Free Consumer Reports

  • 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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Tag Archives: claim

I have applied for Social Security Disability Benefits and wonder why I have been scheduled for a Social Security Disability medical exam?

FAQ: I have applied for Social Security Disability Benefits and wonder why I have been scheduled for a Social Security Disability medical exam?

If you do not have enough medical documentation to support your claim or you haven’t gotten treatment within sixty days as part of your Social Security Disability application, the Social Security Administration will, most likely, schedule you for what is called a Social Security Disability medical exam or consultative exam. It is crucial that you be prepared for what will happen at the Social Security Disability medical examination and that you be honest and trustworthy. While it is not the job of the Social Security Disability medical doctor to award you benefits, what they say in their report can make or break your Social Security Disability claim.

How to Calculate Your Long Term Disability Benefits and the Insurance Carriers Right to a Social Security Offset

Did you know that many long term disability policies are written so that the long term disability insurance company gets to reduce your long term disability benefits by the receipt of “other income” which can include your Social Security Disability benefits, your family member’s Social Security Disability benefits and even workers’ compensation benefits. But it’s worse! Not only does the short or long term disability insurance company get to reduce your monthly long term disability benefits by your monthly Social Security benefits, they will often sue you to recover your back long term disability benefits arguing that you have been “overpaid”.

How does this work?  Under most long term disability policies, you get a percentage of your pre-disability wage, so, for example, if you made $24,000 a year before you became disabled, your pre-disability income would be $2,000 per month. Many long term disability policies pay a percentage of your pre-disability wage which commonly is about 60%. In our example, the gross monthly long term disability benefits would be $1,200.

Now the deductions begin! If you receive Social Security Disability benefits in the amount of $600 per month and your child gets $300 per month in dependent benefits, that $900 will be subtracted from your monthly long term disability benefits. Your net long term disability benefits will only be $300 per month.

Unfortunately, it takes as long as two years to get Social Security Disability benefits. Long term disability carriers will ask you to sign a repayment agreement in which you agree that you will repay the long term disability carrier any overpayment as a result of the later receipt of Social Security Disability benefits. The long term disability carrier will let you collect your full long term disability benefits, but they want their money back immediately if you get your Social Security Disability benefits.

Many times the back balance is in actual policy.

Whether the long term disability carrier can get repayment for an overpayment varies from the United States District Court to district.

Here in the 11th Circuit in Florida, the court has ruled that if you have dissipated or spent the money, that you got for the overpayment that you do not have to repay the long term disability carrier in a lump sum. However, some of the courts in the district in the 11th circuit have indicated that nothing prevents the long term disability carrier from reducing your monthly benefits by the receipt of your Social Security Disability benefits and any pro-rider reduction to recoup the lump sum for overpayment that occurred when you got your back Social Security Disability benefits. In other words, it appears as if in the 11th Circuit, a long term disability carrier is going to get their money one way or the other.

Is Your Social Security Disability Claim Vulnerable Because Your Social Security Disability Attorney Doesn’t Know the Ten Things that Should Be Done in Every Social Security Disability Claim?

Social Security Disability law is complicated and time consuming. However, an experienced Social Security Disability attorney, such as former Social Security Disability staff attorney, Sharon Barrett, knows that there are ten things that should be done in every Social Security Disability claim:

  1. Meet with you personally to discuss your Social Security Disability claim.
  2. Explain the Social Security Disability claim’s process and explain the strategy which will be implemented to win your claim.
  3. Get a copy of your Social Security file from the Social Security Administration.
  4. Get a copy of your medical records.
  5. Assess your claim and determine whether or not it will meet Social Security Disability rules.
  6. File all necessary papers with the Social Security Administration.
  7. Timely appeal any denial of your claim.
  8. Timely request a hearing if your claim is denied after a Request for Reconsideration.
  9. Prepare a comprehensive Memorandum of Law with medical documentation supporting your claim for Social Security Disability benefits.

10.  Prepare you for a hearing in front of the Administrative Law Judge and make sure that your case is presented in the best light possible.

If your lawyer doesn’t understand the Social Security Disability claims process, or hasn’t taken these steps in handling your Social Security Disability claim, you may not have the right attorney to represent you in your Social Security Disability claim.

Experience does make a difference.

Sharon Barrett, former Social Security Disability staff attorney in the Tampa Bay office knows what it takes to create a winning Social Security Disability claim. If you have a Social Security Disability claim, give us a call today to help you answer any questions you may have. 727-894-3188.

If You Don’t Understand the ERISA Regulations Requiring the Disability Carrier to Make a Timely Decision On Your Claim, You’ll Hate Yourself!

If your short or long term disability claim is ERISA claim covered by federal law, the ERISA regulations provide, that “in the case of a plaintiff disability benefits, the plan administrators shall notify the claimant… of the claimant’s adverse benefit determination within a reasonable period of time, but no later 45 days after the receipt of the claim by the plan. This period may be extended by the plan for up to 30 days, provided that plan administrator both determines that such an extension is necessary that it matters in the control of plan and notifies the claimant prior the expiration after the initial 45 day period, the circumstance requiring the extension the time and the date by which the plan expects to render a decision.”

Further, the rules provide for two 45 day extension periods.

The notice of extension, must “specifically explain the standards on which the entitlement to a benefit is based, the unresolved issues the present the decision on the claim, and the additional information needed to resolve those issues.” You will be given at least 45 days in which to provide that information.

If you have filed a long term disability claim and the carrier is making too long to make a decision or they have told you that there is more information that they need, and you have 45 days to respond, you should contact Cavey and Barrett, Florida’s long term disability claim delayed or denied attorneys who can assist you in securing the benefits that you may be entitled to as a result of a disability.

If You Don’t Understand the Games Employers are Playing in Managing Short Term Disability Claims, You’ll Hate Yourself Later

Short term disability attorney Nancy Cavey is seeing employers for short term disability cases is to limit the eligibility periods to as short as thirteen weeks, or more commonly, terminating short term benefits before full recovery.

In the last six months Nancy Cavey has seen the termination of benefits before full recovery either causing a premature forced return to work or a delay in obtaining long term disability benefits. In some instances this may be a strategy designed to make absent employees to seek employment elsewhere or join unemployment.

If your short term disability claim is being delay or denied contact short term disability benefits denied attorney Nancy Cavey for a free, no obligation consultation today by calling 727-894-3188 or filling out the form on the right side of this page to contact us as soon as possible.

Assembling a Paper Trail and Your Long Term Disability Carrier

Unfortunately, long term disability carriers have a habit “losing” important information that you might send to them, including activity of daily living forms. Nancy Cavey has written an informative book The Smart Long Term Disability Consumer Guide for Preparing for Your Statement and Field Visit that you should have before completing any long term disability activity of daily of living forms.

If you are submitting those forms or any other evidence, make sure that you’ve assembled a paper trail that can be followed. That means that you keep a copy of everything that you send and send it certified mail. If you have a conversation with your adjuster, make a summary of it and keep it in your records because you may need it in the future. Assembling a paper trail can be key to winning your long term disability claim.

Are You the Star in a Long Term Disability Movie? How Long Term Disability Carrier’s Use Surveillance to Sabotage Your Case

Video surveillance, under the right circumstances, can provide an overwhelming reason for the Long Term Disability carrier to deny your Long Term Disability claim. It can also capture a mere snapshot in your life and fail to reveal the complete picture of your disability. For example, surveillance may show you at a family gathering, but not show the resulting excruciating pain and misery you suffer for days after.

Long Term Disability carriers use surveillance to document what you do during your day, including the activities of daily living like running errands, filling up your gas tank or going to the bank.

All this minimal activity doesn’t necessarily establish that you are capable of working, but it can be used for the worst to sabotage your case. How so?

Is there a Good Book on Long Term Disability Policies for Florida Long Term Disability Policies Holders that You Would Recommend?

Nancy Cavey, a Long Term Disability ERISA lawyer who practices in Florida, has written two free consumer guides. Robbed of Your Peace of Mind and The Smart Long Term Disability Consumer Guide For Preparing For Your Statement and Field Visit, to help you understand terms you don’t want to see in your insurance policy and the games that Long Term Disability carriers play in denying your claim.

Disability Attorney Nancy Cavey Helps Long Term Disability Insurance Claimants Understand Their Long Term Disability Claims Process

Disability insurance companies like to collect premiums but fight hard to protect their cash reserves, denying claims.

Unfortunately it is not uncommon for Long Term Disability insurance companies to deny or delay a claim, which can lead to financial disasters for Long Term Disability policyholders.

It is important that you understand the Long Term Disability claims process before you file a claim for Long Term Disability benefits. Disability insurance attorney Nancy Cavey suggests that before you file your Long Term Disability claim that you do the following:

1. Find your policy

2. Read the policy and directions for filing your claim. Follow every step in the policy.

3. Make a copy of everything you send, and send everything by Certified Mail Return Receipt Requested.

4. While Nancy Cavey does not recommend that you speak on the phone with the adjuster, if you do so, document the phone conversation by making notes or have a family member listening who can also make notes. All communications with the Long Term Disability insurance company should be in writing.

5. Get a copy of your medical records before you file your Long Term Disability claim and review them thoroughly. If there are things that need to be corrected or supplemented make sure that is done before you file your Long Term Disability claim.

6. Let you doctor know that you will be filing a Long Term Disability claim and see if you doctor supports your claim. If they don’t, Nancy Cavey suggests that you find a doctor who will not only treat you, but who will support your claim for disability.

7. Look at your personal financial situation and determine how you are going to survive if the Long Term Disability carrier denies your claim.

8. Consider filing for Social Security Disability benefits at the same time you file your Long Term Disability application.

Nancy Cavey protects the rights of individuals with disability claims and litigates Long Term Disability and ERISA cases throughout the United States against Long Term Disability insurance companies who wrongly delay or deny Long Term Disability claims.

Why Every Medical Professional Should Have a Disability Claims Consultation Before Filing a Claim for Long Term Disability Benefits

There are many stumbling rocks in the disability process. Before a medical professional considers filing a claim for disability benefits, there is help available. You have a difficult decision to make about whether and when to apply for disability benefits and how to maintain your practice as you move through the disability process.

Disability claims advice should include the following:

1. A professional review of your disability policies, including business overhead policies, a written summary of your benefits and a potential problem errors as you move through the disability claims process.

2. An analysis of your pre-disability income so that you have a baseline of determining the amount of your benefits.

3. An understanding of your ability to work while disabled and the potential to collect residual disability benefits while you continue to work.

4. A complete understanding of your monthly benefits and any reduction of those benefits by the receipt of Social Security Disability, 401k benefits or other income that could be used to reduce your benefits.

5. An analysis of your medical condition, likely date of disability and its impact on your practice. You should have a discussion about your individual situation based on your personal and professional needs.

The disability claims process is not trouble free and more often than not, can be a long, difficult and exhausting process. You should find a Long Term Disability attorney who can provide consultation, monitoring and hands on work in every phase of applying for and receiving and continuing to receive your Long Term Disability benefits.

Unfortunately, sometimes professionals wait until they are so incapacitated that their family and friends have to help them through the disability claims process. Don’t put you or your family in that situation.