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Author: Nancy Cavey

CaveyLaw.com > Articles posted by Nancy Cavey (Page 14)

Discretionary Clauses And Your Long Term Disability Claim

Discretionary Clauses long term disability claims

Get out your long term disability policy and look for something called the “Discretionary Clause”. It’s a clause that lets the long term disability carrier make the decision and requires that the court defer to its decision. It’s what I call a “get out of jail free card.” Fortunately, there are some states that prohibit discretionary clauses in long term disability policies. These states include: California; Colorado; Illinois; Michigan; and Washington. You can determine whether the discretionary clause is applicable to you by looking at your disability policy and what state your policy was issued. What other terms don’t you want to see in your long term disability...

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Making The Decision To Hire An Attorney To Get Your Long Term Disability Benefits If Your Claim Has Been Denied

hiring a long term disability attorney

You bought your long term disability policy to provide you and your family peace of mind if you were unable to work. You’ve even made the difficult decision to apply for disability benefits knowing that your physician and employer have supported your claim. Yet, you’ve gotten a denial from the long term disability carrier. No matter how angry or upset you are, don’t walk away from your long term disability claim. As a disability attorney, I know that very few people look forward to protracted litigation but there are times in life when the only right course of action is...

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Can I Attempt A Trial Work Period While Collecting Social Security Disability Benefits?

twp social security disability

Yes! The Social Security Administration has a trial work period (TWP) that lets you test your ability to work for at least 9 months. You will receive your full Social Security benefits, regardless of how much you earn, so long as you report your work activity and continue to have a disabling impairment. In 2014, the trial work month is any month in which your average earnings are over substantial gainful activity (SGA) and your total earnings are more than $1,070. A trial work period will continue until you work 9 trial months within a 60 month period. Months don’t have...

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Social Security Disability Benefits For Wounded Warriors

wounded warrior social security disability

Military service members who became disabled while on active military service on or after October 1, 2001, regardless of where the disability occurs, may be eligible for expedited processing of their Social Security Disability claims. How you qualify for Social Security Disability benefits! Social Security Disability benefits are different than the VA. The Social Security Administration has its own claims process (linked to our articles) and to be found disabled for Social Security purposes, you must: Be unable to do substantial work because of your medical condition(s); and You medical condition(s) must have lasted or be expected to last at least one year or...

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Cardiomyopathy And Florida’s First Responded Presumption

Cardiomyopathy disability attorney

In a case of Orange County v. Wilder, the 1st District Court of Appeals has ruled that viral cardiomyopathy constitutes heart and “heart disease” as the term is used in Section Florida Statute 112.18.  If a presumption applies, a first responder is under no obligation to establish occupational causation and the employer has the burden to prove that they did not get the virus at work. Are you a first responder and have a question about this issue? We represent all over the state of Florida First Responders who need help just like in this situation. Give us a call 727-894-3188...

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Law Enforcement Agencies Don’t Have To Tell First Responders About The Statutory Presumption

first responders claims tampa

The 1st District Court of Appeal recently ruled that there is no requirement that an Employer/Carrier provide injured law enforcement officers information regarding the statutory presumption. Officer Guevara was employed by the City of North Bay Village and was placed on light duty on March 15, 2007 after a physical revealed his blood pressure was elevated. His supervisor completed a Notice of Injury and the City of North Bay Village, through Florida Municipal Insurance Trust/Florida League of Cities, sent Officer Guevara an initial claim packet which included an informational brochure approved by the Department of Financial Services. The packet did not enclose...

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Unemployment Benefits And Your Rights To Social Security Disability Benefits

unemployment social security disability benefits

The receipt of Unemployment Insurance benefits does not prevent you from getting Social Security Disability benefits. In Cleveland v. Policy Management Systems Corp. 526 U.S. 795 (1999), the United States Supreme Court held, in a unanimous decision, that a claim for Social Security Disability benefits is consistent with a claim for relief under the Americans with Disabilities Act (ADA), even though there must be an ability to work in order to obtain relief under the ADA. The United States Supreme Court held that under the presumptions embodied in the 5-Step Sequential Evaluation process, a person can qualify for Social Security Disability benefits...

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How Do Long Term Disability Carriers Use Position Statements To Deny Fibromyalgia Claims?

long term disability carriers position

Many long term disability carriers are in the business of collecting premiums and not paying benefits to fibromyalgia policy holders. Many long term disability carriers will deny fibromyalgia claims on the basis that fibromyalgia is largely based on self reported symptoms and that there isn’t any objective evidence of restrictions and limitations. It’s not uncommon to see a denial letter language that describes fibromyalgia syndrome as a functional somatic syndrome. The denial language will say that FMS sufferers symptoms are “exacerbated by a self-perpetuating, self-validating cycle in which common, endemic, somatic symptoms are incorrectly attributed to serious abnormality, reinforcing the patient’s...

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Surviving Spouse Social Security Benefits For Same Sex Couples

social security disability same sex couple

The Social Security Administration (SSA) issued rules on December 16, 2003 authorizing the processing and payment of some surviving spouse lump sum death benefits for same sex married couples. SSA has also begun to process claims for the spouses of retired workers, if the couple is married and domiciled in a state that recognizes same sex marriages. There is the question of what happens if the couple was married in the state that recognizes same sex marriage but the wage earner lived in a state that didn’t recognize same sex marriage. We’ll keep you advised once the Social Security Administration addresses this...

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Are There Disability Plans That Are Not Governed By The Erisa Statute?

erisa disability plans

The Employer Retirement Income Security Act of 1974 governs employee welfare benefit plans, including disability insurance plans. ERISA is not a plaintiff friendly statute and, fortunately, there are plans that are not governed by ERISA. These include plans by: • Churches; • Government; • Entities; • Plans maintained for the purposes of complying with Workers’ Compensation; and • Plans maintained outside the United States for the benefit of persons for non-resident aliens. The great news is that if you’re employed by a government agency such as state or a local government, your long term disability benefits are not governed by the ERISA statute. You can learn more about...

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