Doctor’s Corner: Behind a Carpal Tunnel Syndrome Diagnosis

As many professional jobs become more and more computer-based, disabilities that involve nerve, muscle or tendon damage in the hands have become a major issue.  These conditions prevent people from typing reports, replying to e-mails, and completing the day-to-day tasks of their jobs.  These conditions can range from work modifications to a short-term disability, simply requiring a short period of rest away from the office and the stresses of work, to a total and permanent disability.  One common condition causing such disability claims is carpal tunnel syndrome (CTS).  In today’s blog, I am going to walk through the information many doctors will look for and use in writing a report for your disability insurance company.  Even if you aren’t suffering from carpal tunnel syndrome, this article can be useful to show the steps an examiner follows when diagnosing your condition. Continue reading

The Doctor’s Corner: 9 Tips for Dealing With Chronic Pain Syndrome

Our firm gets many questions from individuals experiencing all different kinds of issues with their disability insurance.  From questions about nuances between companies and policies to what could be considered to be appropriate care, we help with details of disability insurance everyday.  However, these aren’t the only issues facing our clients.  We know that our clients can better help themselves and return to work more successfully if they take care of themselves and follow some simple steps to help improve their recoveries.  In today’s blog, I am going to talk about a few simple techniques to help those suffering from some of the most common condition that reach out for our help: chronic pain syndrome. Continue reading

The Value of Medical History Documents in a Disability Claim

Having a clear and complete diagnosis and medical history are crucial aspects of any successful disability claim.  Disability insurance companies are masters at seizing on any potential discrepancies in these records as a basis to dispute, delay or deny a claim.  One of the best ways to help yourself, your doctors, and your disability claim is to prepare a medical history document that tracks your health information over time.  While this document is not intended to replace your medical records or an interview by a physician, it can be a crucial reference tool that provides much needed information in a condensed and organized manner when deciding on best courses of treatment – or when discussing your claim with a claims examiner or field investigator.  The best advice would be to calmly and thoroughly prepare a medical history document for every member of your family before a critical need arises.  As almost everyone has done, you’ve completed a general health history form at your doctor’s office before seeing the doctor. Continue reading

Uncovering the Secrets of Insurance Company Surveillance

Surveillance is an issue that has been mentioned in several past blogs and creates tension and stress for claimants and insurance companies.  Disability claim examiners are trained to recognize certain “red flags,” ranging from incorrect statements on claims forms, to inconsistencies with medical information, to the experiences of a claims handler, that can trigger different types of surveillance.  In response to several questions about specific surveillance techniques and how to handle them, I’d like to explain some of the more common tactics used on a regular basis by insurance companies.   Continue reading

Successfully Defending a Claim Against Denial

Today’s blog is my favorite type – a success story!  One of our clients has graciously allowed me to relate his story to our readers as an example of how having expert help and standing up for your rights can lead to a positive outcome in your disability claim.

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Ensuring Your Disability Benefits After a Stroke

As one of the leading causes of long term disability, insureds who have suffered a stroke are some of our most common clients.  Almost 75 percent of individuals who experience a stroke suffer lasting symptoms that reduce their work capabilities.  Between 15 and 30 percent of individuals who have suffered a stroke become permanently disabled, experiencing impairments such as paralysis, sensory disturbances, language issues, memory problems, and emotional disturbances.  Survivors who unfortunately experience these symptoms are often unable to continue in their profession, or any profession, and then face having to file a claim for disability insurance benefits.  As we have seen time and time again, this is where new problems begin.   Continue reading

Does the Affordable Care Act Affect Your Disability Insurance?

With last week’s Supreme Court ruling confirming the constitutionality of the Patient Protection and Affordable Care Act (PPACA), informally referred to as Obamacare, it’s now time to start looking forward to the parts of PPACA that have not yet taken effect and analyze the repercussions.  While it may not directly affect the disability insurance market, the PPACA will affect every individual currently receiving benefits.  Health insurance is an important part of physical and financial well-being, and the PPACA dramatically changes how we view health insurance in this country.  In the opinion of our firm, the PPACA helps most individuals, especially those people who are experiencing substantial medical problems in their lives.  Today I am going to break down the PPACA into its 10 Titles and touch on how each title may affect disabled individuals and specifically how they relate to disability insurance claims.  Continue reading

The Symptoms of Chronic Fatigue Syndrome and How to Obtain Insurance Benefits

Chronic Fatigue Syndrome, often called CFS, is a debilitating condition that is still relatively ambiguous to the medical field.   CFS is also referred to as Immune Dysfunction Syndrome (CFIDS) and Myalgic Encephalomyelitis (ME).  Led by persistent, unexplained, recurring feelings of exhaustion, CFS can have debilitating side effects, leaving the sufferer unable to perform most daily tasks or hold a steady job.  Disability insurance companies label cases of CFS as self-diagnosed conditions, somewhat similar to Fibromyalgia, making CFS based disability claims much more difficult to get approved.  Developing solid, concrete evidence is critical.  Today I am going to describe the symptoms that are often present with CFS and how to present the information needed for a successful disability insurance claim. Continue reading

Defining and Decoding “Appropriate” Care

Disability insurance claim examiners often bring up the issue of “appropriate care” when questioning benefit claims and often use this same term as an excuse to deny claims.  Many claimants do not properly understand this term and how it can be used by the insurance company to manage your disability claim.  Older disability policies used to require that a claimant be under the “regular care” of a physician and required little more.  As insurance companies seek more control over disability claims and their direction, this policy language has been changed to “appropriate care,” which has a much more stringent definition.  Regular care was usually based on a time perspective, ensuring disabled claimants were receiving some sort of recurring medical treatment.  The shift to “Appropriate care” has given the insurance companies the liberty to retain their own experts to decide if the claimant’s choice of treatments or physicians is “appropriate” for the condition. 

The motivating factor behind this change is control of your disability claim.  If insurance companies have the latitude to decide what care is (or isn’t) appropriate, they can influence your medical care and treatments with the goal being to reduce the length and amount of the claim, either by discounting the medical support presented by the claimant or by making a disabled claimant return to work no matter the treatment risks or if the claimant is actually ready and able.  Several factors are taken into account by the insurance companies when determining appropriate care.  Knowing these factors and what to look for can allow you to receive the appropriate care from professionals of your choice rather than that dictated by the insurance company.

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Monthly Mailbag: Depression, Chronic Pain, and Logistics

We often get questions from people who have called or e-mailed us to take advantage of our free consultations that prompt great discussions of issues common in many disability claims.  Some of these wouldn’t justify an entire blog post, so we’ve decided to put together a “mailbag” of some of our recent questions.  If you have more questions, you can visit our FAQ page or contact our offices.

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