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Has Your Long Term Disability Claim Been Denied When the Carrier Used the Wrong Expert for Your Medical Condition?

Nancy Cavey — Tue, 22 Dec 2009 14:53:27 +0000

Long Term Disability carriers will routinely have a Long Term Disability claim reviewed by a panel of hired gun medical reviewers. We see these same reviewers time and time again.

One of the most common mistakes Long Term disability carriers make is to use the wrong medical expert for the medical condition that is being claimed. Now that sounds dumb doesn’t it?

The Florida federal regulations, which governs ERISA claim’s handling requires that the Long Term Disability carrier consult with a health care professional that has “appropriate training and experience in the field of medicine involved in the medical judgment,” 29 c.f.r. section 2560.503-1 (h)(iii).

Unfortunately, it’s not uncommon for Long Term Disability carrier’s who are evaluating Fibromyalgia or chronic fatigue cases to use physicians who have no expertise in those areas.

Nancy Cavey, Florida Long Term Disability Denied lawyer, checks the medical and professional background of any health care professional used by the Long Term Disability carrier in a claim’s denial to ensure that the carrier, in fact, used the right expert for your medical condition.

If you believe that the Long Term Disability carrier has denied your claim by using the wrong expert for your medical condition immediately contact Tampa Bay Long Term Disability Attorney Nancy Cavey.

Disability Insurance Myths | Tampa Bay Long Term Disability Lawyer

Nancy Cavey — Mon, 05 Jan 2009 18:57:13 +0000

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

Mistake 20 – Restrictions and limitations – Recreation/Hobbies/Social activities | Bellaire Beach Long Term Disability Attorney

Nancy Cavey — Sat, 11 Oct 2008 15:48:12 +0000

Long-term disability and ERISA insurance companies confuse recreational activities, hobbies, or social activities as the equivalent of working. They think that if you can go on vacation, have a social life, or maintain a hobby you can work. We all know that’s not true!

You will be asked questions on activities of daily living forms about whether you been on vacation, when, how often and, of course, what you did on vacation. In answering these questions you may want to think about how your vacation destination might have changed because of your disability, how you were unable to play with your children on vacation, or limited your activity.

You might have had to make multiple stops if you drove to your vacation destination. Just think about how your vacation has been impacted by your disability when answering this question.

Do you have any hobbies? If your disability has impacted your enjoyment or even ability to do one of your hobbies, explain that impact.

Your disability probably has impacted your social activities or even how often you get together with friends or family. Your disability may have even changed the kind of activity you do or how often you do that activity.

You should fully explain what problems you have, what you can and can’t do, and what problems you have had when you engage in recreational, hobby or social activity.

You can be assured that if any of your recreational or social activity is outside of your home, a long-term disability/ERISA carrier will consider placing surveillance on you. Be on the lookout! If they have surveillance on you, they will follow-up and want to take a recorded statement. If that happens, you should talk with an experienced ERISA/Long term disability Attorney like Nancy Cavey before giving any statements that could be used against you in your long-term disability case.

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

FAQ – What if I asked for my plan or other documents and I can’t get them? | Tampa Long Term Disability Lawyer

Nancy Cavey — Sun, 25 May 2008 18:57:47 +0000

You really do want to have a copy of the summary plan description (SPD) and your disability insurance policy before you even think about filing a disability claim.

So how do you get it? You should have been given a summary plan description when you signed up for your benefits. It may even be online.

Look at the summary plan description and see if it has the name of the plan administrator. If the plan administrator is identified, send a letter certified mail return receipt requested, asking for a copy of your policy and any amendments or changes made to the policy since you signed up.

If you can’t figure out who the plan administrator is, ask your human resources department. If they can’t give you an answer, send a written request to your employer certified mail, return receipt requested, asking for the name of the plan administrator, disability insurance company and a copy of any policy they might have.

Under the ERISA statute, the failure to provide a summary plan descriptions in a timely manner can result in a fine, under ERISA, of $110.00 per day. Unfortunately, that penalties is only awarded under certain circumstances, and by a judge.

If you can’t get a copy of a summary plan description or policy that is your first warning sign that problems lie ahead. You should obtain the assistance of an attorney to get the summary plan description and policy. Your attorney can file a lawsuit asking for enforcement of ERISA and the imposition of penalties.

Disability insurance companies who don’t play nice when asked to provide basic information aren’t going to play nice when it comes to deciding if you’re entitled to disability benefits. Take warning!

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