Many employers offer their employees an opportunity to purchase a short term disability policy or allow the employee to participate in an employer self-funded disability plan or state mandated program.
A short term disability policy or plan will commonly pay disability benefits for 13, 26 or 52 weeks. Once the short term disability benefits are exhausted, the employee can be eligible for long term disability benefits if they have purchased a policy through their employer.
Long term disability policies require that all short term disability benefits be paid out before the disabled employee is eligible for long term disability benefits. It is not uncommon for the STD insurance company or plan administrator for a self- funded STD plan to deny the balance of the STD benefits in a conscious effort to deny the policy holder LTD benefits.
It is crucial that every STD policy holder or plan participant get help with the STD application process before they stop working and file for STD benefits.
You must make sure that your application explains in detail the material and substantial duties of your occupation, is supported by your treating physician and explains why you are unable to perform your own occupation. You owe it to yourself and your family to have an experienced STD and LTD disability insurance attorney help you file the STD application, work with you through the STD benefit period, help you prepare the LTD application and insure that you are successful in getting both your STD and LTD benefits.
The denial of your STD claim has serious implications for the success of your LTD claim. It is not uncommon for STD policies or employer self-funded plans to be administered by the LTD carrier.
The fox is watching the hen house and, while the LTD carrier is “managing” your STD claim, the LTD carrier will also look closely at:
1. How you explained your occupational duties,
2. How you answered the questions in the Activity of Daily Living forms,
3. What your physician has to say about the objective basis of your diagnosis and your restrictions and limitations,
4. Whether your physician supports your claim,
5. Whether there is any conflict between your statements and medical records,
6. Whether you have a high dollar claim,
7. Whether your LTD claim will last a long time and
8. How they can deny your STD and LTD claims.
The LTD carrier is trying to head off the LTD claim by denying the STD claim in its entirety or denying the claim before all STD benefits are paid out. Remember, you can’t file for LTD benefits if you haven’t been paid out ALL of the STD benefits. It is as simple as that.
So now that you know why the carrier did what they did, what should you do? You will only have, as a rule, 180 days in which to file an appeal of your STD claim denial. Call today for a complimentary consultation and learn how we can handle the appeal of the wrongful denial. We will:
1. Get your claims file from the carrier,
2. Review it cover to cover to find out why your claim was denied,
3. Create and implement a strategy to get the balance of your STD benefits,
4. Collect and create the necessary medical and vocational evidence to support your claim,
5. Submit a shock and awe appeal for your STD claims denial and
6. Prepare, file and manage your LTD claim while fighting to get your STD benefits paid.
You can’t be eligible for a closed period of disability if:
The medical evidence establishes you are unable to engage in a substantial or continuous period of 12 months, but by the time your disability decision is made, your condition has improved to the point where you are no longer disabled;
You haven’t filed an application within 14 months after the period of disability has ended.
If you do meet the requirements for disability benefits, there is a 5 months waiting period before you get your first monthly benefit. You can receive up to 12 months of retroactive benefits from the date you file an application with Social Security.
So, if you have a closed period of disability, you may be eligible for Social Security Disability benefits.
You can contact Tampa Bay Social Security Disability attorney, Nancy Cavey, to learn more about whether you can receive benefits for a past disability.
Making the decision to stop working and apply for Social Security Disability benefits can be tough, particularly if you don’t have another source of income while you’re waiting for your Social Security Disability claim to be processed.
It’s not uncommon for individuals who are having financial difficulty to apply for both Social Security Disability benefits and unemployment benefits. Many people in the Social Security Administration look at this as being inconsistent and even dishonest.
When you apply for Social Security Disability benefits you are claiming that you are physically and psychologically unable to work. However, when you apply for unemployment benefits you are claiming that you are capable of working in some capacity. Obviously, that’s inconsistent.
When you apply for unemployment benefits you have to show that you lost your job through no fault of your own. For example, you may have lost your job because of a layoff, staff downsizing, or being fired.
In Florida you are required to prove that you have worked in the states within the last past 12-18 months, your employer paid you within the previous 2 or more months, and that you are willing and ready to accept gainful employment. You’ll have to document an ongoing job search and you’ll be continuously asked about your intentions to return to work.
Many who are disabled do want to try to work even in a part-time capacity. So long as you don’t earn more than $1100, you won’t lose your eligibility for Social Security Disability benefits. While you may not be able to work full-time, you may be able to work part-time and that is not inconsistent with a claim for unemployment benefits.
Some Social Security Judges understand how difficult it can be to live without an income and will say “No harm, no foul”; other Judges won’t award benefits for any period in which the Social Security applicants collect unemployment. It is the luck of the draw.
You should contact an experienced Social Security Disability attorney such as Nancy Cavey who can help you with your SSD application process and get answers to your questions about filing for unemployment benefits.
There is absolutely no guarantee that you will continue to receive Social Security Disability benefits for your lifetime. Your Social Security Disability benefits could be suspended or even terminated if there is an improvement in your medical condition or you return to work.
Most Social Security Disability claimants will typically have their benefits continued after a continuing disability review which is done approximately every 3 years.
If you feel that you are able to work in some capacity the Social Security Administration won’t penalize you. You can attempt a trial work period of time, where you can work for nine months with no limit on the amount of your earnings to see if you are capable of working.
This nine-month trial period can occur anytime within a five-year period of time and it doesn’t have to be a consecutive nine months.
If you are able to perform what’s called substantial work activity in the tenth month, your disability benefits will be suspended. However, you will then be granted what’s called an extended period of eligibility (EPE), which is a 36 month period in which you can stop work at any time and be reinstated regardless of how much you were making. Beware however in that 36-month EPE has passed, any month in which you have earned more than your benefits will be terminated.
What happens if you become disabled again as a result of the same medical condition? You might be able to file for an expedited reinstatement at any time within five years of your previous disability termination months.
All Social Security Disability claims are reviewed periodically and there are times when benefits are terminated improperly. If you’ve been receiving Social Security Disability benefits and the Social Security Administration has advised you that they will suspend or terminate your Social Security Disability benefits, you need to immediately contact Social Security Disability suspended attorney Nancy Cavey, who practices Social Security Disability Law in the Pinellas Pasco Hillsborough County areas.
There are many myths that I hear from Social Security Disability Applicants. I am a myth-buster! Some of these myths include:
Fact: No! The amount of your Social Security Disability benefits is based on your earnings record but there is a maximum payment of $2,687.00 which changes every year. According to statistics the average currently monthly payout is $1,171.00.
Even if you made a million dollars a year, your maximum Social Security Disability benefit would be $2,687.00.
Fact: If you are awarded Social Security disability benefits, you should know that there is a 5 month waiting period. Once you’ve been found entitled to benefits, you won’t get benefits for the first 5 months of your disability.
Fact: No! Everyone who receives Social Security Disability benefits is going to be scheduled for a reevaluation for what is called a “continuing disability review”. How often this occurs will depend on your condition and how likely you are to recover.
After waiting month after month for a hearing, your big day has finally arrived. The good news is that the Administrative Law Judge is not bound by the two earlier claims denials. The judge uses the Five-Step Sequential Evaluation process to decide your claim.
The bad news is that you have only 45 minutes to put on your case. You won’t have much of a chance of winning unless you:
Without knowing, it’s like throwing yourself at the mercy of the court and hoping that everything you need to win is in your claims file. Not great odds!
Your story has to be presented to the judge in the context of why you can’t return to the lightest job you held in the last 15 years, and why there is no job in the mythical national economy you can perform based on your age, education, transferable skills, and your physical or psychiatric restrictions and limitations. Why mythical? The judge won’t consider that you can’t find a job or that you couldn’t keep a job even if you found one. That isn’t the test.
There are many ways Ms. Cavey goes about preparing and presenting your story to the judge. These include:
This is not the time to do it yourself or to hire an inexperienced attorney. Hundreds of thousands of dollars of monthly income benefits and lifetime medical expenses are at stake. Make the right decision and increase your chances of winning your Social Security disability claim by calling Social Security Disability attorney Nancy L. Cavey today.
Her initial consultation is free, and you don’t pay her an attorney’s fee unless she wins your case. Her fee is set by the Social Security Administration (SSA) and is limited to 25% of your back benefits, to a maximum of $6,000. You will receive her personal assistance and have the benefit of her 35 years of experience in helping disabled Floridians get the Social Security disability benefits they deserve.
Call today at 727-894-3188 for a free consultation. Don’t delay!