Long Term Disability – Ocala Disability Attorney

Archive for the ‘Long Term Disability’ Category

Questions After a Favorable Decision: What is a continuing disability review?

Thursday, February 16th, 2012

As an Ocala disability lawyer, I know that successful claimants are sometimes worried about losing their benefits after a continuing disability review. The Social Security Administration, or SSA, performs continuing disability reviews to ensure that individuals receiving disability benefits are still disabled. The SSA usually performs a continuing disability review of each case every three years, but the SSA may choose to review a case more frequently for a variety of reasons. The Notice of Award that you receive following your initial disability claim approval may inform you regarding when to expect a review of your disability benefits.

A continuing disability review requires little effort from you. During a continuing disability review, you complete a form detailing your medical treatment, any changes in your condition since receiving approval for disability benefits, and if you have recently engaged in any work training or work related activities. You must answer all questions truthfully.

It is important to continue seeing your treating doctor after receiving disability benefits to strengthen the evidence that your disability benefits are necessary. Even if your condition is not improving with any treatment recommended by your treating doctor, it is essential to create a medical record of your condition. If a treatment is not successful, your treating doctor will record this information, thus strengthening your case for continuing to receive disability benefits. During your periodic review, the SSA may contact your treating doctor to determine if the doctor’s opinion of your condition has changed. If you are no longer seeing the doctor for treatment, the SSA may interpret this as an improvement in your medical condition, and deny any additional disability benefits.

You will receive a notice by mail if the SSA deems your disability benefits unnecessary. However, you can appeal the SSA’s decision. If you file an appeal within ten days of receiving the notice, you can continue to receive disability benefits while you pursue an appeal.

Call (352) 304-5300 or fill out the form on this page for a free consultation from Ocala disability attorney CJ Henry.

Posted in Claims, Disability Claims, Long Term Disability, Social Security Disability | No Comments »

Social Secuirty Disability And Your Long Term Disability Claim

Saturday, October 30th, 2010

Facing a double whammy of the aging of the baby boomers and the economic downturn, the Social Security Administration faces an unprecedented backlog of claims, Michael Astrue, commissioner of the Social Security Administration, told members of the House Ways and Means Committee earlier this year.
“Over the past few years, we anticipated and planned for the additional disability claims caused by the aging of the baby boomers who are now entering their most disability-prone years. Regrettably, the deterioration we saw in the national economy exacerbated our already fragile situation,” Astrue testified on April 27.

Nationwide, Social Security anticipates this year receiving 3.3 million disability claims, up 700,000 applications – or 37 percent – from 2008. Because of this backlog, it may take years before you receive a favorable decision from the Social Security Administration. For these reasons your LTD policy is even more valuable than ever. You cannot afford to be denied. Getting your LTD benefits upon initial application or on appeal may be vital to your survival. It will fill the gap while waiting for Social Security Disability.

At CJ Henry Law Firm, PLLC, we fight for the disabled. We assit client in all stage of thier claim from application, to appeal, mediation or fighting in court if necessary.

Tags: Add new tag
Posted in Benefits, CJ Henry Law Firm Blog, Long Term Disability, News | No Comments »

CAT SCAN TECHNOLOGIST WITH FIBROMYALGIA AND CHRONIC PAIN WINS AGAINST UNUM

Saturday, October 30th, 2010

A CT technologist at an area hospital applied for benefits under her disability insurance policy that she paid for through payroll deductions. Although she had rotator cuff tear for many years, her employer accommodated her restrictions so that she could continue working. She filed a claim when Fibromyalgia and Chronic Fatigue, combined with her other medical conditions, made it impossible for her to perform the duties of her occupation. As a CT technologist, she needed to be able to walk, bend, stoop, lift and reposition patients and equipments and be ready to respond in an emergency.

Unum denied her STD claim, solely on the basis that the condition was work related. Claudeth Henry, of CJ Henry Law Firm, PLLC partnered with her workers’ compensation attorney and her physician to establish her disability independently of the work related injury. She provided excerpts of her client’s orthopedic surgeon deposition, who testified that the industrial injury did not cause her fibromyalgia or her rheumatologic condition. She also proved that her primary medical conditions, Fibromyalgia and Chronic Fatigue, limited her ability to meet the physical demands of her occupation as a CT Technologist independent of her rotator cuff tears.

CJ Henry Law Firm, PLLC filed the appeal on December 15, 2009, and on January 13, 2010, received a letter reversing the denial. A week later we received a check covering the entire 22 weeks of STD benefits. This quick resolution was due to the hard work of Ocala disability insurance attorney Claudeth Henry and the her team at CJ Henry Law Firm, PLLC, whose mission is to seek justice for the disabled, one client at a time.

We have represented many policyholders who have claims against their disability insurance carrier and many who suffer from the debilitating effects of Fibromyalgia or other disabling conditions. We represent clients with initial applications for benefits, in appeals, litigation, settlement and policy buy-outs. If you have a problem with a disability policy, or are preparing to file a disability claim, please call us at 352-304-5300 or click here to contact us.

Posted in Appeal, Benefits, Chronic Pain, CJ Henry Law Firm Blog, Employee Retirement Income Security Act, Long Term Disability, News | No Comments »

My ERISA disability insurance claim was denied. What do I do next?

Saturday, May 16th, 2009

Once your ERISA claim is denied, you can file a federal lawsuit to get your benefits. However, ERISA laws require that you submit an appeal to the plan administrator (or insurance company), within 180 days of the date of the denial letter. If an administrative appeal is not submitted timely, your right to sue will be lost. That does not mean you must rush with a knee-jerk reaction to request a review.

You would never think of having a trial on a disability issue without calling witnesses: your doctor, maybe a co-worker, employer, friends, or family who knows you best. Yet, that is exactly what you will do if your appeal is not properly prepared and presented. That is because in most ERISA disability cases, once your lawsuit is filed, the only evidence that the court will consider is that contained in the Administrative Record, which is the claim file put together by the insurance company. Your appeal is your last opportunity to put your case together.

The first thing you should do is to make sure you fully understand the reasons for the denial. Once you understand what is missing or lacking, you will need to gather evidence to address the deficiency. Then gather supporting information – witness statements, doctor’s reports, or anything else you would want the judge to see at trial. Submit your appeal with all your evidence in a timely manner. My best advice, however, is to seek the help of an experienced ERISA disability insurance lawyer. For help with filing your claim or administrative appeal, contact Ocala ERISA disability insurance lawyer at C J Henry Law Firm, PLLC, for a free consultation.

Posted in Appeal, CJ Henry Law Firm Blog, Claims, Disability Claims, Insurance Claims, Long Term Disability, Tips | No Comments »

Elimination Period

Wednesday, February 4th, 2009

Do you ever wonder what would happen if an injury or illness wiped out all of your savings? You may say “I have disability insurance for that”. That’s a good start, but what if they don’t pay? Then what? Do you have a back up plan? Waiting to find out could cost you everything you own.

If you have already purchased a disability policy, here is some of what you should look for:

How long is your elimination period?

The elimination period is the amount of time you must remain disabled before the insurance company will begin paying you. For most long term disability, the elimination period is 180 days. That means you will need at least enough money to meet 6 months living expenses while you are waiting for your disability insurance benefits.

Does your insurance policy require you to be under the continuing care and treatment of a physician in order to prove your disability?

With the high cost of COBRA some individuals choose to drop their health insurance as a means to cut expenses. However, if your policy requires you to be under the continuing care of a physician or to be treated by a specialist for your condition, for most individuals this would be impossible without health insurance.

Does your policy require you to provide proof of disability at your expense?

Some disability carriers will tell you that it is your obligation to get them proof of your disability or they could terminate your benefits or not pay at all. Sometimes the doctors could charge upward of $100 to complete those forms. You need to plan for this, so that you are not caught off guard.

So here is what you do: Go to our website and contact us for a free copy of our book on long term disability insurance policies, the claims process and how to get your long term disability benefits.

Posted in CJ Henry Law Firm Blog, Long Term Disability, Tips | No Comments »

ERISA: How To Keep All Your Long Term Disability Benefits

Wednesday, February 4th, 2009

It’s a fact that most Americans are only a few paychecks away from financial disaster. Disability Income insurance offers some protection by protecting a portion of your income. Most disability plans will only cover up to about 2/3 of your gross income. However, I’ve seen some plans that cover only 40 % of your income. In an ERISA plan where the premium comes out of your paycheck, you’ll want to have your employer deduct the premium after taxes, or out of your net paycheck. The reason is that if you deduct the premium before taxes are taken out, when you have a claim, your benefit will be subject to income taxes. As you can see, if you had to pay income taxes on 40% of your income, you would be left with almost no coverage at all. For most, it is far better to pay a small amount of tax on the premium rather than having to pay full income taxes on the benefit at a time when you need all the money you can get.

Posted in Benefits, CJ Henry Law Firm Blog, Long Term Disability, Tips | No Comments »

Top 5 Tips on Keeping Your Long Term Disability Payments

Thursday, January 29th, 2009

Go to the doctor. Regularly. Make sure you are clear with the doctor about new symptoms. If you are shy or nervous and feel uncomfortable about doing this, bring along a family member.
Keep a diary of symptoms. Have your client keep one too. We have a sample form on our website here . This is important. It lets the disability carrier know how disabling your condition really is. Send the diary to the LTD carrier and advise the carrier if it is a representative, i.e. typical, week or week for you. Keep a copy.
Ask your doctor about the combined effects of your medications. Sometimes your condition alone may not be disabling but the combination of your medications can have a synergistic or additive effect such that the medication side effects can be disabling.
Do your own research. There are many wonderful and informative websites that can help you understand your condition. For some examples of potential avenues of research, go to our medical links page here. You can then provide useful information to your doctor…and the carrier.
If your doctor will not take the time to help you…find another who will! Occasionally, doctors become overwhelmed and refuse to fill out those forms submitted by the Insurance Company. Without your doctor’s assistance, you lose. Consider making an appointment with him or her, explaining the situation and then offering to pay for his or her time to fill out the report. Doctors become resentful if they feel taken advantage of and offering to pay for their time is reasonable. We’ve had many cases where the treating doctors were not cooperative because they were upset about the paperwork. Once we explained the situation to them, they have all, thus far, been very willing to help.

Posted in CJ Henry Law Firm Blog, Long Term Disability, Tips | No Comments »

A Picture is Worth a Thousand Words

Thursday, January 29th, 2009

Here a simple thing you can do that could have a tremendous impact on your long-term disability claim: Take a picture! Suppose you have a condition that is visible to the naked eye, or you struggle to perform certain activities. How do you convey this to the insurance carrier who is deciding your case? There are many different possibilities:

Day in the Life Video – Have a family or friend take a video of you going through a routine day showing difficulties such as making your bed, combing your hair, using medical equipment if that applies, or capturing a medical condition such as a drop foot.

Videotape a few of the activities you struggle to perform – Ex: transferring from a wheelchair to a shower chair in the bathroom; getting in and out of bed; going up and down stairs.

Pictures of your injury – bruises on your body from falling; Swelling in extremities. Do not use this to manufacture evidence, and if your condition doesn’t lend itself to video, don’t do this, as it could hurt, rather than help, your case. However, do not be afraid to use this it if it will show your limitation. Insurance companies use surveillance all the time to capture your activities, but they do not always show a true picture of what you can do over the course of a day. So why not level the playing field!
Give this a try if you find yourself having to do an appeal or in a dispute with your ERISA disability carrier over your functional ability.

Posted in CJ Henry Law Firm Blog, Employee Retirement Income Security Act, Long Term Disability, Tips | No Comments »

Top 5 Mistakes in ERISA Disability Cases

Thursday, January 29th, 2009

No one is immune from everyday pitfalls and mistakes that everyone is bound to make, but there are some avoidable ones I see over and over again.

Applying for disability benefits before reading the disability insurance policy. I tell my clients that applying for disability benefits without reading your policy is like playing baseball where only one team has the rule book. Your disability policy governs your claim. It tell what it means to be disabled, how benefits are calculated, the deadline to provide proof of claim, limitations on benefits and much, much more! Wouldn’t it be devastating to make the difficult decision to leave your job, apply for benefits, and then find out your condition is limited or excluded by your policy? Get your policy before you even apply and don’t just put it aside, read it!

Appealing a denied disability claim without getting a copy of the claim file. In ERISA claims, the claim file will be the evidence presented to the Judge. It consists of all the evidence the insurance carrier has gathered about you: medical records, surveillance, notes from telephone calls, their in- house doctor’s report. You cannot adequately challenge the denial without knowing what’s in the claim file. Get your claim file; do it right away as soon as you get the denial and go through it with a fine tooth comb.

Failing to present additional evidence to support your appeal. This is the evil twin of #2. In addition to failing to get the claim file, many fail to send in additional or useful evidence to support their claim. Just sending a note threatening to sue, or saying the same thing as before will not cause the insurance company to change their position. Most importantly, by doing so, you have lost your last chance of presenting evidence that will be presented to the Judge, since that letter will be considered your appeal.

Saving best evidence for trial. In ERISA claims, there is NO TRIAL, not as most people know it! Chances are you will never be called to testify, your doctors won’t be able to go to court and testify as to how disabled you are, and you can’t call friends, relatives, or co-workers to testify how you can’t do your job. These are administrative procedures. A Judge, not a jury, will decide your case based largely on your claim file put together by – you guessed it – the insurance carrier! You want to make sure all the evidence you want the Judge to see is in that file before the record is closed!

Missing deadlines or waiting too long to get legal help. This can be fatal to your claim. ERISA is an unforgiving law. You must exhaust the administrative remedies before the claim can be filed in court. That means you must appeal the denial first. If you miss your deadline, you could conceivably lose your right to present your claim in court. Preparing a comprehensive appeal is time consuming, and not all lawyers handle ERISA disability claims. Get competent legal advice as soon as you get that denial letter.

As you can see, there are many costly mistakes that are entirely avoidable.

Posted in CJ Henry Law Firm Blog, Employee Retirement Income Security Act, Insurance Claims, Long Term Disability, Tips | No Comments »

Deadly Deadlines

Thursday, January 29th, 2009

In ERISA long term disability cases there are a number of deadlines. Missing any of them could be fatal to your claim.

>Providing Proof of Loss – Most insurance policies will have a deadline for providing proof of your disability. Some require that you submit proof as soon as you know of your injury/illness or disability resulting from those. Others may extend the time period up to a year from when you became disabled. Failure to notify your insurance carrier in a timely manner could result in a denial of your claim.

I see this often when a disabled individual has another claim such as a workers compensation claim and they fail to put the disability insurance carrier on notice of their disability because someone told them they could not collect both workers compensation and disability. Waiting to notify the disability carrier until the WC carrier stops paying or after settling the WC claim is often too late. Knowing what your policy requires is the key.

>Filing Administrative Appeal – When you receive a denial letter, one of the first things to look for is your time frame for filing an appeal. This is important because ERISA laws require a claimant to exhaust their administrative remedies before filing a lawsuit. Failure to exhaust the administrative remedies may result in a dismissal of a subsequently filed suit. Generally speaking, the policy requires an appeal within 180 days of receipt of the denial. Keep the envelope the denial came in. This will help establish when the denial letter was mailed.

> Statute Of Limitations - The laws of ERISA do not set a specific statute of limitation. However, often the disability policy will. The courts will generally uphold it if it is reasonable. If the statute of limitation is not listed in your policy, the court will look to your state law governing contracts.

Posted in CJ Henry Law Firm Blog, Employee Retirement Income Security Act, Long Term Disability, Tips | No Comments »

CJ Henry Law Firm - Your Disability Law Partner

Speak with a Representative Today! Call 352.304.5300

Our Book

CJH Law Blog

Archive for the ‘Long Term Disability’ Category

Social Secuirty Disability And Your Long Term Disability Claim

CAT SCAN TECHNOLOGIST WITH FIBROMYALGIA AND CHRONIC PAIN WINS AGAINST UNUM

My ERISA disability insurance claim was denied. What do I do next?

Elimination Period

ERISA: How To Keep All Your Long Term Disability Benefits

Top 5 Tips on Keeping Your Long Term Disability Payments

A Picture is Worth a Thousand Words

Top 5 Mistakes in ERISA Disability Cases

Deadly Deadlines

Free Case Evaluation

Practice Areas

CJ Henry Law Firm, PLLC