Disability insurance companies don’t always make it easy for policyholders who have headaches or migraines to get the disability benefits they deserve. There are many reasons that carriers deny claims.
How Do Disability Carriers View Headache and Migraine Disability Claims?
It is not uncommon for policyholders to have had chronic headaches or migraines for years. You will have to overcome the carrier’s argument that after working with these problems all these years, nothing has changed. It is crucial that your medical records develop the progression of your symptoms.
Disability carriers also frequently argue that coverage is excluded under the pre-existing condition clause of your policy, or that benefits are limited under the subjective limitation clause. It takes exquisite planning and preparation to be successful in a headache or migraine claim.
Many disability claims for headaches or migraines are denied because the disability insurance company says:
(1) There is no objective basis of the headaches or migraine diagnosis,
(2) There is no objective basis for the restrictions and limitations assigned by your physician, or
(3) There is no causal relationship between your headaches or migraines and/or your restrictions and limitations, and your inability to do your own or any occupation.
Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many policyholders with headaches or migraines. She overcomes a claims denial by working closely with you and your physician.
She often employs a vocational expert to address the disability carrier’s argument that you have been able to work for years or there is no vocational reason you can’t work in your own or any occupation, despite your inability to come to work each day.
Nancy Cavey offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.
How To Win Your Headache and Migraine Disability Claim
A disability carrier can’t legally deny a claim if there is no objective testing to support a diagnosis. Yet headache and migraine claims often are denied on the basis of a “lack of objective findings.” There is no gold standard test for diagnosis, and CT scans or MRIs often are normal.
The diagnosis is made based on your subjective complaints. A diagnosis of migraines is made by identifying a recurrent headache with:
* Sensitivity to light,
* Sensitivity to sound,
* Sensitivity to movement,
* Nausea,
* Vomiting,
* Aura,
* Visual disturbances.
Other organic causes are ruled out. The International Headache Society has created a table with diagnostic criteria that can be used to explain the basis of the diagnosis. One way to begin to overcome the carrier’s argument is to make sure that at each physician visit, you give your physician a history of your symptoms between visits, and how those symptoms impacted your ability to function.
However, a carrier legally can say there is no basis for the restrictions and limitations your physician has assigned. They will assign an investigator to film you outside your home and then say you can work.
You should keep a headache diary on a calendar. Give your physician a copy at every visit and ask that it be made part of your chart. That will help rebut any surveillance.
Another tip is to take pictures as appropriate documenting your vomiting or pain. This will help show a basis for the assigned restrictions and limitations.
Carriers also will argue that your physician isn’t qualified to render opinions in your claim, or that you aren’t getting the right type of treatment.
It is crucial that you see a neurologist who specializes in headaches and migraines and, if necessary, also get treatment from a pain specialist. That will take care of those arguments.
How Do I Get The Disability Insurance Benefits I Deserve?
Headaches and migraines can interfere with your daily activities and with your ability to work. If you no longer can work because of headaches and migraines, or your doctor has told you to apply for disability benefits, you should take steps before you apply:
- Obtain a copy of your disability policy. See how it defines “disability,” “occupation” and “self-reported conditions.” You’ll need to understand what you have to prove and if there are limitations in your coverage.
- Obtain a copy of your medical records. Review them to see if there is an objective basis for your diagnosis, what your records say about your report of symptoms and your restrictions and limitations.
- Obtain a copy of your personnel file to see if your headaches and migraines have affected your work performance.
- Obtain a copy of your job description. Create your own description of your physical duties with an explanation of how your symptoms impact your ability to do your occupation.
- Provide your doctor with the occupational description. Ask your doctor to prepare a report that explains the objective basis for your diagnosis, the objective basis of your restrictions and limitations, and the objective reasons you can’t perform some or all of the material and substantial duties of your occupation.
- Prepare a headache diary that explains and gives examples of how your symptoms interfere with your ability to do things on a daily basis and the side effects of your medication.
- Hire Nancy Cavey to help you file your initial application. The application process is confusing and designed so you and your physician make mistakes that can result in a delay or even a denial of your benefits. Ms. Cavey knows how to prepare and file a winning shock and awe disability application that leaves the carrier little reason to question your claim.
- Hire Nancy Cavey to help you appeal a wrongful denial or termination of your disability benefits. Disability carriers are in the business of collecting premiums and not paying disability benefits. They’ll use any reason to deny your claim. The odds of getting your benefits on appeal are greater when you are represented by an experienced ERISA/private ID policy disability attorney.
Contact Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live
Headaches and migraines can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Nancy Cavey can review your policy and your medical records, and explain to you what your policy says and how to get your disability benefits. Call today for a free consultation at 727-894-3188.
