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No. 10 – The seven things long-term disability policyholders should do.

No. 10 - The seven things long-term disability policyholders should do. Nancy Cavey, Hillsboro and Pinelas 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)...

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No. 9 – Has your claim for long-term disability benefits been denied on the basis that you haven’t been putting forth your best efforts?

No. 9 - 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 Reid Group, to review long-term disability claims. Unfortunately, the Reid 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 Reid Group will conclude that you haven't been "cooperating" under the terms of the plan. If your claim for long-term ...

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No. 8 – Psychological disability and long-term disability claims

No. 8 - Psychological disability and long-term disability claims 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...

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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?

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...

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No. 6 – The Long-term Disability Carrier is trying to talk with my treating physician behind my back. What should I do?

No. 6 - The Long-term Disability Carrier is trying to talk with my treating physician behind my back. What should I do? Unfortunately, it's not uncommon for the long-term disability insurance company to use the medical release which you signed to communicate directly with your treating physicians without notice to you. They will also tell your treating physician their version of your medical condition and your policy terms in an attempt to get the physician to release you to some form of employment. In the case of Safon v. Wells Fargo & Company, Long-term Disability Plan,...

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No. 5 – What every medical professional needs to know about ERISA

No. 5 - What every medical professional needs to know about ERISA It is important that medical professionals understand their long-term disability policy so they can prevent the disaster of being disabled and being unable to recover the benefits they deserve. Did you know that there are three types of disability policies? Do you know which kind you have? The first is an individual disability policy, which you may have purchased directly from a carrier and which provides you long-term disability benefits in the event of sickness or injury. Do you know that there are two types of...

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No. 4 – The 2008 economy and the payment of long-term disability benefits.

No. 4 - The 2008 economy and the payment of long-term disability benefits. At the Law Office of Nancy L. Cavey we are seeing a "slow pace strategy" by long-term disability carriers. We have found that carriers aren't "receiving paperwork," asking for the same information over and over, suggesting that they need information, indicating that there is a delay in getting information from physicians. These are all delay tactics that the carriers are using to delay payment to you. With stock prices down and a lack of investment income earnings, disability insurance companies are taking longer to determine disability claims and to...

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No. 3 – Long-term disability and financial planning.

No. 3 - Long-term disability and financial planning. At The Law Office of Nancy L. Cavey we assist our Long-Term Disability/ERISA clients in dealing with the challenges they confront in the disability claims process. These questions include: (1) What are my benefits when I'm going to start working? (2) How do I file for Social Security? (3) Should I COBRA my health coverage? (4) Do I have alternative sources of healthcare? (5) How do I make the health insurance gap between my Medicare eligibility and the loss of my healthcare? For assistance with these questions and your long-term disability or Social Security Disability...

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No. 2 – Long-term disability benefits and my healthcare coverage through COBRA

No. 2 - Long-term disability benefits and my healthcare coverage through COBRA At The Law Office of Nancy L. Cavey, it's not uncommon for long-term disability applicants to come to our office with a letter from their employer about continuing their healthcare coverage through COBRA. Federal law requires employers with 20 or more employees to provide COBRA health care continuation coverage, and there are specific time limits for choosing this coverage. Unfortunately, many long-term disability applicants are also applying for Social Security Disability benefits and are in need of medical treatment. They have not become Medicare eligible and are facing a gap in...

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No. 1 – Is the long-term disability carrier entitled to repayment because I got Social Security Disability benefits?

No. 1 - Is the long-term disability carrier entitled to repayment because I got Social Security Disability benefits? Have you read your long-term disability policy? Does it provide that future benefits can be withheld to recover any overpayment arising from a retroactive payment of benefits such as Social Security Disability benefits? In the case of White v. Coca Cola Corporation, the United States District Court for the Northern District of Georgia upheld a provision in Coca Cola's long-term disability plan that allowed Coca Cola to withhold future benefits to recover a retroactive payment of Social...

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