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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. The Long Term Disability carrier will ask your treating physician to complete a physical capacity form and address your restrictions and limitations. It is crucial that your doctor accurately fill out your ability to work taking into consideration your side effects of medication, fatigue, difficulty concentrating and pace. Sometimes treating physicians will be optimistic about your abilities and suggest that you can return to work on a trial basis with certain restrictions and limitations. If you do attempt to...

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Cardiac Long Term Disability Claims Denied as a Result of Vocational Opinions Florida Disability Claims Denied Lawyer

It is not uncommon for Long Term Disability applicants who have cardiac problems to be denied Long Term Disability benefits on the basis that they can return to their own occupation or any occupation within the national economy. Long Term Disability carriers will routinely use vocational evaluators to render an opinion that you are capable of returning to old job or some job in the national economy. If that, in fact, were true you wouldn’t be applying for Long Term Disability benefits. People who have heart conditions are evaluated under a permanent impairment guide that is based on your cardiac functionality. There are...

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Long Term Disability Carrier’s Use of Vocational Experts in Claims Denials

I am sure that you have never heard of a vocational evaluator. Unfortunately every Long Term Disability applicant is going to get an education about vocational evaluations and their impact on your Long Term Disability claim. A vocational evaluator will try to determine your residual functional capacity by reviewing your medical records. Your residual functional capacity is a disabled persons remaining physical and mental work potential even in spite of their disabling condition. It is very important that your doctor accurately fill out a residual functional capacity scale so there is no question in the vocational evaluators mind about your restrictions and...

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Surveillance Video and the Life of a Long Term Disability Applicant

If you are applying for or receiving your Long Term Disability benefits, you should assume that you are being watched and video-taped by the Long Term Disability insurance company. Video surveillance is being done in an effort to catch you doing activities that could be used against you. The Long Term Disability carrier is going to ask you to complete Activity of Daily Living forms. Florida based Long Term Disability attorney Nancy Cavey has written the go to free book for Long Term Disability applicants and recipients about how to fill out Activity of Daily Living forms. You should be discussing with...

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Long Term Disability Claim’s Denied Video Tape and Your Treating Physician

If the Long Term Disability carrier is thinking about denying your claim for disability benefits they may put surveillance on you. If you claim that you have difficulty bending, stooping and lifting and investigators obtain videotape of you washing your car, bending and polishing or wiping your car dry. You have a problem. You haven’t been truthful with either the Long Term Disability carrier or your physician. The Long Term Disability carrier will provide your doctor with a copy of the videotape and ask them to comment on whether or not your physician still feels that you are disabled. Needless to say, your...

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Long Term Disability Claim Denial Because “You May Be Able to Perform Your Past Prior Work or Other Work”

Unfortunately, Long Term Disability insurance companies deny claims for all sorts of reasons, however, Nancy Cavey, ERISA Long Term Disability denied lawyer, often sees denial letters which contain the language that your claim was denied because “there is no evidence that demonstrates that a Long Term Disability applicant can perform at a certain exertional level and remains able to perform your past, prior work or other work as proposed.” What does that mean? Long Term Disability carriers routinely will determine, based on a review of your medical records, or an analysis of your medical records by an in house nurse...

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Is There a Statute of Limitations in ERISA Cases?

ERISA doesn’t provide for a statue of limitations for suites under section 502(a)(1)(b) to recover benefits. The federal court looks at the most closely analogous statute of limitations, unless the Long Term Disability contract has a specific limitations. In otherwords, the ERISA plan is nothing more than a contract. Under Florida Law, if the policy language can be given more than one interpretation the insurance policy is consider to be confusing and ambiguous. There has to be interpretability in favor of the policy holder. So here’s a test? Lets say your Long Term Disability policy says that: no legal action of any...

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Outrageous Conduct by LINA and CIGNA in Denying Claims for Long Term Disability Benefits

Unfortunately, it is not uncommon for Long Term Disability carriers to have their adjuster, nurse case reviewer, or their medical reviewer call your treating physician and attempt to get them to say that you are able to work. More often than not, Long Term Disability insurance companies, such as LINA/CIGNA’s medical reviewer will distort or misrepresent what your treating physicians had to say. As a result, Fort Myers, Naples, Sarasota Long Term Disability attorney Nancy Cavey routinely revokes the releases her Long Term Disability clients sign to give the Long Term Disability insurance companies such as CIGNA, the ability to speak...

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Signing a Medical Release in Your Long Term Disability Claim

It is not uncommon that Long Term Disability carriers will ask that you sign medical releases letting them get your medical records. Unfortunately, all too often, this medical authorization is too broad. It will allow them to contact other insurance companies, the Medical Information Bureau, Disability Income Records System and Health Claims Index. These are databases of information shared by insurance companies and they will secure your records in an effort to deny your claim for disability benefits. At The Law Offices of Nancy L. Cavey we object to these over-broad releases and crack them, so they only allow the insurance...

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Dr. Gerson and Your Long Term Disability Claim

Dr. Gerson is a well-known psychiatrist in the Long Term Disability world who makes millions doing part time reviews for companies like UDC. Dr. Gerson MO is clear, as revealed in an article “Doctors Paid to Aid Insurers in Disability Claim’s Denial” by Evan George. Mr. George noted that Prudential Claims uses Dr. Gerson to perform medical reviews as an independent contractor. According a Prudential Claims worker, Dr. Gerson tells them how to successfully deny claims including that of a woman with a brain tumor. Dr. Gerson will suggest surveillance and/or having neuropsychological examination among other tests. The Long Term Disability carrier...

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