Another Success Story!

Every once in a while, we like to feature a story from one of our clients about their personal experiences with the disability claim process. Today’s story is an especially touching one. We spent a lot of time with working with Robert and his wife, and he ended up getting the disability benefits he deserved. The nature of his disability and the circumstances of his claim presented some unique hurdles that we had to work together to overcome, but we were able to provide the level of service he needed to satisfy the demands of his claims examiner and move on with his life. Here’s his story, in his own words:

My consultant, Fred Gosman, really helped with my disability claim! After I suffered a broken ankle, I found myself no longer able to work when the injury took a turn for the worse and turned into Reflex Sympathetic Dystrophy and Complex Regional Pain Syndrome. This is when I decided to file for disability benefits. Being an insurance agent, I thought I’d be able to easily complete the claim forms.  But after attempting it alone, I realized the enormity of my situation and decided to find help.  

I hired a claim consultant who promised lots of help, but instead she became abrasive and overbearing, angering my doctors and not helping my claim.  I had to quickly terminate that relationship and start over.  Once I found Royal Claims Advocates, my experience completely changed.  Fred helped me and my wife from the beginning, making sure I understood what was needed and helping gather all of the information.  He helped make sure my claim forms reflected my situation and worked with my doctors (They loved him!) to ensure they understood what was needed by Reassure America for my claim. 

He has helped make sure Reassure America was treating me fairly.  They asked for lots of records that didn’t apply to me or my claim, but he helped us correct their misunderstandings and provide the information they really needed. 

I’ve struggled through some rough parts of my disability, and Fred was flexible when I needed it.  Everything he’s done helped us move closer to filing my claim with support and documentation. His knowledge of disability insurance and claims helped my claim go smoothly.

Once we submitted my claim, my benefits were approved and paid within weeks, far quicker than I imagined.  Fred and his team at Royal Claims stayed with me to support and guide us through this challenging time.  Their help really has been invaluable to me and my wife.  As a former insurance agent, I appreciate the depth of their knowledge and the quality of their work.  It’s allowed me to focus on my recovery instead of fighting the insurance company for my benefits! 

– Robert S., Philadelphia, Pennsylvania 

Thank you Robert for your kind words!  Stories like these are the purpose we created our firm and the reason we fight so hard to ensure our clients get the disability benefits they deserve.

We’ve helped many others receive their benefits as well. If you or someone you know is in need of help on their disability claim, please contact us. You may call us toll-free at (855) 828-4100 or visit our website to sign up for a free consultation.

Happy Holidays From All Of Us!

From all of us at Royal Claims Advocates to you and your loved ones, we wish you a happy and healthy holiday season!  This blog normally provides you with advice and tips on filing a successful disability claim, but today we’re going to take a break from the normal claims grind – and explain why you should too. 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

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.

Continue reading

Getting Back to Work After a Disability

This month, we celebrate the 22nd birthday of the ADA, the Americans with Disabilities Act, so I’d like to talk about some of the many resources and support groups our clients have used when going back to work after a period of disability.  Most people have a negative impression of disability insurance, both public and private, creating a stigma which mislabels many disabled individuals as lazy or slackers.  Based on our clients, these stereotypes couldn’t be further from the truth.  Most of the claimants we work with would jump at the chance to return to productive, rewarding work and forget all about their disability claim along with the burdens they have to bear.  The Social Security Administration, along with several private organizations, have created multiple programs to help individuals transition from disability to recover their ability to be gainfully employed. Continue reading

UNUM Success Story!

A 56 year-old surgeon, suffering from arthritis and lumbar disk problems, had become uncertain whether he could remain in a surgical suite for sufficient periods to complete all of his surgeries. To compensate for his chronic pain, he reorganized his responsibilities to assisting on some surgeries and doing more clinical work, including pre- and post-op patient visits. He was in a multi-physician practice that was able to accommodate his changes by rearranging duties and work schedules.

The surgeon bought a UNUM disability insurance policy in the early 1990’s that provided for $12,000 of monthly benefits and had faithfully paid his premiums. Since he was no longer performing most of his surgical procedures due to his pain and weakness, he realized the only way he could maintain his income would be to file a disability claim with UNUM. The office manager of the practice contacted their insurance agent, who referred her to the claims department. Claim forms were obtained, completed, and submitted.

After almost 75 days of repeated telephone calls and letters back and forth, UNUM denied his disability benefits due to ambiguity in the symptoms, unclear medical proof of the claimed conditions, and an unduly broad inclusion of occupational duties.

A mutual friend mentioned our firm to the very upset and frustrated doctor. After calling and meeting, he decided to engage our firm to go through the documents that were already submitted to UNUM. We worked with the doctor to prepare a much stronger, more detailed, and clearer disability claim. After working with the insured, his practice manager, and his attending physicians, we were ready:

  • Complete and detailed descriptions of his occupational duties were prepared.
  • Additional tests were performed to document the claimed conditions.
  • A clear and fully documented history of his disabling conditions was written.
  • Letters were written explaining the errors that were made in evaluating the originally submitted claim.
  • Claim forms were completed again with the additional, more complete, information.

Finally, all of this information was compiled and presented in a manner that was easy for the claims examiner to review and accept…which is exactly what happened!

Our client started receiving his monthly disability benefits within 2 weeks, plus 9 months of retroactive benefits. His only regret is that he didn’t use our firm from the beginning! His benefits are still continuing today, more than 7 years after starting his claim. Of course, we’ll check in or he’ll have questions from time to time – as the claims process never stops. But, he’s been able to collect on the promises made when he made the wise decision to protect his income in case of disability.

This case is just one of the many examples why you should never give up when an insurance company denies your disability claim. With the standard operating procedure of “question then deny,” many companies exhaust their insureds into giving up when they get the dreaded denial letter. With our help, clients can easily handle the mass of paperwork and communication the insurance companies use as weapons to deny claims.

We welcome and encourage your comments on this blog. If you would like to add your own experiences, please share them!