What Are the Common Mistakes to Avoid in Long-Term Disability Claims in Florida?

Do You Need Long-Term Disability Benefits?

Did you purchase a long term disability policy through an insurance agent or did your employer offer you long term disability benefits? If you are disabled and out of work and have long term disability coverage,  you should have the services and advice of a Florida disability lawyer for a number of reasons.

A disability attorney can advise you about the difficulties you may encounter in the application process, how to appeal a denial of your application, and the common mistakes that many applicants make when they apply for long-term disability benefits.

What Are the 10 Mistakes Made by Those Seeking Long-Term Disability Insurance Benefits that can Destroy Your Claim?

Most employer-provided disability insurance plans are governed by a federal statute – the Employee Retirement Income Security Act (ERISA). Here are the common mistakes many make when they file for ERISA long-term disability benefits – and how to avoid those mistakes:

1. Don’t assume that the disability insurance company or plan will pay benefits just because your employer supports your claim and told you to apply for benefits. The disability insurance company or plan decides whether you meet the policy or plan definition of disability.
2. Don’t assume that your human resources department’s advice to you is correct because they are not experts in disability insurance policies or plans nor do they know your unique personal situation. As a result, they often give the wrong advice that  results in delay or even a denial of a legitimate claim.
3. Don’t pick the wrong date to stop work and apply for benefits only to find out that your doctor doesn’t support your claim or that your medical records document the nature of your symptoms and functionality before you stopped working. It can be hard, if not impossible, to fix these mistakes after you have stopped working.
4. Don’t assume that  a letter from your doctor that says you can’t work will result in a disability check being Fed-Exed to your home. Your medical records must establish an objective basis of your diagnosis and your restrictions and limitations that explains why you can’t perform the material and substantial duties of your occupation. 
5.  Your employer’s statement to the insurance company regarding your disability is sufficient. The insurance company, and not your employer, will determine if you are disabled based on your insurance policy’s definition of disability.
6. Do not limit your application for long-term disability benefits to the forms provided by the insurance company. Instead, you should meet with your doctor and review with them the policy or plan definition of disability and your occupation. You should ask your doctor to complete a full report explaining how your disability is preventing you from performing the material and substantial duties of your occupation. Some doctors charge for preparing forms and writing reports and it is well worth the cost to give your disability carrier or plan more than what they asked for on the Attending Physician Statement forms.
7. Do not miss any of the deadlines. Your policy will specify the deadlines you must meet. Failing to meet your insurance company’s deadlines may lead to the rejection of your application for long-term disability benefits.
8. Doing physical activities that your doctor told you not to do or are greater than your restrictions and limitations are a red flag to a disability carrier or plan. They will compare what you said you could do on the Activities of Daily Living Forms you have to complete and what is in your medical records. This discrepancy can make it look as if you are exaggerating the extent of your disability. The insurance company may even monitor your social media posts and may even surveil you directly after receiving your claim, particularly if they think you’re exaggerating.
9. Using the disability carrier or plan’s Social Security lawyers to file for Social Security disability benefits is a huge mistake. These lawyers don’t work for you! The disability insurance carrier or plan wants you to work with their lawyers for one reason. While you may have many medical conditions that cause you to be disabled, these lawyers will pick a disabling medical condition, like depression,  as the  basis of your social security claim that will  make it hard to win your long term disability claim or limit how long they have to pay your long term benefits.   
10.  Don’t stop getting medical treatment after your claim is approved. Your policy or plan requires you to get treatment even if your doctor   says there is nothing more they can offer you.

What Else Should You Know About ERISA?

ERISA is a complicated law with a number of rules that govern the long-term disability insurance application process. Any mistakes that you make when you apply for ERISA long-term disability benefits could mean a delay or denial of those benefits.

If your application for long-term ERISA disability insurance benefits is rejected, you only have 180 days in which to file an appeal. The appeal is the trial of your case and no new evidence can be added to your claim once the appeal process time expires. Our appeal letters are 25 to 65 pages long and explain in detail why the carrier or plan was wrong to deny or terminate your benefits.

Only after the appeal time has expired,  can you  file a lawsuit in federal court. You should be represented by a Florida disability attorney who has substantial experience working for those who seek long-term disability benefits under ERISA.

What if Your ERISA Disability or Individual Disability Benefits Claim is Rejected?

If your application for long-term ERISA disability or individual disability insurance benefits is rejected, and if you’re not already working with an attorney, speak with a disability attorney at once about an appeal. A disability attorney will handle your appeal and ensure that you’ve complied with the ERISA guidelines.

Put the Law Office of Nancy L. Cavey to Work for You

Located in St. Petersburg, the Law Office of Nancy L. Cavey specializes in disability law and helping disabled clients. We serve long-term disability insurance clients nationwide and Social Security Disability Insurance clients throughout the State of Florida.

If you have a disability insurance claim or a Social Security disability claim in Florida, do not hesitate to contact the Law Office of Nancy L. Cavey before you apply for SSDI benefits or speak to an insurance company.

We have four decades of experience helping the disabled, and we handle the most complicated disability cases. If you need disability benefits, or if you have been rejected for disability benefits, call us now at 727-477-3263, and put our disability team to work for you. Your first consultation with the Law Office of Nancy L. Cavey is offered without cost or obligation.

Who May Qualify for SSDI Benefits and What Mistakes Can You Make That Will Result in Delay or a Denied Claim?

Social Security Disability Insurance (SSDI) pays disability benefits each month to those who are disabled prior to reaching retirement age. Qualified SSDI applicants have paid Social Security payroll taxes for a number of years, have a sufficient number of work credits to be insured for SSDI purposes, and have a “severe, long-term total disability. The Social Security Administration (SSA) defines:

1.  A “severe” condition as a condition that prevents you from performing essential, job-related tasks.
2.  A “long-term” disabling condition as a disabling condition that is expected to last for at least a year.
3.  A “total” disability as a disability that keeps you from performing “substantial gainful activity” for at least a year.

What Mistakes Are Commonly Made by Those Who Apply for SSDI?

The SSA carefully scrutinizes applications for SSDI benefits and the medical records of applicants. Any mistakes that you make when you submit your application for SSDI benefits could mean a delay or even a denial of those benefits.

A Florida disability lawyer will help you ensure that your application is accurate and complete. Applicants who seek SSDI benefits without a disability attorney’s help commonly make the following mistakes:

1.  Continuing to work is a mistake. If you are still working when you submit your application for SSDI benefits, the SSA may assume that you are not sufficiently disabled to qualify for disability benefits.
2.  Waiting too long after you stop working to apply can be fatal. Over time, you can lose your work credits and your eligibility for SSD.
3. Forgetting to tell SSA on your application all of the physical and mental conditions that you have, even if those conditions aren’t the only reason you can’t work. You might meet SSA’s disability test because of one condition or a combination of medical conditions.
4. If the Social Security Administration sends you any forms or paperwork to complete, fill out and return that paperwork as quickly as you can. Otherwise, the SSA may reject your disability benefits claim based on a lack of information.
5. Do not miss any deadlines. The Social Security Administration has established a number of deadlines for filing applications, responding to requests for more information, and appealing a rejection of your SSDI application.
6. See your doctor regularly and follow your doctor’s recommendations. Failing to keep your appointments or take your medications may lead the Social Security Administration to suspect that you are not sufficiently disabled to qualify for SSDI benefits.
7. Failing to explain to your doctor your disabling symptoms and how those symptoms impact your ability to work and your activities of daily living.
8. Failing to ask your doctor to fill out a Residual Functional Capacity (RFC) form to document your diagnosis, treatment and restrictions and limitations. SSA will never tell you about these forms that we SSDI lawyers have created for over 70 different medical conditions. A properly completed RFC form can make all the difference in a claim.
9. Exaggerating or overstating the severity of your medical problems. Consistency is the key. SSA will look at the forms you filled out, your medical records, and the Third Party Function Forms. You don’t want to overstate or even understate the nature of your medical problems.
10. Waiting too long to hire an SSDI attorney can result in delay or denial because you didn’t understand what you have to prove to win your claim. You may have gotten limited treatment, your medical records may not have been well developed, an RFC may not have submitted or you didn’t timely submit an appeal of a denied claim.

What if Your Social Security Disability Claim is Denied?

If your first application for SSDI benefits is rejected by the SSA, it’s imperative to retain the help of a Florida disability attorney immediately. After your first application is rejected, you need to file an appeal, called a Request for Reconsideration, within 60 days of the denial.

If your claim is denied at the Request for Reconsideration, you will only have 60 days to file a Request for a Hearing. Missing these deadlines means you have to start all over and get back in line.

If your claim is denied at any stage, and if you’re not already working with an attorney, speak with a SSDI attorney at once about an appeal. A SSDI attorney will handle your case and ensure that you’ve compiled with the time deadlines.

Put the Law Office of Nancy L. Cavey to Work for You

Located in St. Petersburg, the Law Office of Nancy L. Cavey specializes in Social Security disability law and helping disabled clients. We serve Social Security Disability Insurance clients throughout the State of Florida.

If you have a Social Security disability claim in Florida, do not hesitate to contact the Law Office of Nancy L. Cavey before you apply for SSDI benefits or appeal a wrongful denial of your claim.

We have four decades of experience helping the disabled, and we handle the most complicated medical conditions. If you need disability benefits, or if you have been rejected for disability benefits, call us now at 727-477-3263, and put our Social Security disability team to work for you. Your first consultation with the Law Office of Nancy L. Cavey is offered without cost or obligation.