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

Protect Yourself Against A Functional Capacity Evaluation

In addition to IME’s (Independent Medical Examinations) insurance companies are also known to use Functional Capacity Evaluations, known as FCE’s, to analyze a claimant’s disability.  These evaluations assess the ability to perform a series of tasks which simulate customary job duties and determine the extent to which the claimant can complete these job duties on a regular basis.  FCE’s can have different focuses and purposes and be referred to as Physical Capacity Evaluations, Work Capacity Evaluations, or Disability Assessments, but they all mean the same thing: the insurance company is attempting to use a biased and flawed evaluation system to challenge the statements of you and your doctor about your ability to return to work.   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

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

6 Potential Pitfalls of Your Chronic Back Pain Disability Claim

Almost everyone will experience some sort of back pain during the course of their lives.  This can extend from the cervical to thoracic to lumbar, not to mention shooting into arms and legs, and range in severity from a minor, short-term twinge to protracted, excruciating pains that last for months.  For people who deal with chronic back pain on a daily basis, performing what used to be simple tasks and normal work functions can become difficult and sometimes unbearable.  Even with surgical intervention, the pain may prove too overwhelming for many people.  In addition, this pain can lead to a host of other conditions such as depression and anxiety.  When this occurs, sufferers of chronic back pain may need to consider applying for their disability benefits.

The claim process is full of unexpected pitfalls and hurdles that may weaken the claim and cause benefits to either be delayed or denied, preventing you from having the money you were counting on to pay the many bills that crop up when you become disabled.  These following six tips represent some of the most common problems our clients have experienced when filing their claim for benefits based upon conditions that cause chronic back pain and the ways to avoid these problems, helping you receive your benefits as soon as possible when you need them most.   Continue reading

Dealing With an Aggressive Claims Examiner

When you file a disability claim, your main point of contact with the insurance company is usually a claims examiner who has been assigned to your claim.  These individuals are trained to act as your lifesaver during your time of need, but they’re specifically trained (and sometimes even rewarded) to search for reasons to deny claims and goad claimants into making statements that are not representative of the truth and can be twisted to the insurance company’s advantage.  There are many different ways that the insurance companies try to reach their profit goals, but one of the most obnoxious techniques seems to use aggressive and pushy tactics in the claim departments to force mistakes or cause anxiety and fear that cause claimants to reconsider whether they should even pursue their benefits.  Knowing the fragile state of many claimants when they file for disability benefits, some claims departments capitalize on these weaknesses and manipulate LTD claims process to their advantage. 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

Finding The Proper Disability Insurance Policy For You

Many claimants who contact our offices know little about disability insurance.  Some are aware that they have disability insurance and need help, while others don’t even know what kind of policies they have and just happen to find our firm while trying to figure out their next steps.  Most people realize the need for disability insurance but because it’s bundled in group packages from their employer, they have never seen their actual policy and  know little of their coverage rules and limitations.  When the time unexpectedly comes to file a claim for benefits, disability insurance companies capitalize on this lack of knowledge and use it to place some claimants at a significant disadvantage when initially filing their claim for benefits.

However, it doesn’t have to be this way.  Information is available to learn about the risks you face of becoming disabled, different types of policies and options, and how you can protect yourself and your income.  Doing this homework before purchasing a disability policy will help ensure that you have an understanding when you have to file a claim for benefits while you’re disabled along with the comfort that you and your family is protected if something prevents you from earning a living or continuing in your job.  This ounce of preparation will allow you to use disability insurance for its intended purpose:  to reduce the risks of everyday life.   Continue reading

The Battle Between Insurance Companies and Mental Illnesses

Mental illness is on the forefront of much medical innovation and research today.  As we continue to better understand and comprehend the human mind and its illnesses, we’re able to more accurately diagnose and treat many different psychiatric conditions that were either misdiagnosed or simply ignored in the past.  Mental illnesses range greatly in length and severity of the conditions, but they can all be debilitating and render the patient unable to work in their or often, any chosen occupation.  If you or someone you know is suffering from a mental illness and has disability insurance through their employer or individually, you should be able to obtain disability benefits through your policy.  However for reasons I’ll discuss below,  insurance companies unfortunately tend to make this difficult and will vigorously try to delay, reduce, and deny your disability claim due to mental or nervous conditions.  Mental illness has a become a prime target for disability insurance companies, and those souls who are simply trying to collect their benefits have to be prepared for a fight. Continue reading