(1).
However, the 1st District Court of Appeals reversed the decision finding that Employer/Carrier’s don’t have a statutory duty to provide injured law enforcement officers details regarding the statutory presumption of compensability on first responder cases.
If you are a first responder and need help with this issue, give us a call today. We may be able to help you with your situation.
Many long term disability carriers are in the business of collecting premiums and not paying benefits to fibromyalgia policy holders. Many long term disability carriers will deny fibromyalgia claims on the basis that fibromyalgia is largely based on self reported symptoms and that there isn’t any objective evidence of restrictions and limitations.
It’s not uncommon to see a denial letter language that describes fibromyalgia syndrome as a functional somatic syndrome. The denial language will say that FMS sufferers symptoms are “exacerbated by a self-perpetuating, self-validating cycle in which common, endemic, somatic symptoms are incorrectly attributed to serious abnormality, reinforcing the patient’s belief that they have a serious disease.” Barsky A. Borus J: Functional Somatic Syndromes (review). Ann Intern Med. 1999: 130:910-921.
Further, the long term disability companies will cite to an outdated study in the Journal of Rheumatology of 1996 called the “FMS Consensus Report.” The outdated report concludes that “only a minority of FMS patients are unable to work.”
Long term disability carriers use this study to justify claims denials on the basis that “at a minimum, FMS claimants should be able to perform sedentary or light work.”
If your claim for long term disability benefits has been denied, contact fibromyalgia long term disability attorney, Nancy Cavey, at 727-894-3188 who can help you get the benefits you deserve no matter where you live in the United States.
The Employer Retirement Income Security Act of 1974 governs employee welfare benefit plans, including disability insurance plans.
ERISA is not a plaintiff friendly statute and, fortunately, there are plans that are not governed by ERISA. These include plans by:
• Plans maintained for the purposes of complying with Workers’ Compensation; and
• Plans maintained outside the United States for the benefit of persons for non-resident aliens.
The great news is that if you’re employed by a government agency such as state or a local government, your long term disability benefits are not governed by the ERISA statute.
You can learn more about your rights to short and long term disability benefits by contacting governmental plan disability attorney, Nancy Cavey, who can help you regardless of where you live in the United States.
Your employer should be able to provide you with a copy of the summary plan of description (SPD) which provides you with a description of the benefits that you may be entitled to as a result of disability, the definition of disability and how to make a claim for benefits.
You can also request relevant documents from the plan under a 29CFR Section 2560.503-1(N)(8) if your benefits have been denied. Long term disability carriers are required to provide you with a copy of documents to:
• Rely on in making the benefit determination;
• Submit, proceed or generate in the course of making a benefit determination, regardless of whether relied upon;
• Demonstrates compliance with administrative procedures in making benefit
determinations in accordance with the plan documents; and
• In a case of denied disability benefits, constitutes a statement of policy concerning the denied treatment, regardless of whether relied on in making the benefit determination.
If you’re thinking about applying for disability benefits or your claim has been denied, you should obtain these important documents to learn about your rights.
If you have questions about the disability claims process or your claim is wrongfully denied, long term disability attorney, Nancy Cavey, can help you get the disability benefits you deserve. Call her today at 727-894-3188.