28 October

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What is ERISA?

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...

28 October

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Will My Employer Help Me with My Long Term Disabiity or ERISA Claim?

Posted by Nancy Cavey

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Maybe! If your employer is self insured for short term disabiity, the money to pay you is coming from your employer's pockets. If you have a good claim and were a good employee, you might be paid your short term disability benefits. I have had cases where the employer has overridden a short term diabiility administrator's decision to deny benefits because the employer liked the employee. I have seen cases where just the opposite took place! Rarely will an employer work with you so you can keep your job after you have become disabled. Your employer provided you with a disability policy...

28 October

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If Your Individual or ERISA Long Term Disability Policy Contains Any of These Clauses…You Should Be Concerned

Posted by Nancy Cavey

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The insurance company has the "discretion" to determine your benefits. You only get paid benefits if you can't perform "each and every" important duty of your job. The duties of your job are determined by the insurance companies' use of the “Dictionary of Occupational Titles,” and not based on how you have performed your job for your employer. Your benefits are limited to 24 months if your disability is caused, or contributed to in any fashion, by mental illness, depression, or anxiety. Your benefits are not payable, or can be limited, if your illness is fibromyalgia, chronic fatigue, chronic pain, or an illness in...

28 October

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Myths About Disability Insurance Claims You May Have Heard (From neighbors, friends, or other lawyers and insurance companies)

Posted by Nancy Cavey

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MYTHS/ LIES: You are on a level playing field with the insurance company. If your employer says you are too injured to work, the insurance company will automatically pay. Filling out the disability insurance company’s forms will automatically result in your being paid disability benefits. If you have been awarded Social Security disability benefits, you will have no problem getting your long-term disability benefits. If your doctor writes that you are "disabled", you will win your case. If the insurance company sends you an "activity log," it is because they are sincerely interested in what you do on a daily basis. The best way to convince the...

28 October

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The Truth About Long Term Disability Insurance Companies

Posted by Nancy Cavey

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THE TRUTH: Numerous judges have acknowledged that you are not on a level playing field with the insurance company during the claims process. Your employer's opinion of whether or not you can work carries little weight. Many employers are very upset to learn that the policy they purchased for their employees and themselves is not paying disability benefits. Many insurance companies will say, "your opinion does not count" or "you should have bought a better policy." Insurance company forms are actually designed to trick you into giving up information, that will later be used to help the insurance company deny your claim. Insurance companies...

28 October

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How We Handle Your Long Term Disability Claim

Posted by Nancy Cavey

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Fewer cases = More Time for You We are “different.” We don’t rely on a high volume of cases. We don’t claim to handle every type of law because we don’t want to. Each year we accept a limited number of long-term disability, Social Security, workers’ compensation, and wage and hour cases from the hundreds of people who ask us to represent them. We are not a “TV advertising mill.” We do not allow paralegals or assistants to negotiate your case. Fewer cases means more of our time is spent focusing on your needs, which we believe produces better results overall. Our best advice...

28 October

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What you DON’T Want To See In Your Your Long Term Disability Policy

Posted by Nancy Cavey

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Unfair Language # 1: "We Have Discretion to determine Benefits" Most disability insurance companies hide behind a clause hidden in their policies known as a "reservation of discretion". But don't bother to look in the ERISA statute for anything about a "reservation of discretion" clause. The federal courts have given the insurance companies the right to hide the so-called "reservation of discretion" clause, leaving all employees at risk! Florida is part of the Federal 11th Circuit Court of Appeals which has chosen to create its own rules on how it will review an insurance company’s long-term disability claim denial. First, the federal judge...

Author: Nancy Cavey