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No. 7 – The long-term disability carrier is denying my benefits because my physician won’t respond to their request for information. What should I do?

The long-term disability carrier should not be contacting your treating physician without letting you know. In a 9th Circuit court case, Safon v. Wells Fargo & Company, Long-term Disability Plan, 522 F.3d 863 (9th Cir. 2008), the court held that direct contact with a treating physician was a direct violation of the ERISA fiduciary duty. This court also held that Met Life and Wells Fargo violated ERISA by attempting to use the physician's failure to respond as evidence against the claimant: "A doctor is not a lawyer; though he may provide information that is relevant to a claimant's disability, his actions...

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Psychological Disability and Long Term Disability Claim

Unfortunately, long-term disability carriers routinely use companies such as PSY BAR to review long-term disability/ERISA claims involving psychiatric conditions. I recently reviewed PSY BAR's website and noted that they offer online courses to adjusters and IME doctors. One of the courses, "Psychological and Psychiatric Assessment of Individuals for Disability Insurers," actually teaches "independent medical doctors" what the long-term disability insurance company's expectations are and how to meet those expectations in an ethical manner. Interestingly enough, this course identifies what PSY BAR believes to be "common IME errors:" ERROR NO. 1 - Confusing the needs of the disability carrier with other kinds of coverage, including...

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Has your claim for long-term disability benefits been denied on the basis that you haven’t been putting forth your best efforts?

Long-term disability carriers routinely hire companies such as The Reed Group, to review long-term disability claims. Unfortunately, the Reed Group will use, as a basis for denying claims, an allegation that a psychiatrically disabled person hasn't put forth their best efforts in neuropsychological testing based on tests of memory validity. The Reed Group will conclude that you haven't been "cooperating" under the terms of the plan. If your claim for long-term disability benefits has been denied or the carrier is sending you to a neuropsychiatry examination, contact Nancy Cavey immediately. Also, Contact us for our free, no-obligation books "Robbed of Your...

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Disability insurance companies are increasing their Long Term Disability Denials

Attorny's Jason Newfield and Justin Frankel , disability law colleagues of Nancy Cavey, have noted that "disability insurance companies are fighting to protect their cash reserves and the claims area is the first place to shore reserves. There is no downside to these companies when they delay or deny claims, and long-term disability policy holders must keep that in mind." Disability insurance lawyer Nancy Cavey urges that you understand the claims process and written two critical books to assist you through the Long Term Disability Claims Process. Please contact us for your free, no-obligation books, "Robbed of Your Peace of...

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The Seven Things Long-Term Disability Policy Holders Should Do

Nancy Cavey, Hillsborough and Pinellas Counties disability insurance company lawyer, suggests that longer-term disability applicants call and: (1) get a copy of their policy; (2) read the policy and the directions for filing their claim and follow every step; (3) make a copy of everything you send to the disability carrier; (4) send everything to the long-term disability carrier with return receipt request to prove that you sent the material; (5) if you speak with the adjuster, which Nancy Cavey does not suggest you do, document every telephone conversation; (6) if you have a high monthly benefit policy, be prepared for surveillance. The disability insurance company...

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No. 10 – Can I refuse to attend a neuropsychological exam at a long-term disability carrier?

If a long-term disability carrier is scheduling you for a neuropsychological exam, I strongly suggest that you contact an attorney like Nancy Cavey immediately! Nancy Cavey is familiar with the neuropsychologists routinely used by long-term disability carriers. We won't ever refuse an exam, but there are a number of things that can be done to protect your interests. These include: (1) obtaining your own neuropsychological exam before attending the long-term disability carrier's neuropsychological exam; (2) videotaping the independent medical examination; (3) limit the carrier's neuropsychological review to the raw data of your examination. To discuss this, and any other issues you have with your long-term...

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Dental disability insurance is essential.

If you become disabled and are unable to work, dental disability insurance is essential to help you maintain your current practice. According to a recent survey, nearly half of one million people who filed for bankruptcy in the United States did so because of an illness or an injury. If you're involved in a car accident, suffered a sports injury, or have any other painful condition, you may be unable to continue your practice and be forced to close or even sell your practice. It's essential that you find a disability plan that meets your occupational needs. Determining which policy is...

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Shopping for a physician and dental disability insurance.

Physicians and dental disability insurance can help protect medical providers and their families in the case of injuries or unexpected circumstances. You and your family rely on your paycheck to pay bills, feed and clothe your family, and to provide a home and a lifestyle that have come to expect. There are a number of things that you should consider before choosing a disability insurance policy. At Cavey & Barrett, we recommend that physicians and dentists purchase private disability insurance policies instead of a policy through a group plan. You should consider the following: 1. Quality. This disability plan will be the...

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Long-term disability carriers’ Independent Medical Examiners.

Unfortunately, it's not uncommon for long-term disability carriers to use "independent" medical examiners to evaluate your entitlement to continuing long-term disability benefits. This is particularly true in the case of psychiatric or psychological conditions such as depression or anxiety. One of the most common "tricks" is to have a long-term disability carrier schedule an independent medical examination with a psychiatrist or a psychologist who will have you sit in a room with a computer and answer hundreds of questions on the computer. This is known as psychological or psychiatric testing. What you will find is most of the questions don't apply to...

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Three things that claimants must do before filing a disability claim.

It is crucial that any long-term disability policyholder who is about to file a claim for immediate disability benefits do the following: 1. Get a copy of the original policy. 2. a. Read the policy so that you understand whether or not your disabling condition is, in fact, covered under the terms of the policy and for how long benefits will be paid. You also need to understand whether there will be any reduction from your disability benefits for income such as Workers' Compensation, Social Security, or even 401K deductions. 2. b. You should also read the policy for the directions required for...

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