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Long Term Disability Carriers Team Approach to Denying Your Long Term Disability Claim

Have you ever wondered how the Long Term Disability carrier goes about evaluating a Long Term Disability claim? They allegedly have “professional disability management teams.” These can consist of a “disability claims managers, disability management services and Social Security assistants.”What is a disability claims manager? That’s a person who is supposed to work with a disability claims management team that consists of their medical directors, clinical experts, Social Security specialists and other staff, who will evaluate your entitlement to benefits and quite frankly, how they will deny your benefits or reduce their exposure.Disability management services do that by developing “relationships...

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Tactics Used to Delay or Deny Long Term Disability Claims

At The Law Offices of Nancy L. Cavey we represent claimants against disability insurance companies at all stages of the disability process. Long term disability insurance companies use a number of tactics to deny or to delay claims. These include:1.     Failing to explain to you all your rights under your disability policy.2.     Making endless requests for employment, medical or other documentation or information.3.     Failing to tell you about the appropriate deadlines, which, if ignored, can result in the loss of your benefits.4.     Using in house medical or vocational evaluators to cherry pick your medical or vocational records as a reason...

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Long Term Disability Insurance Company Peer Review Scams

Long Term Disability carriers only need a reason to deny your disability benefits and, the way they get that reason is to send your file to a handpicked peer review doctor. They will use firms that are set up all over the United States who have recruited doctors to review your medical records and write a report. Guess who’s making the money! First, it’s the peer review or company who hires these peer review doctors and ostensibly, trains them. They are trained to never use the work “disabled” and to always determine that the claimant is capable of working in...

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Own Occupation Claim for Long Term Disability Benefits and Fibromyalgia

Your Long Term Disability policy may provide that you are entitled to disability benefits if you are unable to engage in your own occupation. It is important that you first understand how the Long Term Disability carrier defines “own occupation.” The Long Term Disability carrier may define your “own occupation” as the occupation you are performing for your employer, the occupation as it is performed in the local economy or the occupation as it is performed in the national economy. Note that we are not talking about a new way to do your job or how the job is performed...

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Fibromyalgia and Your Long Term Disability Claim Part 1

Introduction and the Three Things Every Fibromyalgia Disability Applicant Should KnowThere are three things the Long Term Disability carrier looks for in every Fibromyalgia Long Term Disability claim:1.     Objective evidence of the diagnosis of Fibromyalgia2.     Objective evidence that Fibromyalgia is causing physical restrictions and limitations that result in you being disabled.3.     A causal relationship between your diagnosis and disability and your inability to work.The Long Term Disability carriers know that there are many people with Fibromyalgia that are able to work and unfortunately, they evaluate Fibromyalgia claims through that mindset.Is Your Fibromyalgia Condition Covered in Your Long Term Disability policy?One...

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Sleep Apnea and the MS Patient’s Claim for Long Term Disability Benefits

If you suffer from MS and are having difficulty with your long term disability claim, Nancy Cavey, experienced long term disability MS attorney, suggests that part of the problem you might be having is your failure to fully explain all the problems that you have as a result of your MS. This can include difficulty walking, balance and coordination. However, obstructive sleep apnea is a common sleep disorder among people with MS.Many people with MS, also have bladder problems which means that there are in and out of bed frequently. They may also have restless limp syndrome, or periodic limb...

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Lupus and Benlysda: Short and Long Term Disability

If you are a short term or long term disability recipient who suffers from Lupus, there is new drug, Benlysta, specifically designed to treat lupus. It is expected to receive FDA approval this year but it is very expensive. Local Rheumatologist, Dr. Michael Burnette of the Tampa Medical Group has been working with Benlysta as part of the clinical trial for the last five years.In a recent article in St. Petersburg Times on April 29th, 2010, he explained that Benlysda works by "suppressing the part of the immune system associated with Lupus".Research by GlaxoSmithKline has found that Benlysta can...

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Dr. Amy Hopkins and Your Long Term Disability Claim

In a blockbuster article, “Doctors Paid to Aid Insurers in Disability Claims Denial,” Daily Journal staff writer Evan George exposed Dr. Amy Hopkins for what she is. Dr. Hopkins is routinely hired by Long Term Disability carriers to do peer review analysis of Long Term Disability claims.Dr. Hopkins is an occupational medicine specialist who has been paid “$493,832 for file reviews from 2001 to 2004 from just one company.” Her opinions have been challenged in lawsuits repeatedly. In 2004 a Federal Judge in Pennsylvania described Dr. Hopkins approach to disability claims as a “pick and choose approach” that “ignored evidence...

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Dr. Mahwar and Your Long Term Disability Claim

Have you ever heard of Dr. Suresh Mahwar, an internist in Freemont, California? If you are a Long Term Disability claimant, beware because he moonlights by reviewing disability claims for a company called “University Disability Consortium” who is hired by Long Term Disability carriers to provide peer reviewed medical reports. Long Term Disability carriers do this because they need a “legitimate” reason to deny your claim.They routinely will pick organizations such as University Disability Consortium to hire doctors like Dr. Mahwar who rarely disagrees with the Long Term Disability carrier’s decision to deny benefits. In an article by Evan George,...

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UNUM Forces Long Term Disability Applicant to Return to Work and Then Denies Claim

Can you imagine waiting 13 years to get disability benefits? That’s what happened to Johnny McAulley who was insured under a disability policy purchased through his employer Socretes Holdings and later under a conversion policy. UNUM denied coverage to Mr. McAulley on the basis that he untimely exercised his rights to convert his group Long Term Disability policy to an individual policy. UNUM argued that Mr. McAulley should be denied 13 years of disability benefits because he had “tried to return to work.”In Johnny McAulley v. First UNUM Life Insurance Company the trial court “ruled earlier this week that Mr....

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