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Author: Nancy Cavey

CaveyLaw.com > Articles posted by Nancy Cavey (Page 15)

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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How Can I Obtain A Copy Of My Disability Documents?

disability documents

Your employer should be able to provide you with a copy of the summary plan of description (SPD) which provides you with a description of the benefits that you may be entitled to as a result of disability, the definition of disability and how to make a claim for benefits. You can also request relevant documents from the plan under a 29CFR Section 2560.503-1(N)(8) if your benefits have been denied. Long term disability carriers are required to provide you with a copy of documents to: • Rely on in making the benefit determination; • Submit, proceed or generate in the course of making...

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What Is Erisa And Why Should I Care That My Long Term Disability Carrier Might Be Governed By Erisa?

erisa lawyer disability tampa st petersburg

What you need to know about the claim forms ERISA is shorthand for the Employer Retirement Income Security Act of 1994. It’s Federal legislation that governs how insurance companies handle disability claims and it gives disability carriers a “get out of jail free card.” In most ERISA governed claims, a court can only overturn the long term disability carrier’s decision if you prove that the denial was “arbitrary and capricious.” That’s the highest burden of proof in a civil court and it’s the “get out of jail free card” that disability insurance companies, like UNUM Provident, MetLife, Cigna/LINA, Aetna, Lincoln Financial, Prudential...

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How Long Term Disability Carriers Will Use Functional Capacity Evaluations To Deny Your Claim

long term disability insurance claims

Long term disability carriers play hardball on claims and one of the ways they play hardball is to have you undergo a functional capacity evaluation. Why? If the long term disability carrier can show that you’re capable of engaging at least sedentary work, they will have legitimate grounds to deny your claim for disability benefits, notwithstanding what your physician has said about your restrictions and limitations. What is a functional capacity evaluation? It’s a 3 to 5 hour confidence evaluation used to determine your current ability, strength endurance, sensation, hand function and gross and fine motor coordination. They will evaluation the appropriateness...

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What Are The Five Reasons Disability Insurance Companies Wrongfully Deny Or Terminate Long Term Disability Benefits?

5 reasons long term disability

If you purchased your disability policy through your employer the policy is most likely governed by the ERISA statute. The Employer Retirement Income Security Action (ERISA) of 1994 is Federal legislation that has given a “get of jail free card” to disability insurance companies. In most ERISA governed claims, courts will only overturn the insurance company’s decision if you can prove that denial was “arbitrary and capricious.” That’s the highest burden of proof in a civil case and it allows insurance companies to “play hardball” on claims. The most common reasons that long term disability carriers wrongfully deny or terminate benefits are: 1....

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SOCIAL SECURITY DISABILITY BENEFITS AND ACUTE LEUKEMIA

If you’ve been diagnosed with acute leukemia you may be entitled to Social Security disability benefits. The Social Security Administration uses a 5 Step sequential evaluation to determine if you are entitled to Social Security disability benefits. [caption id="attachment_5175" align="aligncenter" width="250"] Leukemia social security disability[/caption] How does the Social Security Administration decide if I qualify for disability benefits for leukemia? The Social Security Administration will consider whether or not your leukemia is severe enough to meet a listing at Step 3 of the sequential evaluation process. There is a medical listing 3.06A for acute leukemia. The Social Security Administration will want to see...

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Your Plan for Long Term Disability Benefits and a Functional Capacity Evaluation

functional capacity evaluation disability

One of the best ways to establish your functional restrictions and limitations is a functional capacity evaluation. However, all to often, long term disability carriers use functional capacity evaluations as a basis to deny claims. Many long term disability carriers will deny claims on the basis there is no objective basis for the physical restrictions and limitations assigned by your physician. The long term disability carrier will request a functional capacity evaluation to determine the validity of your subjective complaints and prove you can work. What is a functional capacity evaluation? A functional capacity evaluation is a 3 to 5 hour comprehensive evaluation...

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