Mistake 3 – Handling Questions About Your Medical Condition | Bradenton Long Term Disability Lawyer

When the insurance adjuster or investigator comes to take a continuing disability statement they are going to ask you questions about your “disabling condition” and your “symptoms.”

Now, I find that rather silly. You have been filling out statements about your condition on a regular basis and the carrier has probably had your physician fill out forms at least once every three months. Can’t the disability adjuster read?

You probably haven’t seen what your physician has said in the your medical records or how they fill out the forms. The long-term disability carrier is trying to catch you complaining of different disabling conditions than you’re claiming or which are being discussed in your medical records. One of the reasons to have an attorney present is to review all the forms and medical records so you know what’s in them.

Symptoms are the things you are complaining of or present with on examination. Why are you asked questions about your symptoms? To compare what you said on your statements with what your doctor has recorded.

More importantly, the questions about symptoms are a prelude to asking about what you can and cannot do. The carrier wants to see whether your complaints about symptoms and your physical activity is consistent with what is reported in your doctor’s notes, whether that’s consistent with your diagnosis, and whether that’s consistent with any surveillance they have on you.

If you say your symptoms prevent you from lifting, bending, or stooping because you have constant back pain, and they have film of you, stooping and lifting boxes or bending at the waist repetitively, you’re in trouble.

I suggest you consult with long-term disability Attorney Nancy Cavey, who can prepare you for handling questions about your medical condition and symptoms.

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

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FAQ – How Does The Disability Carrier Define My Occupation? | Lakeland Long Term Disability Attorney

“I’m disabled! Can’t the long-term disability carrier see that based on my medical records? Why do I care how the disability carrier defines by occupation? This is about my job not my occupation. I just want to be paid my disability benefits!”

I hear those complaints frequently. I have to explain that the second most important definition in your long-term disability policy is how your disability carrier defines “occupation”. Not “job”

It is the standard by which your disability is measured.

And, it might be defined as your regular occupation, your occupation as performed for your employer, your occupation as performed in the regional economy, your occupation as performed in the national economy, or your occupation as defined by the Dictionary of Occupational Titles.

Or, is it the job you are doing while you are disabled but before you stopped working?

If you are going to have your doctor comment on on your ability to work, you are asking the wrong question. Your doctor will need to comment on your physical restrictions and limitations by having the right definition of occupation. You can destroy your claim by having your doctor use the wrong definition of occupation.

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

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FAQ – What is ERISA? | Sarasota Long Term Disability Lawyer

Do you remember Jimmy Hoffa? Jimmy Hoffa stole money from the Teamsters so Congress decided to enact federal legislation to protect pension funds. This legislation also regulated other employee benefits such as group health, group life, pension and disability policies. This law is called the Employee Retirement Income Security Act of 1974 or ERISA.

It’s complicated, complex, and always changing. Most lawyers don’t like this kind of law and its been nicknamed “Everything Ridiculous Invented Since Adam.”

The purpose of ERISA is to “protect… the interests of participants in employee benefit plans… by establishing standards of conduct, responsibility, and obligation for fiduciaries of employee benefit plans, and by providing for appropriate remedies… ready access to federal courts.” ERISA Section 2 (b). This federal statute preempts or chromes state law for the most part.

The reality is, of course, completely different. The Department of Labor rarely enforces the applicable regulations and disability carrier’s wrongfully deny claims. People, such as yourself are forced to file federal lawsuits to get their benefits.

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

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