Long Term Disability Insurance Check Up | Review Your Long Term Disability Policy

It’s not the most exciting thing you can do in your life, in fact it’s pretty tedious but long term disability attorney Nancy Cavey suggests that you review your long term disability policy. The hours that you spend reviewing your policy can make the difference between being robbed of your peace of mind when you become disabled or actually protecting your family’s income.

Nancy Cavey has written Robbed of Your Peace of Mind, an informational guide, that explains the terms that you don’t want to see in a long term disability policy. Review that report and make sure that you have the right type of policy that will protect you and you family in the event of disability. Click the link or order your copy on the right side of this page.

How Long Term Disability Physician’s Companies Use The Dual Occupation Defense to Deny Physician’s Claims| Clearwater Long Term Disability Insurance Lawyer

Are you a physician who has multiple specialties or businesses? If so, you must properly protect yourself in the event that you become disabled, because one of the common defenses to a long-term disability claim is the “dual occupation” defense. What is this defense?

The long-term disability insurance company will argue that you have two or more occupations at the time you claim to be disabled. Because you’re able to work full time in one of those occupations, a long-term disability carrier will argue that you are not entitled to ANY benefits.

Let me give you some examples.

In Giampa v. Trustmark Insurance Co., 73 F.Supp.2d 22 (D. Mass. 1999), Dr. Giampa, a chiropractor, spent 85% to 95% of his pre-injury time treating patients by conducting examinations and performing manipulations or chiropractic adjustments. He injured his back, which limited his ability to perform manipulations. He had spent incidental time managing his two other chiropractic facilities before his injury.

After his injury, Dr. Giampa devoted all of his time to administrative duties managing the other chiropractic facilities, which resulted in a dramatic increase in his income. He claimed long-term disability benefits, which were denied.

His disability insurance policy had both a total disability clause and a partial disability clause.

The Federal Court decided that the total disability clauses should not be read so literally that an insured persons ability to perform some business duty, no matter how small, would prevent the finding of total disability.

Another twist on the dual occupation issue involved a dentist who had retired and begun working in the real-estate field.  He became disabled and filed a claim asking for the payment of long-term disability benefits based on his inability to perform dentistry. The court found that regardless of whether he intended, even after the sale of his dental practice to resume dentistry, dentistry wasn’t his regular occupation at the time he became disabled. The un-controverted medical evidence show that he was unable to perform most of the substantial material duties of his regular occupation as a real estate developer. The clause in the disability policy defined total disability as the inability to perform some substantial and material duties of his regular occupation. The long term disability policy  did not unambiguously require that he be unable to perform all of the substantial maternil duties of his occupation.

Another example involves the policy of a general surgeon who had on the side, developed a second business doing cosmetic surgeries including vein striping. Needless to say, that was far less stressful and more remunerative than doing general surgery. Unfortunately, he became disabled and unable to perform general surgery. Was he entitled to long-term disability benefits?

The answer could be found in the terms of the disability policy. He had a policy that looked at the occupation he was engaged in at the time of his disability and also had a residual disability provision. The residual disability provision paid benefits even if he was working at another occupation.

The residual disability provision said that “residual disability must follow right after a period of total disability that lasts as long as the qualification period, if any.” Huh?

This would seem to say that one could never get residual disability benefits, unless there was some initial period of total disability. Another question would be whether you had to be totally disabled from work as both a general surgeon and as a cosmetic surgeon to get benefits?

Another paragraph says that “This (residual disability benefit) will begin on either the commencement date or the day after the total disability ends up later.”  You could argue that if he are unable to do general surgery, but the same day could do vein stripping, the doctor  would be entitled to residual disability benefits.

You have significant choices to make and you can inadvertently shoot yourself in the foot and screw up your eligibility for disability coverage by making the wrong decision

It is crucial that you consult with a qualified long-term disability/ERISA attorney before you file your disability application to avoid making crucial mistakes that can result in the complete denial of your claim and cost you residual disability benefits.

You must determine what your policy says about the criteria for being disabled, what occupation your policy covers, whether there is a residual claim, what percentage of your revenue comes from both occupations, how your disability impacts your ability to perform both occupations, and how you’re going to prove that disability. That determination should be made BEFORE you even file your long-term disability claim.

Nancy Cavey, a long-term disability/ERISA lawyer, can be a great resource to you before you apply for long-term disability benefits. Nancy Cavey will be able to review your policy, advise you as to the best course of action to preserve your benefits and maximize your disability income, and assist you in gathering the necessary documentation to prove your entitlement to disability benefits.

Finding a lawyer with long-term disability/ERISA experience who has a proven background in dealing with physicians committee will make the difference between obtaining your long-term disability benefits or being denied. The lawyer who helped you set up your practice, helped you write your will and helped you purchase your house does not have the experience handling disability/ERISA claims.

Contact Attorney Nancy Cavey, who represents physician’s  through out the United States for more information on the dual occupation defense and to get your free no obligation copy of “Robbed of Your Peace of Mind.”

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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UNUM’s 2008 Third Quarter Profits Come at UNUM LTD Policy Holder’s Expense | Spring Hill Long term Disability ERISA Lawyer

UNUM’s 2008 Third Quarter Profits are in! UNUM reported a “net income of $108.00 million in the third quarter of 2008 compared to a net income of $187.00  million in the third quarter of 2007”. Mr. Thomas R. Watjen, president and CEO, commented in an article that he was “pleased with our operating results and the quality of our balance sheet . . .”

Well, his pleasure at UNUM’s profits is coming at the expense of UNUM LTD Policy Holder’s peace of mind.    UNUM is robbing their long term disability policy holders by denying  valid long term disability claims and offering buyouts of 15% – 35%. UNUM’s profits are, in part, generated out of their long term disability claims handling process.

To learn more about how long term disability insurance companies write policies that rob long-term disability applicants of their peace of mind go to Cavey law.com where you can order Nancy Cavey’s book “Robbed of Your Peace of  Mind”.

In my next blog post, I’ll report on the verdict recently entered by a federal jury in Boston finding that UNUM committed fraud in some long term disability cases by requiring long-term disability applicants to apply for Social Security benefits even though UNUM knew their long-term disability claimants weren’t eligible for Social Security 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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FAQ – Okay, I got the plan. Now what does it say? | Clearwater Long Term Disability Attorney

Congratulations! You’ve gotten the summary plan description which is just what it says – a summary of the plan. Let’s hope you got the policy.

Sometimes we find that there is a difference between what’s in the plan and what’s in the policy. For the sake of this posting, I will just talk about what’s in the disability policy.

Remember when I said there was no uniform disability policy in the United States. There are, however, some basic things I look for when I review a disability policy.

1. Is there a provision that requires you to have a policy for certain length of time before you can claim entitlement to disability benefits? If so, how long is it?

2. Is there a provision that excludes certain physical or mental conditions from coverage? If so, what’s excluded?

3. Is there a provision that limits coverage for certain physical or mental conditions? If so, what are those provisions, and how long is the coverage?

4. What is the definition of disability? Does the definition require objective proof of your disability?

5. What is the elimination period or the time you must be disabled before you are entitled to receive benefits?

6. How does your plan define occupation? Is it your occupation? Your occupation as performed for your employer? Your occupation as performed in the national economy? The Dictionary of Occupational Title definition of your job?

7. What is the claims process? When do you have to put the disability carrier on notice of your claim? How many appeals can you file? How long does the disability carrier have in which to make a decision?

8. How much are your benefits? Is there a set off against your disability benefits that will reduce your long-term disability benefits? Does that set off include Social Security benefits, your children’s Social Security benefits? Workers’ compensation or pension benefits?

9. Is there a limitation in the policy on when you must file suit?

10. What is the track record for this disability insurance carrier denying claims? Settling claims? Litigating claims?

Without knowing the answers to these questions, you are setting yourself up for a denial of your disability claim.

Nancy Cavey’s book, “Robbed Of Your Peace of Mind“, is a must read if you’re going to have any chance to avoid making mistakes, even before you file a disability claim.

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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Overview of Frequently Asked Questions | Bradenton Long Term Disability Lawyer

You have many questions about your Short and Long Term Disability benefits. There is no uniform long term disability policy in the United States. Every policy is different. The answers provided to frequently asked questions are general in nature. If you would like a full explanation concerning your specific problem, consult an experienced long-term disability attorney.

Please feel free to order your free, no obligation, copy of Attorney Nancy Cavey’s book

“Robbed of your peace of mind? Important information on long-term disability insurance policies, the claims process and how to win your long-term disability benefits”

You can order a copy on the home page of this blog or by going to www.caveylaw.com.

Ms. Cavey can be reached at 727 -894-3188 for a free, no obligation, phone consultation. She handles long-term disability cases nationwide.

Frequently asked questions include:

What is ERISA?

What impact does ERISA have on my claim?

What if I asked for my plan or other documents and I can’t get them?

Okay, I got the plan. Now what does it say?

How do I file a claim?

Will my employer help me with my disability claim?

What does my doctor have to do to help me with my claim?

Are there certain medical conditions excluded from my policy?

What is the definition of disability?

How does the carrier define my occupation?

How much will my benefits be if I get approved?

Are my benefits subject to taxation?

How long will it take for an initial decision?

What if I get a notice of denial letter?

What is the disability claims appeals process?

What seven clauses you don’t want to see in your long-term disability policy?

What are the common mistakes I can make in trying to handle my own disability case?

What happens if my benefits are denied?

What is a Standard of Review and why do I care?

When should I get a disability attorney?

What type of legal services do I need?

I have a limited income. How do I pay for lawyer?

When can we sue the long-term disability carrier?

If there are other questions you’d like answered, use the comment function and send me an e-mail about your questions. I can either answer them online publicly, or we can communicate privately. Don’t be shy about asking questions!

My father became disabled when I was in middle school. He, like you, wanted to be prepared in the event that he became disabled and could not support his family. He purchased a long-term disability policy through USF&G. I remember the monthly trips he made to his doctor, asking for the appropriate long-term disability forms to be completed service benefits would continue. I remember my mother’s fear that the long-term disability benefits will be suspended.

I understand your fears and the unanswered questions you have. I have been there. So, don’t be shy about asking questions, as the purpose of this blog is to help educate you about the ERISA and short term/long-term disability process. I hope you find this information useful.

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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