If you don’t Understand the Difference Between Short Term and Long Term Policy, You’ll Hate Yourself Later When You Are Unable to Work

Your employer may offer you both a short term and long term disability policy, what are they? What should you choose?Short and Long Term Disability

Short term disability policy normally pay 70-80% of your income for periods generally up to 6 months.

Long Term Disability policies will pay you 40-60% of your income and potentially can pay you benefits up to retirement so long as you meet the definition of disability.

Did you know that over 50% of all mortgage foreclosures and 20% of all personal bankruptcy in 2001 were caused by disability? You need to protect your income and your family’s well being.

If you have a choice, Pinellas and Hillsborough County certain long term disability attorney Nancy Cavey suggests that you get both short and long term disability coverage to protect your income.

If you have questions about which policy is right for you, you can order Nancy Cavey’s free no obligation book, Robbed of Your Peace of Mind. In this book it explains everything you need to know about your short term or long term disability claim.  If you have other questions, call us today at 727-894-3188.

Dirty Secrets About Long Term Disability Claims Denials

In the experience of Nancy Cavey, Florida Long Term Disability benefits denied attorney, many long term disability claims are denied unnecessarily.

She has written the go to book: Robbed of Your Peace of Mind that contains valuable information on how to understand your long term disability policy, filing your claim “right” for the first time, and what you need to do if your long term disability claim is wrongfully denied. Each year, millions of dollars in long term disability benefits are denied. Long term disability applicants don’t understand the long term disability claims process and what they need to do to get the long term disability benefits they rightly deserve.

To order your no obligation copy of Robbed for Your Peace of Mind contact the law office of Cavey and Barrett at 727-894-3188, or fill out the form on the right side of this page. We will rush you the book as soon as possible.

If You Are a Physician and Don’t Understand How Long Term Disability Carriers Use CPT Codes in Analyzing a Claim for Disability, You’ll Hate Yourself Later

Many physicians will have what is called an “own occupation” disability insurance policy that will pay benefits if you are no longer able to carry out the duties of your own occupation.Physician Long Term Disability Lawyer

Unfortunately, many physicians don’t understand the games that long term disability carriers will play in determining what a physicians “own occupation” might be at the time that they become disabled.

For example, a UNUM disability policy provides for “total disability” benefits when the insured, due to injury or sickness is “unable to perform the important duties of his occupation and is under the regular care of a personal physician”. Dr. Natarajan, a board certified Cardiologist, had such a policy through Paul Revere Life Insurance Company and UNUM. Dr. Natarajan opened the first cardiac catheterization in Venice, Florida and, following the adoption of innovational cardiology, Dr. Natarajan became certified in interventional cardiology in the year 2000.

Unfortunately, he developed severe arthritic degeneration in his hands and lost his ability to perform the surgeries.

As a result, and over time, he had to reduce the number of cardiological interventional procedures he conducted.

He filed a claim for total disability benefits and, as part of the claim UNUM completed the medical billing review/ CPT Code Analysis.

Based on UNUM’s analysis, they concluded that surgical or invasive/interventional procedures only accounted for 12% of the total number of procedures performed by Dr. Natarajan and accounted for only 25% of all the billings and charges prior to the onset of his disability.

In line with the CPT Code Analysis, UNUM determined that Dr. Nataregan was not engaged in a specialty of invasive/interventional cardiologist on account of his disability.

They concluded, that he was a general cardiologist, since he maintained a limited office practice as a cardiologist, he was not entitled to total disability benefits.

UNUM suggested that he seek the payment of residual disability benefits and Dr. Natarajan disagreed then sued Paul Revere UNUM Provident aka the UNUM group.

The court held that the policy defined “Your Occupation” as the occupation in which “the [insured] is [readily engaged] at the time [the insured] becomes disabled” and that Dr. Natarajan had to demonstrate there was “evidence of means by which a reasonable jury might find he was employed as a interventionist/invasive cardiologist (as opposed to a general cardiologist) at the time he became disabled”.

The Court pointed out that Dr. Natarajan had “considerable evidence” including documentation that he was a board certified interventional cardiologist and the affidavit from the administrator of the facility where Dr. Natarajan was employed, which confirmed that he was specifically hired because he was an interventional cardiologist.

The Court denied UNUM’s motion for summary judgment, agreeing with Dr. Natarajan that the CPT analysis was, alone, insufficient to establish that Dr. Natarajan was a general cardiologist.

UNUM offered up it’s own claims manual in support of it’s allegation that they were entitled to apply “more narrow definition of own occupation”.

The Court rejected this interpretation in denying UNUM’s motion for summary judgment.

If you are a physician who has a “own occupation” policy, you should consult an experienced long term disability attorney to assist you in helping you understand your policy terms, how they carrier might limit your coverage, and how they may use the CPT Codes in denying your claim for benefits. Give us a call today at 727-894-3188 to discuss your policy.

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