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Author: Nancy Cavey > Articles posted by Nancy Cavey (Page 16)

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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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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How Your Doctor Can Help You Win Your Long Term Disability Claim

Doctor Long Term Disability Claim

The long term disability carrier will send your doctor a physician disability form to complete which asks questions about your physical restrictions and limitations. Unfortunately, there is no routine form and many of the forms are designed so that your physician will ultimately opine that you’re capable of sedentary work. Why? The long term disability carrier wants to deny your claim. If the form that your doctor has been sent by the long term disability carrier simply doesn’t address all of your restrictions and limitations, have your doctor document on the form what, in fact, your restrictions and limitations...

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Long Term Disability Claims For Leukemia

Leukemia is a form of cancer of the bone marrow that can cause fatigue, weakness and bone pain. If you have a long term disability policy through your employer or you purchased one on your own, you may be entitled to long term disability benefits if your physician has told you that you are unable to work. Acute Leukemia There are over 10,000 cases of acute leukemia (acute myelocytic leukemia or AML) diagnosed yearly in the United States. One third of the patients have a mutation of the FLT3 gene which produces abnormal enzymes that drive the production of leukemic cells. Experimental...

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What is the difference between Social Security’s definition and a long term disability definition of disability?

The Social Security Administration uses a five step sequential evaluation, the five step sequential evaluation asks whether or not you have engaged in gainful activity, whether you have a severe impairment, meet a listing, whether you can return to the work that you did in the past and whether you are capable of performing other work in the national economy based on your age, education and transferable skills. On the other hand, each long term disability policy has their own definition of disability that generally the definition is the inability to engage in the material and substantial duties of your occupation. The...

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How Does the Government Shutdown Affect My Disability Claim?

government shutdown social security disability claim

Many have wondered how the Government Shutdown will affect their disability claims. While the shutdown will limit the services that the Social Security Administration (SSA) will offer, the good news is they will continue to make payments as scheduled. The SSA will remain open for the following functions: Applications for benefits Requesting an appeal Changing your address or direct deposit information Accepting reports of death Verifying or changing your citizenship Replacing lost or missing Social Security Payment Issuing a critical payment Changing a representative payee Processing a change in your living arrangement or income (SSI only) The hearing office will remain...

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What Proof Does SSA Require to Establish a Medically Determinable Impairment of Fibromyalgia?

SSA has issued Social Security Ruling SSR-12-2p for the evaluation of fibromyalgia in disability claims. Nancy Cavey, fibromyalgia disability attorney hopes that this ruling will result in a proper evaluation of fibromyalgia by Administrative Law Judge’s. Fibromyalgia will be considered a medically determinable impairment when it is established by appropriate medical evidence. Under SSR-12-2p a claimant who alleges disability cased on fibromyalgia must: 1. Be diagnosed by a licensed physician (medical or osteopathic doctor). 2. The doctor must have reviewed the person’s medical history and conducted a physical examination. 3. The medical records must document the claimant’s symptoms over time. 4. The diagnosis must be consistent...

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Social Security Ruling on Fibromyalgia

Those diagnosed with fibromyalgia had a difficult battle proving that they are entitled to Social Security Disability benefits because of the lack of objective medical findings. Over the years the Social Security Administration’s position has evolved and in 1999, SSA issued Social Security ruling (SSR (99-2p)) that provided that claimants with fibromyalgia could be evaluated under the criteria for chronic fatigue syndrome. Despite this directive, ALJ has continued to deny claims based on fibromyalgia finding that Social Security Disability applicants were not credible when there was no medical diagnoses or that the claimants occasional daily activities conflicted with their allegations...

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