How Your Employer and The Disability Insurance Companies Takes Advantage of the Disabled
Your employer and their disability insurance company will take advantage of you. They have already taken advantage of you even before you become disabled!
1. The Disability Insurance Company Has Calculated The Profits and the Odds.
One of the most interesting persons who works for a disability insurance company is an actuary. An acutary is an insurance bookie- they know the kinds of illness people have in the United States, at what age they develop these illnesses, how long the disability lasts, what other medical conditions are seen in this disabiling medical condition, and whether people with these kinds of disabling conditions ever go back to work and even if these people get Social Security Disability. They know the odds you will become disabled.
The actuary knows how many people you work with, if you are likely to become disabled during the policy period, and how much the disability carrier is likely to pay. The actuary knows how much the disability carrier has to charge to make a profit.
Even more importantly, the actuary and the claims folks also know that every claim they wrongfuly deny means a bigger profit- a windfall for the disability insurance company, its stockholders, and even sometimes its claims personnel and the peer review companies the disability carrier hires to “independently” look at your case. The disability insurance company is in the business of making money and NOT paying claims.
2. The Disability Insurance Company Writes the Policy to Limit Your Benefits.
What did your HR person tell you about what conditions were covered or limitations in your coverage? Have you ever seen your policy? Have you read it?
Probably not! So, if you have not read it, get it out and start reading it. Ok, it probably reads like something a bunch of lawyers wrote for the purpose of confusing, limiting, and denying benefits. Did you know there is no requirement in ERISA that there be just one uniform policy in the United States that says the same thing in every policy. That would be too simple.
The disability insurance folks hope you won’t read the policy or even understand it. They hope you will faithfully put your trust and financial future in their hands even as the rob you of your peace of mind. And, they also hope you will faithfully put your trust and financial future in their hands as they deny your claim, hoping you won’t find an attorney to help you with your appeal.
3. The Disability Insurance Company Is Not There to Help You with Your Claim.
The disability insurance adjuster is not going to help you fill out your claim, but they will be quick to cite anything you did wrong as the reason why you are not due any benefits.
The disability insurance company is looking for the objective basis of the doctor’s diagnosis of your disabling condition, the ojective basis of your disability in terms of your ability to function, and the connection between how your diagnosis and your functional disability makes you unemployable. You won’t find that in your policy.
Read your policy to determine the standard of disability, how your occupation is defined, whether your disabling condition is covered under the policy or excluded, and what kind of evidence you need to submit to win your cliam.
The burden is on you to prove your case. A letter from you doctor saying you are disabled is not proving your case. If the carrier asks for more information, that is your signal to speak with an experienced long term disability insurance attorney like Nancy Cavey.
4. The Disability Insurance Company Will Use The Activities of Daily Living Forms You Complete Against You.
Do you really think the disability carrier cares what you do during the course of the day and is asking to be nice? I hope not.
You are asked to fill out those forms so the disability carrier can compare what you say you can do with the medical literature about your condition, compare what you said you could do and not do with what your doctor said, and put surveillance on you so they can catch you in a “lie” about what you can and cannot do.
5. The Disability Insurance Carrier Denys Your Claim and You Have to Figure out Why.
Have you ever read the “I Spy” series with your children. You look at the picture and, using the list of hidden objects, try to find them all.
A denial is like a game of “I Spy”… except all you know is you have been denied. The disability carrier does not tell you what the disability picture looks like so you have no idea what is in their file or what should be in the file so you look like the picture of disability. And, they don’t tell you what the hidden objects are so you know what is missing to complete your picture of disability.
They will hide behind a generic disability claim denial and tell you you need to send in this medical report or the results of that test or even have your doctor write a letter for you. The carrier is deluding you into thinking that with just this piece of information, you will have won the “I Spy” game.
They are hoping you won’t get a disability insurance attorney to help you with your disability appeal so they can deny you again.
This gives the disability carrier the advantage since you won’t know what evidence you need to submit in a timely fashion to win your appeal. When you finally wake up and understand the game, it will be too late for a disability lawyer to help.
The carrier will have lulled you into destroying your claim by having you act as your own attorney during the claims process. Thinking you can do it yourself and the carrier will just pay once I send in this or that or somthing else is letting the carrier win. It rarely, if ever, works since you will be denied again.
What Can You Do to Prevent Being Taken Advantage of By the Disability Carrier?
You can prevent this from happening by never handling your claim with out the assistance of an experienced long term disability/ERISA attorney who understands ERISA and has dealt with your disability carrier in the past.
Long term disability insurance attorneys are hard to find. Run from an attorney who tells you they will “see what they can do” as that means they are clueless. Run if the attorney asks to meet you in person for an hourly sum so they can figure out what to do and how to charge you while they figure it out.
At The Law Offices of Nancy L. Cavey, your St. Petersburg/Tampa Bay ERISA and Long Term Disability attorneys, we provide a comprehensive long term disability claims analysis appointment at no charge. If Nancy Cavey, an expereinced Tampa Bay ERISA attorney, thinks she can help you with you ERISA claim or appeal denial she will work with you in reaching an acceptable fee agreement.
If you are thinking about filling a claim for ERISA or long term disability benefits, you canot afford to make a mistake. Order our free book “Robbed of Your Peace of Mind”.
How Your Employer and The Disability Insurance Companies Takes Advantage of the Disabled.
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.