Financial Preplanning and Your Claim for Long Term Disability Benefits | Florida St. Petersburg Long Term Disability Lawyer

At Cavey and Barrett we want to remind you that your financial pre-planning did not begin and end with the purchase of a long-term disability policy. That was only the beginning!

You still have to make significant plans for your financial future. What do I mean?

If you suffer from a gradual onset disease like degenerative joint disease, Parkinson’s disease, Lou Gehrig’s disease, multiple sclerosis, or Alzheimer’s, the disease process will give you the time you need to make significant work and financial decisions.

There are a number of steps that you must take, sooner and not later, in financial pre-planning.

1. Learn about the disease and how it progresses over time.

It is important for you to understand how your disease will impact your ability to work, how it will progress over time, what your future medical needs are going to be, and when
you will become unable to work.

The answers to these questions will impact how long you will be able to work and maintain any group insurance coverage.

2. Look at your current financial condition and determine how it might change over time.

This step requires a critical look at your current financial condition and obligations.
What are your assets? Is there any disability coverage that would make the mortgage payment if you’re unable to work or disability policies that would make the payment on vehicles or for consumer debt? How much do you owe? Do you have a budget? How would that budget change if you become disabled? Can you get your finances under control in the time frame you have available to continue working? If not,
how were you going to meet those obligations?

Do you know how long it takes to get Social Security disability benefits? When would you be entitled to Medicare? Can you afford to Cobra your group insurance coverage? How long can you Cobra your group insurance? Is there going to be a gap in time between you running out of group health insurance coverage and becoming eligible for Medicare? Can you find alternative insurance?

3. Set financial goals.

These financial goals can be short-term or long-term. Do you have flexibility built in to these goals as your condition changes? How are you going to be able to live on a reduced income? How are you going to get medical treatment with reduced or limited medical benefits?

4. Obtaining assistance.

It is crucial that you understand what your long-term disability policy provides in the way of benefits, whether those benefits can be reduced by various offsets such as Social Security, how long you are entitled to benefits, and what limitations may exist on your coverage.

It is also crucial that you understand your rights to Social Security disability benefits and the amount of benefits you might be entitled to, including dependent benefits. Many states have a significant delay in getting a Social Security disability hearing. Your data eligibility for Medicare will depend on the date you become disabled for Social Security disability purposes.

It may be necessary for you to hire a long-term disability or Social Security disability Attorney and you can use this time to get answers to your questions. You may also have to consult with your insurance agent, tax advisor or financial planner.

5. Make flexible decisions.

As your disability progresses, your options will change, and you need to be prepared financially to address those changes. Having a game plan before your disability progresses gives you more control.  Unfortunately, your options can become significantly limited if you have failed to get advice before you become disabled. It’s not uncommon that these decisions become more typical as your disease progresses
and your ability to make those decisions comes compromised.

Financial pre-planning is a team effort, and one that should be done earlier and not later. Don’t place yourself in a situation where you have to struggle to make difficult financial decisions in a time of need.

You can learn what 7 tips for which Long Term Disability Policy Holders should apply.

Experienced long-term disability/ERISA and Social Security attorney Nancy Cavey can provide guidance to you in the financial preplanning required as a result of your disability.

If you have any questions, please give us a call at 727.894.3188 or contact us online by clicking here.

Rate this:

Can a Long Term Disability Insurance Company Make You Use Allsup, Occudanta, Advantage 2000, Disability Services, Inc. for your Social Disability Claim? Tampa, St. Petersburg, and Clearwater Long Term Disability ERISA Attorney

Many long-term disability insurance policies require you to apply for Social Security disability benefits, and will offer the services of companies like Allsup, Occudanta, Advantage 2000, or Disability Services, Inc. to help you with your Social Disability Claim. Should you use these companies?

As an experienced long-term disability/ERISA and Social Security disability Attorney, my answer is unequivocally “No”!

Of course, some may think my answer is based on the fee I might earn on the Social Security disability claim. Nothing is further from the truth!

In my experience, most of these companies have non-attorney representatives handling the Social Security disability claim. The quality of this representation is suspect. I have had long-term disability cases where the company recommended by the long-term disability carrier did not develop the evidence properly before the Social Security administration. I have had other cases where the company recommended by the long-term disability carrier has purposely developed a condition, such as fibromyalgia or psychiatric conditions, so that they can only only provide limited long-term disability benefits. In other cases they have ignored proceedings on Social Security disability claims that could entitle the applicant to continued long-term disability benefits.

If you do get Social Security disability benefits, you are generally entitled to a retroactive lump sum payment. The long-term disability carriers want their money back – immediately. Allsup, Occudanta, Advantage 2000, and Disability Services, Inc. will have you sign an agreement that allows them to automatically take a withdrawal from your checking account on any overpayment that might be due to your long-term disability insurance company. On the face of it, that’s fair.

However, more often than not, long-term disability carrier’s will immediately suspend the payment of your long-term disability benefits when you been awarded Social Security benefits saying that you are “no longer disabled” based on your long-term disability policy requirements.

As long as you keep the Social Security overpayment in your checking account, you and your long-term disability attorney will have greater leverage with a long-term disability insurance company to get your long-term disability benefits reinstated

Unfortunately, I find  long-term disability carriers use these companies for their own best interests. They want these companies to help you get Social Security disability benefits so that they can take back all the long term disability benefits that you’ve been paid, and then justify their immediate suspension of your long-term disability benefits.

These companies will  also share with your long-term disability carrier the medical reports they obtained or developed in your Social Security disability claim. If they develop a bad report, you can be assured that report will get to your long-term disability carrier and be a basis for denial of your long-term disability claim.

Allsup, Occudanta, Advantage 2000, and Disability Services, Inc. will tell you if they work for you when, in fact, they get the referrals from a long-term disability carrier and get paid by the long-term disability carrier. They will use any agreement you sign to suck out of your checking account any Social Security benefits you get, and they will share the bad information about you with your long-term disability insurance company.

What should you do? If you have signed a contract with Allsup, Occudanta, Advantage 2000, or Disability Services Inc., send a one sentence letter to the Social Security administration terminating their services. If you signed an authorization allowing Allsup, Occudanta, Advantage 2000, or Disability Services Inc., to take money from your checking account, you need to revoke it immediately by writing to your bank and keeping a copy for your records. Send Allsup, Occudanta, Advantage 2000, or Disability Services Inc. a copy of that revocation by certified mail.

Allsup, Occudanta, Advantage 2000, and Disability Services, Inc. may tell you that the long-term disability carrier won’t include any attorney’s fees paid to Allsup, Occudanta, Advantage 2000, or Disability Services, Inc. in any long-term disability overpayment calculations. There are anti-discrimination provisions in ERISA, so that if a long-term disability carrier pays a fee to any of these companies or reduces the overpayment by a Social Security attorney fee, it has to do the same thing if you hire a private Social Security disability Attorney. Don’t be intimidated!

You should find an attorney who does both Social Security disability and long-term disability/ERISA litigation. Cavey and Barrett are experienced Social Security disability and long-term disability attorneys based in St. Petersburg , Florida , who coordinate the handling of both claims. We develop the necessary evidence needed in both Social Security disability and long-term disability claims and handle cases nationwide.

If you can’t find a lawyer who does both, make sure that your Social Security disability lawyer is coordinating his or her work with your long-term disability attorney. There are times when the Social Security disability lawyer can be working at cross-purposes. For example, they may be developing a psychiatric aspect of your claim for Social Security purposes and be unaware that there is a limitation in your long-term disability policy for mental conditions.

Don’t be taken advantage of by your long-term disability insurance company or Allsup, Occudanta, Advantage 2000, or Disability Services, Inc. Protect yourself by hiring an experienced long-term disability/ERISA and Social Security disability Attorney, such as Nancy Cavey.

If you have any questions, please give us a call at 727.894.3188 or contact us online by clicking here.

Rate this:

How Long Term Disability Physician’s Companies Use The Dual Occupation Defense to Deny Physician’s Claims| Clearwater Long Term Disability Insurance Lawyer

Are you a physician who has multiple specialties or businesses? If so, you must properly protect yourself in the event that you become disabled, because one of the common defenses to a long-term disability claim is the “dual occupation” defense. What is this defense?

The long-term disability insurance company will argue that you have two or more occupations at the time you claim to be disabled. Because you’re able to work full time in one of those occupations, a long-term disability carrier will argue that you are not entitled to ANY benefits.

Let me give you some examples.

In Giampa v. Trustmark Insurance Co., 73 F.Supp.2d 22 (D. Mass. 1999), Dr. Giampa, a chiropractor, spent 85% to 95% of his pre-injury time treating patients by conducting examinations and performing manipulations or chiropractic adjustments. He injured his back, which limited his ability to perform manipulations. He had spent incidental time managing his two other chiropractic facilities before his injury.

After his injury, Dr. Giampa devoted all of his time to administrative duties managing the other chiropractic facilities, which resulted in a dramatic increase in his income. He claimed long-term disability benefits, which were denied.

His disability insurance policy had both a total disability clause and a partial disability clause.

The Federal Court decided that the total disability clauses should not be read so literally that an insured persons ability to perform some business duty, no matter how small, would prevent the finding of total disability.

Another twist on the dual occupation issue involved a dentist who had retired and begun working in the real-estate field.  He became disabled and filed a claim asking for the payment of long-term disability benefits based on his inability to perform dentistry. The court found that regardless of whether he intended, even after the sale of his dental practice to resume dentistry, dentistry wasn’t his regular occupation at the time he became disabled. The un-controverted medical evidence show that he was unable to perform most of the substantial material duties of his regular occupation as a real estate developer. The clause in the disability policy defined total disability as the inability to perform some substantial and material duties of his regular occupation. The long term disability policy  did not unambiguously require that he be unable to perform all of the substantial maternil duties of his occupation.

Another example involves the policy of a general surgeon who had on the side, developed a second business doing cosmetic surgeries including vein striping. Needless to say, that was far less stressful and more remunerative than doing general surgery. Unfortunately, he became disabled and unable to perform general surgery. Was he entitled to long-term disability benefits?

The answer could be found in the terms of the disability policy. He had a policy that looked at the occupation he was engaged in at the time of his disability and also had a residual disability provision. The residual disability provision paid benefits even if he was working at another occupation.

The residual disability provision said that “residual disability must follow right after a period of total disability that lasts as long as the qualification period, if any.” Huh?

This would seem to say that one could never get residual disability benefits, unless there was some initial period of total disability. Another question would be whether you had to be totally disabled from work as both a general surgeon and as a cosmetic surgeon to get benefits?

Another paragraph says that “This (residual disability benefit) will begin on either the commencement date or the day after the total disability ends up later.”  You could argue that if he are unable to do general surgery, but the same day could do vein stripping, the doctor  would be entitled to residual disability benefits.

You have significant choices to make and you can inadvertently shoot yourself in the foot and screw up your eligibility for disability coverage by making the wrong decision

It is crucial that you consult with a qualified long-term disability/ERISA attorney before you file your disability application to avoid making crucial mistakes that can result in the complete denial of your claim and cost you residual disability benefits.

You must determine what your policy says about the criteria for being disabled, what occupation your policy covers, whether there is a residual claim, what percentage of your revenue comes from both occupations, how your disability impacts your ability to perform both occupations, and how you’re going to prove that disability. That determination should be made BEFORE you even file your long-term disability claim.

Nancy Cavey, a long-term disability/ERISA lawyer, can be a great resource to you before you apply for long-term disability benefits. Nancy Cavey will be able to review your policy, advise you as to the best course of action to preserve your benefits and maximize your disability income, and assist you in gathering the necessary documentation to prove your entitlement to disability benefits.

Finding a lawyer with long-term disability/ERISA experience who has a proven background in dealing with physicians committee will make the difference between obtaining your long-term disability benefits or being denied. The lawyer who helped you set up your practice, helped you write your will and helped you purchase your house does not have the experience handling disability/ERISA claims.

Contact Attorney Nancy Cavey, who represents physician’s  through out the United States for more information on the dual occupation defense and to get your free no obligation copy of “Robbed of Your Peace of Mind.”

If you have any questions, please give us a call at 727.894.3188 or contact us online by clicking here.

Rate this:

Choosing The Right Disability Insurance Company | Florida Tampa Long Term Disability Insurance Attorney

The time to learn that you’ve picked the wrong disability insurance company isn’t when you’re sitting in a lawyer’s office. Unfortunately, there are many times I have to explain to my clients that they’ve picked the wrong disability insurance company.

There are many factors and variables that should be considered in picking out a disability insurance policy, which are discussed in Nancy Cavey’s book, Robbed of Your Peace of Mind, which is free of charge.

This article focuses on choosing the right disability insurance company.

First, and foremost, you should purchase an individual disability policy which you pay for yourself with post-tax dollars.

If you have any questions, please give us a call at 727.894.3188 or contact us online by clicking here.

Rate this:
2.0 (1 person)

Overhead Expense | Long Term Disability Insurance | Florida Tampa Long Term Disability Lawyer

Have you purchased an overhead disability insurance policy? When’s the last time you read it?

Most policies agree to “pay benefits to during a period of disability for covered overhead expenses which accrue while you are totally disabled after the elimination period.” These policies can define disability as the “inability to perform a substantial and material duties of your occupation.”

Overhead disability insurance policies also may pay benefits if you are partially disabled. “Partially” disabled can mean conditions where you are “unable to perform one or more substantial and material daily business duties” or are unable to do “usual daily business duties for as much time as you would normally take… to do them.”

An important provision in this policy was the definition of office expenses. “Covered overhead expenses” were defined as items of expense incurred by you, which are usual and customary in the operation of your business or profession. They must be generally accepted as tax-deductible business overhead expenses.”

There are lessons to be learned about these policies before you claim you are disabled and stop practicing.

In Uno v. Provident Life and Accident Insurance Company, Dr. Uno, a urologist, or became disabled and stopped practicing. He retired his medical license and canceled his medical malpractice insurance.  However, he continued to maintain his medical office, employing a part-time employee for the limited purpose of collecting accounts receivable, copying and mailing patient charts, paying bills and storing his financial and patient records.

Dr. Uno made a claim for benefits under the policy for expenses in maintaining is downsized medical practice. Provident ultimately denied his claim on the basis that is overhead expenses weren’t covered. Provident argued that Dr. Uno was essentially operating a collection agency

The trial court agreed saying that the office expenses were not incurred in the operation of his business or profession, reasoning that he had to be currently active in his urology practice.

The parties differed on whether the costs associated with continuing his business during his disability where items of expense incurred in the operation of his business or profession.

The appellate court found that the plain meaning of operation of the business in the context of an insurance policy included performing actions to continue the business, without regard to whether patients were still being treated. The court found that billing and collection efforts are normal activities that are part of a professional practice, and that the policy contemplated incurring expenses by disabled insurer over a long period of time.

The result would have been different if Dr. Uno had sold his practice or had entered into a stock purchase agreement over time. The court, most likely would’ve found that he was not conducting a business or profession after he sold his stock.

It is crucial that you secure the services of a experienced long-term disability/ERISA attorney to review both your disability and overhead expense disability insurance before you decide to stop practicing. You need to understand what long-term disability benefits your policy provides and what overhead disability coverage you have before making a crucial mistake that could destroy or limit your entitlement to benefits.

Nancy Cavey specializes in representing professionals, such as physicians, in the long term disability and overhead expense disability insurance claims. She has written extensively on the terms that you do not want to see in your long-term disability policy and pre-disability planning, including the 7 Tips for Long Term Disability Policy Holders Before Applying for Benefits.

If you have any questions, please give us a call at 727.894.3188 or contact us online by clicking here.

Rate this: