08 November

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Chapter 440 First Responder Workers Compensation Benefits Rights

in Florida City and State Pension Disability Claims

Chapter 440 has a section that deals with the authorization of medical care found in section 440.13. At various times Chapter 440 has required an employer/carrier to offer First Responders a list of least three physicians from which to select when there has been a request for a one time change of physician. This statute is honored by a number of changes and, currently, the statute does not require that the employer offer a choice of providers. Once the Employer/Carrier offers an appointment with a physician you have the obligation to accept care and treatment from an authorized physician before you can...

08 November

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The Truth about the US Economy and its Impact on Long Term Disability Claims

Posted by Nancy Cavey

in Long Term Disability

In Hartford's 2010 Benefit Landscape Study, Long Gendreau, Executive Vice President of the Hartford Group Benefits, explained that the number of employees in the United States with "short term disability insurance rose from 41% in 2009 to 55% in 2010" the percentage of American workers with "long term disability insurance increased from 36% in 2009 to 47% in 2010". Income production is key to protecting your financial well-being. Nancy Cavey, Florida individual policy attorney, recommends that if you are considering the purchase of a long term disability policy, that you purchase your own personal individual disability policy as opposed to a grouped...

08 November

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The Truth About Long Term Disability Carriers Attending Physician Forms

Posted by Nancy Cavey

in Long Term Disability

All long term disability carriers will have your physician complete what called an attending physician form. Unfortunately, there are no uniform forms. AETNA, for example, asked doctors to comment on activities of daily living driving, lifting, pulling and pushing. In Helms vs. Gerald Dynamics Corp, 2007 US.app.Lexus 4534 (11th Circuit February 7th, 2007) in a published decision, the 11th circuit held that AETNA "unreasonably construed what qualified as restrictions and limitations", ignoring the opinions of the treating physician which established the extensive restrictions and limitations and which were greater than AETNA's own attending physician form. Initially, AETNA concluded that the claimant had...

08 November

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The Dirty Little Secret that Hartford Doesn’t Want you to Know about Juan Mendez, Dr. Mark Burns and Dr. Michael Ratter

Posted by Nancy Cavey

in Long Term Disability

Long term disability carriers, like Hartford Life Insurance Company routinely see claims like fibromyalgia syndrome which cause persistent and debilitating pain. For example, in Klehforf vs. Hartford Life and Accident insurance Company, 201.WL.260066018 (N.D. Ind., June 22, 2010), Mr. Klehforf was employed as Vice President and Senior Fiduciary Officer at JP Morgan Chase from 1976 until September 2007. Unfortunately Mr. Klehforf, had suffered from fibromyalgia and was unable to continue to work at Chase. Hartford review the medical evidence and concluded, mysteriously, that the “medical evidence didn’t support” the claim. This, of course is a common Hartford defense and one that...

08 November

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The Truth about ETNA’s Claim Handling of Spinal Injuries | St. Petersburg Disability Attorney

Posted by Nancy Cavey

in Long Term Disability

Long term disability carriers, like ETNA Life Insurance Company are in the business of collecting premium and notInsurance Carriers Like Etna Claim Handling paying benefits. In the case of Capone vs. ETNA Life Insurance Company, 22 Florida Law Weekly Fed C368 cited as 592f3d1189 (11th Circuit 2010), Mr. Capone sustained an injury to his spine when he dove head first into the ocean after witnessing others doing so. ETNA denied the claim on the basis that “alcohol had necessarily caused or contributed to the employees injury”. In the great decision, the 11th Circuit took ETNA to task for the policy language...

08 November

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Is Your Financial Future as an Orthopedic Surgeon Vulnerable because You Don’t Understand the Terms of Your Northwest Mutual Long Term Disability Policy?

Posted by Nancy Cavey

in Long Term Disability

Here’s a rhetorical question. When is orthopedic surgery not automatically considered an occupation on your long term disability policy? That’s an important question to know the answer to because you might be jeopardizing you rights to long term disability benefits if you become disabled. Some long term disability carriers, like Northwestern Mutual may deny long term disability claims on the fact that “surgery is not a substantial or material duty of your occupation as an orthopedic surgeon” by looking at the number of surgeries or percentage of income you generate from surgeries. Companies like Northwest will say that your occupation is not...

08 November

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If You Don’t Understand the Games Employers are Playing in Managing Short Term Disability Claims, You’ll Hate Yourself Later

Posted by Nancy Cavey

in Long Term Disability

Short term disability attorney Nancy Cavey is seeing employers for short term disability cases is to limit the eligibility periods to as short as thirteen weeks, or more commonly, terminating short term benefits before full recovery. In the last six months Nancy Cavey has seen the termination of benefits before full recovery either causing a premature forced return to work or a delay in obtaining long term disability benefits. In some instances this may be a strategy designed to make absent employees to seek employment elsewhere or join unemployment. If your short term disability claim is being delay or denied contact short...

08 November

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Bi-polar Social Security Disability Benefits

Posted by Nancy Cavey

in Long Term Disability

Cavey & Barrett’s claimant was employed at Johnson & Johnson Vision Care as a sales representative and became disabled as a result of bipolar disorder for which he was awarded Social Security Disability benefits. The claim for LTD benefits was initially denied since his bipolar condition did not prevent him from doing any job for which he was qualified by training, education or experience. They failed to include the treatment program. Nancy Cavey developed medical evidence to establish that our claimant in fact, complied with the recommendations of his treating psychiatrist and submitted his Social Security decision to Johnson & Johnson...

08 November

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Overpayment of Long Term Disability Benefits and that Call from the Carrier Asking for the Money Back

Posted by Nancy Cavey

in Long Term Disability

Did you know that long term disability policies do have clauses in the policy that provide that if you have been “over paid” benefits, you owe the money back. However, some courts hold that as a matter of law, the carrier can’t be entitled to reimbursement because of these “equitable relief”. Unfortunately, there is no uniformity in the law in the United States on this issue. If you are a long term disability policy holder whose being dumped by the long term disability carrier for an alleged over payment, you need the services of a long term disability overpayment attorney...

08 November

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Assembling a Paper Trail and Your Long Term Disability Carrier

Posted by Nancy Cavey

in Long Term Disability

Unfortunately, long term disability carriers have a habit “losing” important information that you might send to them, including activity of daily living forms. Nancy Cavey has written an informative book The Smart Long Term Disability Consumer Guide for Preparing for Your Statement and Field Visit that you should have before completing any long term disability activity of daily of living forms. If you are submitting those forms or any other evidence, make sure that you’ve assembled a paper trail that can be followed. That means that you keep a copy of everything that you send and send it certified mail. If...

Author: Nancy Cavey