4 Types of Disability Claims Caused By Car Accidents

While a car accident itself may not be a reason to file a disability claim, many disability claims result from injuries sustained in a crash or other type of accident. While you may not qualify for Social Security Disability Insurance if the injuries don’t totally incapacitate you for more than 12 months, many individual and group long term disability policies cover the inability to work due to these incidents as well as almost all short term disability policies. From back problems to broken bones to “whiplash,” there are many different types of injuries that can result from even seemingly minor vehicle accidents, including some that may not become apparent for an extended period of time. Today’s blog post is going to review some of the different types of injuries that may result from these accidents and how to obtain the disability benefits you deserve while recovering from these injuries. Continue reading

3 Major Questions of a Total and Permanent Disability Claim

While most sufferers of chronic back pain are able to recover and return to work in varying capacities, there are many people who experience such severe and debilitating pain that they will never be able to hold a normal job again. Claimants who suffer from such severe conditions are initially approved for their disability benefits, but this may be just the beginning of a long and winding road for claim investigations that can be opened and reopened for years on end. Insurance companies won’t acknowledge what total and permanent represents and require regular and appropriate care for the conditions causing the pain throughout the duration of the claim and can also require other documents ranging from tax returns to activity logs. Insurance companies can also reopen investigations at any time and restart the review process all over again. If you have been approved for benefits and don’t expect to return to work anytime soon, there are several issues you should consider to help reduce the stress going forward in the claims process.

Three of the most common issues we hear about from claimants in this situation are surveillance, settlements, and what the insurance company considers to be appropriate care for the condition. I will touch on each of these topics as well as a few other key issues prevalent in these types of claims. Continue reading

Medical Disability Durations & The Effect on Return to Work Guidelines

We have encountered several cases where claimants have been denied their benefits not because of incomplete or inconclusive evidence of their medical conditions but solely because their conditions kept them from working longer than the guidelines used by disability insurance claim departments. When evaluating disability claims, claims examiners rely on industry developed resources to determine the expected duration of the claim, regardless of the specific circumstances. Based on these claim management practices that have been put into place by most insurance companies, we’d like to shed some light on the process used to assign expected return to work dates for claims and the extra steps that claimants need to take to protect their benefits if they’re disabled beyond these arbitrary dates.   Continue reading

Lyme Disease Diagnosis and Treatment: How These Issues Affect Your Disability Claim

With summer and the outdoor season upon us, there can be different causes of disability to deal with. One of the more common conditions we see during this time of year, especially in the Northeast, is Lyme disease. Although there is evidence that Lyme may be spread through multiple sources, the primary method of infection is a blacklegged or deer tick bite. Lyme is a complex multisystem inflammatory disease that can affect all of the major organ systems in your body and cause a wide range of symptoms including fever, headaches, rash, pain, vertigo, speech impairments, mood swings, depression, and hallucinations. In addition, these symptoms don’t always develop immediately. It can take days, weeks, or even years before the onset of symptoms due to Lyme disease, making it extremely difficult to pinpoint the causal event of the symptoms.  Continue reading

Court Watch: Cases Affecting ERISA and Disability Claims

Although we’re not lawyers or a law firm, paying attention to recent court cases and rulings helps us keep up with the constantly changing rules and regulations of disability insurance claims. In the recent past, we’ve seen two cases taken up by the U.S. Supreme Court as well as a few other cases that affect the way the disability insurance companies treat insureds and their claims and the options to be considered by claimants. These court rulings set precedents and rules for many future claims and help form the disability claims process almost as much as claims examiners or company policies.  Today’s blog post is going to explore a few of the more relevant cases and their effects on disability claims.   Continue reading

The Doctor’s Corner: Diabetes, Complications, and Disability

Diabetes is a growing health problem in America with over 26 million people suffering from the condition and another 79 million individuals suffering from pre-diabetes such as insulin resistance and Metabolic Syndrome. Only approximately 5 percent of diabetics suffer from Type 1 diabetes with the overwhelming majority suffering from Type 2 diabetes. While many of these individuals are able to work long and fulfilling careers, there are increasing numbers of people whose disease prevents them from continuing in their jobs and are forced to file claims for disability insurance benefits.

Insurance companies will often dispute and deny a disability claim based solely on a diabetic condition even if it’s shown that the condition was the root cause of the inability to work.  It’s important to understand that technically, they may be correct.  It’s not usually the diabetes that disables someone but one or more of the many complications that are caused by this disease. If you’re receiving regular care and treatment and are following the plan of your treating physician, being diabetic in and of itself is generally not disabling.  If you find you’re unable to work and are filing a disability claim, you’ll want to document the nature and extent of the complications and the severity of their impacts on your work abilities.   Continue reading

March Madness: Our Elite Eight Blog Posts

What a difference a year makes! Where does the time go?

We’ve been writing articles for this blog for over a year, and we’ve learned as many things from our readers as we hope you’ve learned from us. As our topics have grown and more readers have found us, we wanted to make sure that some of our posts don’t get lost in the noise of the Internet and buried deep away where claimants would less likely be able to find help. In the spirit of the NCAA basketball tournament, we’re going to go through our most popular blog posts as well as highlight some posts that we think include topical, valuable information that may be helpful in your disability claim. Thanks again for reading our blog over the past year and making us one of the top-rated destinations for disability claim advice and help.  While we hope you never have any problems with your conditions or your claim, we’ll continue to be here to read, just in case, for years to come!

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The Disconnects Between Diagnosis and Disability

One of the biggest issues our clients face when filing their disability claim is the lack of clear medical opinions explicitly linking their condition to their disabling restrictions and limitations.  Physicians are skilled at diagnosing a disease or illness, but they may not be the best at explaining why the condition is disabling for the claimant.  This can especially be problematic with mental illnesses or other types of invisible disabilities.  Any ambiguities cause increased scrutiny and in-house referrals by claim examiners and are often used as a basis for a disability claim denial.  Helping your doctor connect the dots between your condition and your inability to work smooths the disability claims process and fosters a quicker claim approval with fewer questions.  We’d like to discuss two perspectives to this issue: the claimant’s and the physician’s.  We’re going to discuss what each party can do to make the disability clearer and the claims process smoother.   Continue reading

Defending Your Claim Against the Insurance Company IME

The most important piece of evidence in a disability claim is the medical basis for the disability.  If there is strong medical proof of the severity and continuation of your disabling condition, then there’s a good chance of your claim getting approved.  However, this may not always be the case.  Many conditions don’t have clear cut tests to prove their existence, and other conditions have testing protocols that either aren’t generally accepted or aren’t always accurate.  Even if appropriate testing exists, claims examiners may try to dispute the opinion of the attending physician.

When these and other issues are noticed in the claim file and want to be explored, claims examiners will often demand that the claimant undergo an IME.   Continue reading

6 Tips To Keep Your Disability Claim Moving

One of the biggest red flags a claimant can inadvertently create in their disability claim is to move.  While there are many legitimate reasons someone can move, claim examiners have been trained to closely scrutinize a case where a claimant moves.  New sets of arguments and investigative avenues are opened for the insurance company to use against you.  As anyone who’s moved can tell you, moving is difficult at best.  And the last thing someone needs, who is already trying to move while dealing with their disability, are new and additional hassles from their disability insurance company, not to mention the added stress of worrying that their benefits will be delayed or stopped.  If you’re currently applying for or receiving disability benefits, there are several issues we think you should understand as well as a few tips on how to keep the disability claim process moving smoothly during this stressful time.   Continue reading