28 October

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Cobra Health Coverage and Long Term Disability Claims

At The Law Offices of Nancy L. Cavey it's not uncommon for long-term disability applicants to come to our office with a letter from their employer about continuing their healthcare coverage through COBRA. Federal law requires employers with 20 or more employees to provide COBRA healthcare continuation coverage, and there are specific time limits for choosing this coverage. Unfortunately, many long-term disability applicants are also applying for Social Security Disability benefits and are in need of medical treatment. They have not become Medicare eligible and are facing a gap in their health insurance coverage. While there is no one-size-fits-all answer, there are considerations that...

28 October

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What Impact Does ERISA have on My Long Term Disability Claim?

Posted by Nancy Cavey

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ERISA stands for “Employer Retirement Income Security Act.” It was passed in 1974 for the purpose of protecting employee benefits for group plan participants. Unfortunately, disability insurance policies are subject to the ERISA regulations, which long-term disability carriers refer to as “Everything Ridiculous in the World Since Adam.” ERISA, which is a federal statute, preempts state law. That means that there are no state law causes of action, including bad-faith claims handling. I am sure that your HR manager thought that having a group LTD policy would be a great benefit to the employees and is part of a benefits package that...

28 October

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What Every Medical Professional Needs to Know about Disability Insurance

Posted by Nancy Cavey

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It is important that medical professionals understand their long-term disability policy so they can prevent the disaster of being disabled and being unable to recover the benefits they deserve. Did you know that there are three types of disability policies? Do you know which kind you have? The first is an individual disability policy, which you may have purchased directly from a carrier and which provides you long-term disability benefits in the event of sickness or injury. Do you know that there are two types of individual policies? The first is a general policy that insures you against being disabled and being able...

28 October

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Long Term Disability Carrier’s Use of PSY BAR

Posted by Nancy Cavey

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Unfortunately, long-term disability carriers routinely use companies such as PSY BAR to review long-term disability/ERISA claims involving psychiatric conditions. I recently reviewed PSY BAR’s website and noted that they offer online courses to adjusters and IME doctors. One of the courses, “Psychological and Psychiatric Assessment of Individuals for Disability Insurers,” actually teaches “independent medical doctors” what the long-term disability insurance company’s expectations are and how to meet those expectations in an ethical manner. Interestingly enough, this course identifies what PSY BAR believes to be “common IME errors:” "ERROR NO. 1 – Confusing the needs of the disability carrier with other kinds of coverage including...

28 October

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Is the Long Term Disability Carrier Entitled to My Social Security?

Posted by Nancy Cavey

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At The Law Offices of Nancy L. Cavey, a Florida based long term disability firm, we are oftern asked "Is the long-term disability carrier entitled to repayment because I got Social Security Disability benefits?" Have you read your long-term disability policy? Does it provide that future benefits can be withheld to recover any overpayment arising from a retroactive payment of benefits such as Social Security Disability benefits? In the case of White v. Coca Cola Corporation, the United States District Court for the Northern District of Georgia upheld a provision in Coca Cola’s long-tern disability plan that allowed Coca Cola to withhold...

28 October

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Horror at Your Door – A Field Visit and Statement by LTD ERISA Investigator

Posted by Nancy Cavey

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Knock! Kniock! Freddy is at your dooor! If the a long-term disability or ERISA carrier calls and asked 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. Long term disability and ERISA disability claims are denied for three reasons: 1. No objective evidence of diagnosis; 2. No objective evidence of disability; 3. No evidence of causal relationship between the disability and the inability to engage in your own occupation or any occupation. The long-term disability or...

28 October

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What is ERISA?

Posted by Nancy Cavey

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If your disability claim will be made under your employer's group disability insurance policy, it is likely governed by ERISA, which stands for the Employment Retirement Income Security Act. This is a Federal Law enacted in 1973. Under ERISA, you have the right to file a suit in federal court if your claim for disability benefits is denied by your insurance company. Unfortunately, unlike almost any other legal situation, under ERISA the disability insurance company will walk into court with an advantage. The ERISA disability insurance system and your disability policy, shaped by insurance company lobbyists in Washington D.C., is...

28 October

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Criminals have more rights than long-term disability claimants when giving a statement

Posted by Nancy Cavey

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The long-term disability/ERISA carrier has called you and asked you to give a statement or to come to your house. What are you going to do? First you really do need to retain an experienced Florida long-term disability/ERISA attorney like Nancy Cavey. We do not allow the long-term disability/ERISA carrier to contact you directly once you retain our services. The long-term disability/ERISA carrier wants to take your statement for the sole purpose of catching you in a trap that they are building, so that they can justify a termination of your long-term disability/ERISA benefits or to force you to settle your case...

28 October

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Everything you need to know about Your Doctor’s Role in Winning Your Long Term Disability ERISA Claim

Posted by Nancy Cavey

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Just because your doctor says your disabled doesn't make it so. And just because your doctor says your disabled, doesn't mean that the disability carrier is going to agree and accept your disability claim application. The long term disability insurance carrier is looking for objective evidence from your doctor about your diagnosis and objective evidence of your disability. Your history of complaints and symptoms, your findings on examination, and the results of objective medical testing are important to establish an objective basis for your diagnosis. There must be objective evidence of your functional restrictions to establish that you are, in fact, disabled....

28 October

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Are You Being Set Up for a Termination of Your Long Term Disability Benefits?

Posted by Nancy Cavey

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

Author: Nancy Cavey