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What You Must Do By The Terms of Your Policy

The truth about disability insurance companies is that once you are being paid disability benefits the battle doesn’t stop. Why? The insurance company has a contractual right to reevaluate your entitlement to benefits every month! They can deny your continued payment of benefits at any time and for any reason.

Many disability policies require that you provide “proof of continued disability and regular medical treatment that is appropriate.”   You have the burden of proving you’re entitled to your monthly benefits.

The carrier will monitor your claim on a regular basis. You need Nancy Cavey to protect you during the monitoring process because if you don’t prove you remain disabled, your benefits can be denied. It is all about control!

What You Must Do By The Terms of Your Policy

Your disability policy requires that you cooperate with the carrier. That means you have to:

  1. Continue to get appropriate medical treatment.

Many times disability carriers will take the position that your treatment is not the right kind of treatment, the level of treatment isn’t enough or that you aren’t getting treatment often enough.  Disability attorney Nancy Cavey makes sure you understand what appropriate medical treatment is based on your medical condition. She will reach an agreement with your disability carrier about what is appropriate medical treatment and how often you must get treatment or see your physician.

  1. Complete Activities of Daily Living (ADL) forms documenting what you do on a daily basis.

ADL forms are a trap for the unwary. You can inadvertently document that the level of your activity is the equivalent of an inability to do sedentary work or you might just give the disability carrier a reason to place surveillance on you. Worse yet, the carrier will seize on any inconsistencies in your ADL form and what is in your medical records.  Disability attorney Nancy Cavey makes sure that your ADL forms are completed accurately and are consistent with your medical records.

  1. Give a statement to the carrier.

Many disability policies require that you be interviewed and your refusal to be interviewed can result in the denial or termination of your claim.

Disability carriers will want to check up on you particularly if there are inconsistencies in your ADL form and medical records. It isn’t uncommon for the carrier to want to take a statement on a regular basis if you are undergoing medical treatment to see “what’s new” and “how you are doing?”

An interview by the carrier is stressful because your claim is riding on how well you do during the interview. Disability attorney Nancy Cavey will prepare for the interview and will be with you during your statement so you don’t fall into the carrier’s traps. She even records the interview so you are protected from any misrepresentations about what you said during the interview.

  1. Undergoing an “independent” medical evaluation.

The carrier’s request for an “independent” medical evaluation (IME) is nothing more than a set up for a claims denial. Most disability policies require that you submit to a medical examination. However, not all policies allow for a functional capacity evaluation. It is crucial that you have Attorney Nancy Cavey review your policy to determine what type of examination the carrier can require you to undergo.

The carrier also may ask you to travel several hours from your home and that is unreasonable. You need protection from these types of unreasonable requests.

Your disability carrier wants medical evidence that contradicts what your doctor has to say so they can deny your benefits.  Disability attorney Nancy Cavey prepares you for the IME and makes sure the IME is videotaped or witnesses are present so you are protected.

  1. Updated medical information and Attending Physician Statement Forms

The carrier will request updated medical records and it is crucial that your records reflect your symptoms and how those symptoms impact your ability to function. Your records will be reviewed for inconsistencies and comments by the physician that you have improved.

You will be required to have your physician submit updated Attending Physician Statement forms. While your physician may be the best in their field, physician did not go to medical school to learn how to fill out misleading insurance company forms.  They can and often do make mistakes in filling out the forms and can easily say something on the form that will be used to deny your claim.  It is crucial that all forms be reviewed by Attorney Cavey before being sent to the carrier

Don’t Be Lulled Into A False Sense Of Security

Just because the carrier started paying benefits doesn’t mean they will keep on paying your benefits. You must submit monthly forms to the carrier and you must make sure that your doctor is accurately and completely filling out Attending Physician Statements (APS). Don’t give the carrier a reason to deny your benefits.

Being represented throughout your claim provides you with a level of protection and a buffer between you and your disability carrier that provides you with peace of mind.  

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