Mistake 19 – Restrictions and Limitations – Your Daily Activities | Pinellas Park Long Term Disability Lawyer

When you apply for long-term disability benefits I’m sure you never thought you’d have to explain what you did inside and outside the house. What does that have to do with your inability to work?

Well, long-term disability carriers like to compare your complaints to your doctor with what are able to do around your home to see if there are any inconsistencies. They’ll also use your responses to put surveillance on you see if you are telling the truth. Their version of the truth doesn’t always match up with reality

A  long-term disability Activity of Daily Living Form will ask questions about both the inside and outside activities.

In regard to your inside activities you will be asked about cooking, cleaning, use of the microwave, laundry, dusting, and other household activities. I am sure that you have difficulties doing these things because of your pain, limitation of motion, or other problems associated with your disabling condition. You may have to break up these tasks or have someone help you. You may no longer cook meals and rely on the microwave. You may have hired someone to clean your house.

The activities of Daily Living Form will ask you what you’re able to do outside of the house such as driving,  taking out the garbage, gardening, weeding, or cutting the lawn. Just make sure that what you’re doing is consistent with the restrictions that your doctors placed upon you. You might have to pace yourself or even have assistance.

Give a broad answers to these questions explaining that your activity depends on how you feel and the side effects of any medication. Make sure you’re treating doctor knows the extent of your physical activity.

For assistance in completing long-term disability/ERISA activities of daily living forms and preparing for a disability statement, contact an experienced disability Attorney, like Tampa Bay lawyer Nancy Cavey to make sure you are prepared for this important event in your long-term disability claim. She can be reached at 727-894-3188.

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Mistake 18 – Restrictions and Limitations – Your Pain Level | Hudson Long Term Disability Attorney

If you have filed a claim for long-term disability benefits you can be assured that the long-term disability carrier will be asking lots of questions!

If your physical condition causes pain that interferes with your ability to work, your long-term disability carrier will be particularly interested in asking questions about your pain. These questions will include:

1.  What is your current level of pain on a pain scale of 1 to 10?

2. Does your pain level vary?

3.  Do you have good days and bad days? How often?

4.  Where do you experience pain?

Some physicians will have their patients complete at each visit a pain diagram that will also ask you to rate your pain on a scale of 1 to 10.  If you fill out those forms for your doctor, get a copy of every form you filled out before you complete the long-term disability questionnaire. You want to make sure that what you’ve told your physician at each visit is consistent with what you’re reporting to the long-term disability carrier.

If the long-term disability carrier doesn’t define the pain scale, ask them how they define before you answer those questions.

Make sure that your explanations about where you have your pain is also consistent with what you’ve reported to your doctor.

To avoid making a crucial mistake in completing the Activity of Daily Living form for your long-term disability carrier, consider consulting with an experienced ERISA disability Attorney, like Nancy Cavey. Long-term disability/ERISA disability carriers love to jump all over inconsistencies and use them as a basis of denying your client. Protect yourself!

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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Mistake 13 – Restrictions and Limitations – Computer Skills | Tampa Bay Long Term Disability Attorney

Okay–so what do your computer skills have to do an Activity of Daily Living Form that the long-term disability/ERISA carrier has sent to you so you can get your long term disability benefits?

Two things! The first really involves what you do with your time. Can you sit at a computer? How long? Is that consistent with what you put on your form about your ability to sit or your need to alternate positions? How much are going to concentrate? And, of course, are you doing any medical research online about your condition?

The long-term disability/ERISA carrier is looking for discrepancies between what you say you can do and what your reported activity is – it’s like saying you can’t drive, but then driving 100 miles to go to Disney World.

Don’t be naive. Long-term disability and ERISA carriers are trolling the Internet looking at social websites to see if you have a posting, how often you post pictures of what your doing. Take them down immediately!

The second reason you’re asked questions about your computer skills have to do with whether or not you’re capable of working. If you can do is sedentary job sitting at a computer your employable and are no longer entitled to disability benefits.

You are going to be asked about your level of computer skills, whether you can do word processing, whether you use e-mail and how frequently you are on the computer.

Be truthful! But be consistent with the answers that you’ve put on the activity of daily living form about your ability to sit, stand, reach, bend, stoop, alternate positions, use of your hands and concentration. The long-term disability/ERISA carrier is looking for inconsistencies.

Questions about your computer skills are really trick questions. I suggest you consult an experienced long-term disability/ERISA attorney like Tampa Bay – based attorney Nancy Cavey as you answer these questions so that you do not jeopardize your long – term disability/ERISA 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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Mistake 8 – Restrictions and Limitations – Lifting and Carrying, Bending and Twisting | Clearwater Long Term Disability Lawyer

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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How to Avoid Making Mistakes In Your LTD/ERISA Statement Or Field Visit | New Port Richey Long Term Disability Lawyer

Quite frankly, if the a long-term disability or ERISA carrier calls and asks to take your statement or arrange a field visit you are in trouble! Call Nancy Cavey, an experienced long-term disability/ERISA disability Attorney, before you make mistakes in your statement or field visit by the long term disability/ERISA investigator.

In my experience, disability claims are denied generally for three reasons:

1. No objective evidence of your diagnosis;

2. No objective evidence of your disability;

3. No evidence of causal relationship between your disability and your inability to engage in your own occupation or any occupation.

The long-term disability or ERISA carrier wants to take your statement or arrange, a field visit because they question what your doctor says about your restrictions and limitations and what you are reporting on your Activities of Daily Living forms that you are asked to complete.

They also question your reported disability and your inability to engage in your own occupation or any occupation.

Unfortunately, by the time the long-term disability or ERISA carrier asks to take your statement or have a field visit with you they probably have done surveillance on you. They want to interview you and have you describe your activities. Once you’ve done so, they’ll have you sign a statement about your activities. As soon as you sign the statement, they spring surveillance on you and then ask you to comment on the surveillance. They want you to acknowledge the difference between the statement you just gave and  what is shown on the film.

The long-term disability/ERISA carrier will then take that information to your treating physicians and ask them to sign off on a letter that says you’re capable of of least sedentary work.

They have sprung a trap on you for the purposes of painting you a malingerer or fraud with the sole purpose of terminating your benefits.

It is my strong recommendation that if you are asked to give a statement or if the carrier wants to have a field visit that you need to immediately retain an experienced long-term disability/ERISA attorney, like Nancy Cavey.

You need to be prepared! You need to have someone with you to make sure that the questions, you are asked are not open-ended questions. You need to have someone with you to make sure that your answers are accurate. You need to have a statement and field visit done in a neutral location.

I never let a statement or field visit be done at my client’s home. I often see statement summaries with questions and comments about how your yard and house look. You will be, innocently, asked about how you keep up with your house or yard work. They would use that information to draw conclusions about your inability to work.

You should have an experienced long-term disability/ERISA attorney, like Nancy Cavey, prepare you for your statement and field visit.

In the following blog postings, I will go through the questions that you will most likely be asked in a statement or field visit. This should help you prepare for and avoid making mistakes that can jeopardize or even destroy your case.

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 – You Are in Line for a Disability Termination | Port Richey Long Term Disability Attorney

You fought long and hard to get the long-term disability benefits you deserve. What the insurance company is already setting you up for is the termination of your long-term disability benefits.

Unfortunately, it is not uncommon for long-term disability carriers to target high-paying cases or cases where the definition of disability will soon change for termination.

The long-term disability carrier isn’t going to call you up and say “Away we go!” No, they will probably send you a vague letter saying they’re going to be doing a review of your case. They are not fooling and this is not fluffy letter.

So, what are they going to do?

First, they are going to contact your doctor to try to get a statement that will be used to terminate your benefits. They will try to get your doctor to say that you can work, that you can work in some accommodate position, that your diagnosis is only based on your complaints to the doctor, that their peer review doctor (who has never seen you) says you can do this activity or that activity and won’t they just agree, that they have surveillance on it and you’re doing lots of things are not supposed to be doing so won’t your doctor agree you can work, etc.

One of the first things that I do as your attorney is to revoke all medical authorizations you signed. Why? Because they will talk to your doctor without my knowledge! They will allegedly have conversations with  your doctor and send a letter that “summarizes” the conversation. More often than not, there’s never been a conversation or they twisted what your doctor who said… Then I have the pleasure of going back to your doctor and trying to undo the unfavorable “what we discussed” letter that your physician signed.

They will also send the infamous letter to your doctor that says “If you don’t comment or disagree with what our doctor says, we’re going to presume you agree with what our doctor said.” I try to avoid this by revoking the medical authorization. If they want to have a real truthful conversation, I’ll be present and it will be recorded!

Insurance companies will also do a background check on you to find out what you own, what bank account you have, and your credit information. I think they do this just find out whether you are living on a limited means and can sustain your lifestyle through their continued denials.

One of the tools in the disability carrier’s insurance bag is surveillance which will be the subject of another posting. Be careful of calls to your home. If you get calls, and the caller hangs up that’s a sure sign of  surveillance. If there’s a strange vehicle down the street, there is surveillance. If there’s an investigator asking your neighbors questions about your activities, there is surveillance.

Don’t put up with it — call the police every time you suspect you are being surveyed.

Another favorite is to schedule you for a functional capacity evaluation by a doctor the disability carrier has selected. Immediately retain an experienced disability attorney as there are things that can be done to either stop the evaluation or make sure that you are protected during the evaluation process. The disability insurance companies hire the same folks for the same results – denial.

Lastly, there is the home interview which will be the subject of a comprehensive posting. Simply put, don’t let them in your house. You don’t have rats in your house — don’t let an investigator in. And, by all means, don’t talk to the claims adjuster. They’re taking notes about what you say you “can” and “cannot” do — they’re not calling to have a social conversation.

An experienced long-term disability/ERISA attorney like Nancy Cavey can help you through this process.

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 – Filing an ERISA Lawsuit | Pasco County Long Term Disability Lawyer

You can only file a lawsuit under ERISA after you have exhausted your administrative remedies. This is called “exhausation”. There is a joke among ERISA attorneys that it really means the “exhaustion of your client” and not exhausting all of your appeals.

You should not file a lawsuit unless you are represented. I will be frank with you. You are going to have a hard time finding an experienced ERISA/LTD attorney to take your case at this stage since you can not add anything to the record. Cases are won or are set up for a win in Federal court based on what is put in your record during the claims denial appeal process.

A Federal lawsuit starts with preparing a complaint and filing the summons and complaint in United States District Court. The filing fee is $350 and Nancy Cavey advances the filing costs.

The suit is served and in the defendant, who is the carrier or the self-funded ERISA plan, has 20 days to file an answer and any counterclaims.

The counterclaims can include a claim for the repayment of disability benefits for an overpayment. Disability plans have offset provisions that let the disability carrier reduce the amount of your disability benefits based on what you receive from Social Security, workers compensation or other sources.

Your lawyer will file the answer to any counterclaim.

Every United States District Court has its own rules about how the lawsuit will be handled. In the middle District of Florida, we are required to have a case management conference soon after the answer is filed so that we can sit down and agree on a schedule for discovery, mediation, the filing of motions, and trial.

The Florida District courts require that ERISA cases have a settlement conference known as mediation.

The insurance company attorney will send me a copy of the disability carriers file which is called the “administrative record” and I will check to see if it has the same things that were sent to me during the appeal process. Don’t be surprised if there are different things in the file the defense attorney sends me.

At our firm, Cavey and Barrett, we routinely schedule a designated representative deposition of the adjuster so that we can learn the basis of the denial and establish the necessary standard of review.

If we are unable to settle the case, the court requires us to prepare a Motion for Summary Judgment. A federal judge will decide your case based on what is in the record. There are no trials! You will not get the opportunity to testify in front of the judge or a jury. Your doctors won’t get the opportunity to explain your condition and how it prevents you from working.

The federal judge will issue an order ruling on your right to benefits or lights and your case back to the insurance company because your case is not “ripe” for review.

Either party can appeal the judge’s decision to the United States Circuit Court for the Federal Circuit in which the district is located. For example, appeals from the district courts of Alabama, Georgia, and Florida go to the 11th circuit in Atlanta, Georgia.

If you win, the court will order the insurance company to pay you back benefits that are due, and sometimes, attorneys fees and costs.

The decision to file a lawsuit is a difficult one and one that you should consult with an experienced long term/ERISA attorney about – and, preferably, during the appeal process and not when it’s time to file a lawsuit!

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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