How We Handle Your Long Term Disability Claim
Fewer cases = More Time for You
We are “different.”
We don’t rely on a high volume of cases. We don’t claim to handle every type of law because we don’t want to.
Each year we accept a limited number of long-term disability, Social Security, workers’ compensation, and wage and hour cases from the hundreds of people who ask us to represent them. We are not a “TV advertising mill.” We do not allow paralegals or assistants to negotiate your case. Fewer cases means more of our time is spent focusing on your needs, which we believe produces better results overall.
Our best advice will come before you file your claim so that you may fully understand the benefits to which you may be entitled, how to successfully prepare your claim, and what you can expect in the claim and litigation process. I will tell you if your claim can be won. I will also tell you if we believe you are better off handling your claim yourself – without an attorney. But, if your case passes my standards and I accept you as my client, you can be assured that you will receive personal attention. I will aggressively represent you, keep you up-to-date on what is happening in your case, and give you advice at each stage of the proceedings.
What do we do for your long-term disability case?
The following is a list of tasks which we may be called upon to help you complete in your case. Remember that each case is different in that not all of these tasks will be required in every case.
As part of our initial case evaluation, we will:
1. Obtain and review the claims file from your disability insurance company.
2. Obtain and review the insurance policy, plan, and summary plan description from your disability insurance company and/or the employer.
3. Obtain and review any updated medical records that have not been provided to the insurance company.
4. Compare the definitions of long-term disability and any policy limitations to past court interpretations (there are eight to 10 standard definitions of “disabled” that various insurance companies may have).
5. Outline your insurance company’s claim notes which often reveal the basis of the denial.
6. Prepare a report for you which outlines the strengths and weaknesses of your case, and proposes a course of action which will create a substantial record in support of your disability claim for the judge. This report will contain a step-by-step plan for creating a record in support of your claim, and a proposed litigation plan where litigation is appropriate.
7. Obtain your agreement to this course of action, arrange for necessary medical evaluations, meet with your treating physicians, obtain necessary medical reports, schedule your functional capacity evaluation and/or vocational evaluation , secure statements from friends or family, and perhaps prepare a video of your job, daily activities, or other relevant evidence.
8. Handle your Social Security case, or have it handled, as appropriate, and coordinate the development and filing of evidence for both cases.
9. Timely file any necessary appeal and monitor the long-term disability carrier’s response.
10. If your benefits are awarded or reinstated, determine the correct amount of your benefits.
11. Prepare a post-acceptance report regarding future disability issues that may arise in your case with a proposed course of action.
12. If your appeal is denied, prepare and file a Complaint with the appropriate court, engage in all applicable discovery, prepare for and attend all mediations with you, prepare Motions For Summary Judgment and, when appropriate, prepare for a jury trial (individual disability claim).
What cases do we not accept?
I have found the only way to provide personal service is to decline those cases which fail to meet my strict criteria. Therefore, I generally do not accept the following types of cases:
1. Cases where your physician does not support your claim.
We cannot be successful in pursuing your long-term disability claim if your physician does not support your claim for disability. While we can help your physician complete long-term disability forms and assist in preparing reports to support your claim, if your physician is not willing to cooperate and support your claim, our time and yours will be wasted.
2. Cases where the client has received medical treatment during a prior time period and later claims that he/she is disabled due to the pre-existing condition. Remember, most long-term disability policies have a clause which excludes coverage for pre-existing conditions. Treating physicians generally are unwilling to distinguish between a currently disabling condition and the same condition which was treated previously.
3. Cases with less than $2,000.00 per month in gross (before tax) disability benefits before offsets are taken against such things as Social Security benefits. While I would like to represent everyone who needs a good attorney, I simply cannot. It is not cost-effective for you or my law firm to expend considerable time and expense when my attorney’s fee may ultimately be greater than the amount of benefits I can secure for you. The last thing I would want to do, would be to put you in a worse position than you were when you started your fight against the insurance company.
4. Cases where the appeal period will end within 30 days, or has already ended.
I need at least four months (approximately 120 days) to adequately investigate and evaluate your claim. This length of time prevents prior delay from becoming an additional obstacle.
5. Cases where the appeal has ended and you seek the services of an attorney to file suit.
I cannot fix other people’s mistakes.
So, are there any cases left?
Absolutely. The point is that I purposely maintain a small law firm, and accept only a limited number of cases each year.
I concentrate my efforts on properly assisting my clients in the claims process, preparing the appeal, and maximizing the opportunity for success – I simply do not pursue frivolous cases.
I represent many clients with valid claims. When I devote my time and resources to representing legitimately disabled people with good claims, I am able to do my best work. Over time, I have learned that getting “bogged down” in lots of small cases, each with a “special problem”, is not good for my legitimate clients’ claims.
Here is a small sampling of just a few types of cases that we have handled in the past. Remember that each case is different. Client testimonials are available upon request.
Long-term disability benefits paid to a truck driver who sustained a brain injury as a result of a stroke.
Long-term disability benefits paid to a vocational rehabilitation counselor with cardiac disease.
Long term disability benefits paid to a flight attendant who sustained spinal injuries while jumping off a waterfall in Hawaii.
Long term disability benefits paid to a medical case manager with fibromyalgia.
I thank you for requesting my book. While I cannot offer a magic solution to your problems, I can offer you guidance. I sincerely hope this book has helped you understand the claims process and your rights.
Answering these broad-based questions isn’t easy. Help is a phone call away. You can contact Nancy Cavey, an experienced long-term disability attorney at 727-894-3188.