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Do I Qualify For Disability Insurance Benefits If I Have Prostate Cancer?

CaveyLaw.com > Do I Qualify For Disability Insurance Benefits If I Have Prostate Cancer?

Disability insurance companies don’t always make it easy for policyholders who have prostate cancer to get the disability benefits they deserve.

1 in 7 men will be diagnosed with prostate cancer; more than 220,000 new cases are diagnosed each year. It is typically slow growing and, unfortunately, in the early stages, there are no symptoms. That is why annual prostate cancer screening is crucial.

Cancer can be aggressive when it spreads and reach the bones, lymph nodes, lungs and other tissue.

Symptoms can include:

  • Pain in the genital and pelvic area,
  • Blood in the urine or semen,
  • Frequent urinary tract infections,
  • Unexpected weight loss,
  • Pain in the lower back or pelvic area,
  • Anemia, and

The symptoms and progression vary from person to person, which disability carriers often fail to take consideration. These symptoms are similar to prostatitis, erectile dysfunction or an overactive bladder.

Disability carriers are notorious for denying and terminating many claims.

Carriers frequently say:

  1. Coverage is excluded by the pre-existing condition clause of your disability policy.
  2. Benefits are limited under the subjective limitation clause. Pain and fatigue can be your most disabling symptoms, but carriers routinely dispute their impact.
  3. You have had prostate cancer for years and have not been disabled before now. You will have to overcome the carrier’s argument that you have been working with these problems for years and nothing has changed. It is crucial that your medical records develop the progression of your symptoms.
  4. Your symptoms are just prostatitis, erectile dysfunction or an overactive bladder.

Many disability claims are denied. Other reasons carriers deny claims:

(1) There is no objective basis of the diagnosis, particularly in the early stages,

(2) There is no objective basis for the restrictions and limitations assigned by your physician because of your prostate cancer,

(3) There is no causal relationship between your prostate cancer and the side effects of treatment and/or your restrictions and limitations, and your inability to perform your own or any occupation.

Nancy Cavey, who has 35 years experience handling disability cases, understands these objections and works closely with you and your physician to overcome a claims denial. If necessary, Ms. Cavey will help arrange for you to have a Functional Capacity Evaluation and a Vocational Evaluation. With her clients she has seen first-hand the devastating effects of prostate cancer; she understands what it takes to get the benefits you deserve.

Nancy Cavey offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.

What Should Be In Your Medical Records

It is important that your medical records document your symptoms and how those symptoms impact your ability to function.

This is particularly true because you probably have been working with difficulty but now find it hard to continue. The disability carrier will want to know what has changed and what caused you to file for disability.

Your symptoms may progress slowly but it is important to chart that progression and how your symptoms impact your ability to function. The progression must be documented in your medical records.

Keep a diary that notes how you feel, the nature of your symptoms and how the symptoms impacted your ability to function. Make sure your entries are consistent with the policy definition of disability and occupation.

Your policy may define your occupation not by how you perform it for your employer but by how it is performed in the national economy. However your occupation is defined, make sure your diary entries give concrete examples of how your symptoms impact your ability to do the required material and substantial duties.

Make sure that your physician has an accurate description of the physical and cognitive requirements of your occupation so he or she can accurately comment on your abilities to perform those duties.

Be sure to give your physician a copy of the diary with the entries between each visit. This diary can show the progression and impact of your symptoms.

How Do I Get The Disability Insurance Benefits I Deserve?

Advanced cases of prostate cancer and cancer that has spread can interfere with your daily activities and your ability to work. If you no longer can work or your doctor has told you to apply for disability benefits, you should take steps before you apply:

  1. 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.

Some policies consider prostate cancer without objective findings to be a subjective condition and limit benefits to just two years. Before you apply for benefits, discover your policy’s applicable limits.

  1. 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.

Your physician might have noted that you were feeling better or had fewer problems functioning. These entries must be addressed before your application is filed or during the appeal process if your claim has been denied.

One of the most common reasons given for a claims denial is that there is “no objective evidence to support your subjective complaints of pain.’’ The carrier often makes a leap of logic and says the policyholder either is exaggerating or faking their pain. Nancy Cavey knows what proof is necessary to meet the policy definition of disability.

  1. Obtain a copy of your personnel file to see if your cancer or treatment has affected your work performance.
  1. 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.
  1. 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. If your physician won’t cooperate or doesn’t support your claim, it might be time to find another physician.
  2. Prepare a diary that explains and gives examples of how your symptoms interfere with your ability to do things on a daily basis, particularly if you have trouble sitting because of back pain or are fatigued. Also include the side effects of your medication.
  3. 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. She will work closely with your neurologist to make sure your records reflect the progression of the prostate cancer and your symptoms.

Ms. Cavey also will make sure that your physician correctly completes the Attending Physician Statement forms. 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.

  1. 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 prostate cancer 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

Advanced cases of prostate cancer or cancer that has spread to the bones, lymph nodes and lungs 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.