09 November

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How Long Term Disability Carriers Use the Mental Nervous Limitation Provisions Against Policy Holders To Limit Benefits

Mental Nervous Limitation Provisions Disability Claims

Many disability policies limit the payment of disability insurance benefits if the policy holder has a psychiatric condition. The key to understanding the Mental Nervous exclusion turns to the language in the policy. Unfortunately, there is no uniform policy language. For example, policies can provide for a: (1) mental illness exclusion based on “caused by or contributed to” language, (2) mental illness exclusion based on a disability based solely on a mental illness. These are completely two different types of mental illness exclusion provisions. The more problematic one is the mental exclusion that uses the “caused by or contributed to” language. Why Is That? For...

31 October

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What Every Long Term Disability Policy Holder Should Do If Their Claim For Cognitive Disorder Has Been Denied Based On A Neuropsychological Report

Posted by Nancy Cavey

in Long Term Disability

Unfortunately, long-term disability carriers don’t make it easy for those with cognitive dysfunction to get the disability benefits they deserve or to stay on claim. One of the tactics that disability carriers routinely use is to claim that cognitive problems are just the manifestation of underlying psychiatric conditions. As a result, a policy holder’s benefits will be limited to just 2 years. To bolster this defense, they’ll have an “independent” medical evaluation by a “liar for hire” neuropsychologist whose job it is to give the disability carrier ammunition to deny the claim. That’s particularly true because cognitive problems can be self-reported....

10 August

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How A Long Term Disability Claimant Can Prove Cognitive Dysfunction In Their Long Term Disability Claim

Posted by Nancy Cavey

in Long Term Disability

Cognitive Dysfunction Long Term Disability Claims

It’s not uncommon for cognitive problems to be caused by: Dementia Traumatic Brain Injury Brain tumors Multiple Sclerosis Acquired Immune Deficiency (AID) HIV associated Dementia (HAD) Stroke Cancer Related Fatigue Huntington’s Disease Parkinson’s Disease. Unfortunately, long term disability carriers don’t make it easy for those with cognitive dysfunction to get the disability benefits they deserve or, improperly, attempt to limit the policy holder’s benefits to just 24 months of benefits under the policy’s mental/nervous limitation. What Should Every Long Term Disability Policy Holder With A Cognitive Dysfunction Do? Neuropsychological testing is one way to establish disability. However, the neuropsychological testing should be only...

02 August

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Symptoms Long Term Disability Carriers Expect To See In A Policy Holder’s Medical Records With Lyme Disease

Posted by Nancy Cavey

in Long Term Disability

Lyme Disease Long Term Disability Claims Attorney

Chronic Lyme disease patients can have a long hard fight to get the disability benefits they deserve. Those with Lyme disease have many debilitating symptoms including severe: fatigue, anxiety, headaches, and joint pain. It’s a complex disease that s difficult to diagnose. Reliable diagnostic studies aren’t available and disability carriers always look for a formal diagnosis of Lyme disease based on the tell tale signs of Lyme disease: (1) the discovery of a tick on the skin, (2) a bulls-eye’s patter rash, and (3) and possible joint pain. However, according to the International Lyme and Associated Disease Society, ILADS, points out that only “50-60% of...

19 June

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This Is What Happens When A ERISA Disability Policy Holder Is Left High and Dry

Posted by Nancy Cavey

in Long Term Disability

You purchase a long term disability policy to provide you with peace of mind if you became sick, injured or disabled. Unfortunately, long term disability carriers don’t make it easy for the disability policyholders to get the disability benefits they deserve. Understanding The Disability Insurance Claims Process There are 4 possible scenarios in the claims process. Be sick, injured or disabled people but haven’t yet filed a claim; Applied for benefits and are waiting for a decision of coverage; Been denied in the appeal process stage or; You exhausted the right to appeal the claims denial. Sick, Injured Or Disabled But Not Yet Filed...

18 April

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The Ugly Truth About ERISA Plans And Contractual Limitations Period

Posted by Nancy Cavey

in Long Term Disability

When Does The Meter Run On Your ERISA Disability Claim? In Heimeshoff v. Hartford Life and Accident Insurance Company, U.S.#12-729(December 16, 2013) the United State Supreme Court found that “absent the controlling statute to the contrary a participant and a plan may agree by contract for particular limitations., even when it starts to run before the cause of action approves, as long as the period is reasonable.” That is bad news for an ERISA policy holder whose claim has been denied. The Contractual Limitations In An ERISA Disability Plan The Hartford Life and Accident Plan in the Heimeshoff case included a provision that...

08 November

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The Ugly Truth About Why Every Physician Should Have Disability Insurance

Posted by Nancy Cavey

in Long Term Disability

Disability Insurance Benefits for Physician

Did you know that nearly 1 in 5 people living in the United States have a disability for over a year or until they reach the age of 65. Physicians see on a day in and day out the devastating impact of injury or illness. Unfortunately, many physicians don’t have long term disability insurance or don’t have proper income protection. It’s The Perfect Time To Add Or Increase Your Disability Insurance If You're A Physician Physicians typically earn more than $200,000.00 per year and have a lifetime earning potentials in the millions. Obviously, they have more to protect and more to lose. It’s...

26 September

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How to Make Your Disability Insurance Company Pay Attention To Your Social Security Decision

Posted by Nancy Cavey

in Long Term Disability

Disability Insurance Company Long Term Disability Attorney

Many times long term disability policies require that the policyholder applies for Social Security Disability benefits (SSDB). The policy will also provide that if you don’t apply for the benefits, the carrier has the right to reduce your disability benefits by what you or your dependent relatives would have received in your Social Security benefits. Once you are awarded benefits, the disability carrier will ask to be repaid any disability benefits and will reduce your benefits in the future. What Happens If They Ignore The Social Security Decision And Deny My Benefits? In the recent case of Melech v. Life Insurance Company of...

12 September

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What Every Disability Policy Holder Needs To Know About ERISA

Posted by Nancy Cavey

in Long Term Disability

“ERISA” stands for the Employment Retirement Income Security Act that was enacted in 1974 as a result of the Jimmy Hoffa’s pension scandals. The United States Congress wanted employers to provide to its employees a pension, health insurance, disability insurance and other employee benefits. To make this insurance affordable, employers asked for legislative protection from being sued. See our practice area page about LTD ERISA Attorney. What Are The Legislative Protections of ERISA? Preemption If you have to file a lawsuit to get your benefits, it must be filed in Federal Court. The ERISA statute preempts or prevents you from filing virtually all...

04 August

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Can You No Longer Work With Your Scleroderma

Posted by Nancy Cavey

in Long Term Disability

Scleroderma Long Term Disability Claims Attorney

The Scleroderma Foundation has recognized June as Scleroderma Awareness Month with annual awareness and fundraising events. What You Should Do If Your Doctor Has Told You That You Can No Longer Work As A Result of Scleroderma You may have purchased a disability policy on your own through your employer hoping you’d never need to apply for disability insurance benefits if you became disabled. Scleroderma in the United States is estimated to be 20 out of every 100,000 people and occurs in all races, genders and at any age. If your doctor has told you that you can’t work anymore as a result of...