Does the long-term disability/ERISA insurance company really care how many times you take a shower or get dressed every day? Of course not!

They ask you questions about your hygiene, not because they care, but to see whether your reported activity is inconsistent with what you’re telling your doctor about your abilities.  A long-term disability/ERISA disability insurance company will ask you the following questions:

*  Do you need help dressing? How often?

*  How long does it take you to get dressed?

*  Do you need help showering?

*  How long does it take you shower?

*  Do you shower every day?

*  Who helps you?

*  What time do you fall asleep?

*  What time do you get up?

*  Have you made any accommodations to your house because of your illness?

If your disability hasn’t resulted in any impact on your hygiene, simply say so. However, if you have difficulty bending, stooping, twisting questions about your hygiene may be relevant. You may need help putting on your socks or shoes if you have a back injury. You may have trouble getting in and out of the shower if you had a stroke.

Don’t be afraid to detail the problems were having with dressing, showering, sleeping, or accommodations you’ve had to make to your home. I would suggest that you advise your treating physician, in writing, all those problems, so they’re documented in your file. That way, there won’t be any inconsistencies between what your doctors records provide and what you are telling the long-term disability/ERISA disability carrier.

It’s important that the Activities of Daily Living form you complete in support of your long-term disability claim be consistent with your medical records. Nancy Cavey, an experienced ERISA long-term disability attorney, strongly recommends that you get a complete copy of your medical records from your treating physician before submitting your claim and supplementing your medical records with information about your Activities of Daily Living so there aren’t inconsistencies that the long-term disability/ERISA disability insurance company can seize on to deny your claim.

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

Learn More About: Mistake 17- Restrictions and Limitations - Hygiene,Preparing for Your Statement and Field Visits By The C | Comments (0)| Permalink | Trackback |  Print This Post |  Email This Post

When you’re asked to give any statement by your ERISA/long-term disability carrier, you can be sure they’ll ask you questions about your ability to squat and kneel.

These questions will include:

1. Are you able to squat to sit in a chair, on the toilet, or to the floor?

2. If you squat, what symptoms do you experience?

3. Do you need assistance from someone or have to hold on to something to get back up from a squatted position?

4. Do you have to crawl to lift yourself up?

5. Can you kneel?

6. If you kneel, what symptoms do you experience?

7. What is your pain level?

8.  Do you need assistance to get back up from a kneeling position?

These questions are designed to see if your symptoms are consistent with your diagnosis and your reported limitations consistent with your degree of your disability.

Of course, if you are out washing your car and kneeling to clean the hubcaps or squatting or kneeling to pull weeds or plant flowers, long-term disability carrier will interpret those activities as being the equivalent of work activity. Don’t jeopardize your long term disability/ERISA benefits.

Be truthful about the extent of your physical activity both to your physician and a long-term disability carrier.

For help preparing for the long-term disability field visit or completing disability forms, contact Nancy L. Cavey at caveylaw.com

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It is important to prepare for your long-term disability statement or field visit by the long-term disability claims adjuster so you can get your long term disability/ERISA benefits.

Long term disability insurance companies like to ask broad, open ended questions which are hard to answer accurately, but which are traps for the unwary long-term disability claimant.

The questions you will be asked will include:

1. How much are you able to lift and carry?

2. Provide an example of something that you can carry it without being uncomfortable?

3. Have you lifted more than 10 pounds?

Why are you being asked these questions? If the long-term disability insurance company can shows that you can do a sedentary job, which requires less than 10 pounds lifting, they will take the position you are not disabled.

Please note that these questions don’t address how much you can lift without having symptoms, how much you can lift repetitively, how much you can with repetitively without becoming uncomfortable, and don’t take into consideration real-life lifting situations at the workplace.

Your answers will be compared against the surveillance film. If they catch you lifting more than what you said, they will play “gotcha!”

Your answers will be given to your doctor. The long-term disability carrier will say to your doctor, “She completed a statement that says she can lift and carry a maximum of 15 pounds.  Doctor, would you agree that she could work at a sit down job where she only had to lift 5 pounds?” What do you think your doctor is going to say?

I am sure that your lifting and carrying ability depends on the size of the object, its weight, whether you’re lifting it off the table, lifting from the floor, how many times you have to lift it, whether you have to bend and lift, twist and lift, or squat and lift.

You will be asked about your ability to bend and twist:

1. Can you bend at the waist to pick something up off the floor?

2. When you bend or flex toward the floor, what symptoms do you experience?

Most everyone has the ability to bend at the waist. Even my clients who have those kinds of problems would bend over to pick up a crying child regardless of how much pain they have. Isn’t that a dumb question?

You will be asked about your ability to twist:

1. Can you twist at the waist?

2. Can you twist to the right or left?

3. Can you twist or turn your head to the left or right?

4. What symptoms do you experience when you twist?

Of course, you can twist but you probably have limitations. Of course, the question is phrased in a way that you have to give an absolute black-and-white answer. Don’t fall for that trap! Don’t answer any question in absolute terms. Use ranges and estimates and make it clear that’s what you’re doing as you answer these questions. Never say that you can never do any physical activity. You’re setting yourself up if you do so.

Answering these broad-based questions isn’t easy. Help is a phone call away. You can contact Nancy Cavey, an experienced long-term disability attorney at 727-894-3188.

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As part of your long term disability statement about your restrictions and limitations you will be asked questions about your ability to stand. These will include:

1. What is the maximum number of minutes you can stand?

2. What happens after you stand that length of time?

3. What is your pain level when you stand for that long?

4. What symptoms or do you have when you stand for that long?

These are absolute questions but you really can’t give a hard and fast answer. I am sure that your ability to stand depends on whether you are having a good day or bad day, what you may have done the day before, and what medication you might be taking.

Interestingly, what’s not being asked is how you may have to alternate sitting or standing, how problems standing interfere with your ability to function, how long you can stand before you develop symptoms that interfere with your ability to engage in activities of daily living.

Aren’t those kinds of questions more relevant? As you can see, such broad-based questions are open to interpretation by you. Regardless of how you answer this question, make sure you qualify your answer so that you narrow the scope of this question.

Often, the disability insurance company will have surveillance film on you. If you say you can only stand for 15 minutes and they have film of you standing longer, you can be assured they will argue that you are not being truthful to your doctor about your abilities. They will question your doctor’s reliance on your statements about your physical abilities. Don’t fall into that trap.

Don’t be afraid to contact a long-term disability/ERISA attorney like Nancy Cavey to assist you in accurately answering questions about your restrictions and limitations so you can get your ERISA/long term disability 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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I suggest that when you are rating your restrictions and limitations you use a scale of 1 to 10. Zero is no pain and 10 is excruciating pain that will send you to the emergency room.

This would be where I would start, but you need to come up with your own scale. This scale may be based on your level of pain, your functionality, or your need to take medication. Just make sure that you explain the scale and write it down.

With that in mind, you will be asked about your walking activity:

How much can you walk?

How far can you walk at one time?

How far or how much can you walk before your pain level increases?

How does your pain level increase?

What happens to you when you walk too far?

How much walking do you do in the course of the day taking care of your activities like taking children to school, going to the grocery store, or the doctor’s appointments?

Do you have to schedule you are walking and spread over several days?

Can you walk the mall? How far?

How often do you have to sit down when you take a walk?

Do you walk with a limp? How frequently?

Do you need a cane? Or any other assistive device while walking?

When you go grocery shopping, do you use the cart to help you walk?

Do you carry things when you walk? If so, how much does the object weigh?

Do you have good days and bad days as a result of your walking?

It is important that you think about these questions and your answers so that you can explain what you can and cannot do. You must explain how your activities are impacted by your pain and medications. You must explain good days and bad days.

And, you must never say “NEVER!” “I never walk, I never walk more than a block, I never…” I promise you that the long-term disability carrier/ERISA carrier will have a picture of you doing what you said you never did.

And, you must never say “ALWAYS!” ” I always use a cane, I always walk with a limp, I always…” I promise you that the long-term disability/carrier/ERISA carrier will have a picture of you not doing what you said always did.

Be prepared to answer questions at the continuing disability statement about your walking by being prepared by disability benefits attorney like Nancy Cavey, who can be reached at www.caveylaw.com.

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All right… you let the disability rats in. What they really want to talk about is:

1. How much you can lift?

2. Can you bend at the waist and how frequently?

3. How long can you stand?

4. How long can you sit at one time?

5. How long can you walk at one time?

6. How much can you pull?

7. Do you have any problems with your memory or concentration?

8. Do you have any problems with side effects of medication?

These questions are designed to establish that you are physically capable of doing at least a full-time sedentary, or light work. They will take answers to these questions back to your doctor and ask whether or not, based on your own admissions, you could do full-time sedentary work.  The disability carrier might even identify a full-time sedentary job and ask your doctor if you could do it.

If your doctor says that you can do full-time sedentary work, the long-term disability carrier will stop paying your disability benefits.

Most disability recipients fail to explain, when answering these questions, that their ability to function is impacted by the medication they take, the side effects of medication, and the fact that they have good days and bad days. You often take these questions literally.

Another mistake disability recipients make is to allow the disability carrier to equate your ability to lift, bend, stand, sit, walk or pull at home with the ability to do that activity in the workplace.

Another mistake disability recipients make is to make broad sweeping and generic statements about their abilities. I prefer specific examples of difficulties you have, how your abilities change based on your pain level, side effects of medication, whether you have good days or bad days, and how often.

Yet another mistake disability recipients make is failing to explain how they need to change position, may need to take naps, how their level of functioning on a good day is different from the level of functioning on a bad day, and how long it takes to recover from a bad day.

Obviously, you should consult disability Attorney Nancy Cavey before you give any continuing disability statement or allow a home visit. Failure to prepare can destroy your claim.

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

Learn More About: Mistake 4 - Questions About Why You Can't Work | Comments (0)| Permalink | Trackback |  Print This Post |  Email This Post

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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