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Have you ever wondered how the Long Term Disability carrier goes about evaluating a Long Term Disability claim? They allegedly have “professional disability management teams.” These can consist of a “disability claims managers, disability management services and Social Security assistants.”
What is a disability claims manager? That’s a person who is supposed to work with a disability claims management team that consists of their medical directors, clinical experts, Social Security specialists and other staff, who will evaluate your entitlement to benefits and quite frankly, how they will deny your benefits or reduce their exposure.
Disability management services do that by developing “relationships with specialty consultants,” that will help them assess the basis of your diagnosis, your level of functioning, whether you are getting the right kind of medical care, and whether your condition prevents you from returning to your own occupation or any occupation.
More often than not this done by a paper review by an in staff nurse or a review by a medical consultant who will be asked to review all or part of your medical file and ask specific questions. Unfortunately, it is not uncommon of this disability management consultant to make a livelihood from reviewing Long Term Disability carrier’s claims. Do you think that they would remain as a consultant if they told the Long Term Disability carrier the truth?
It is not uncommon for Long Term Disability carriers to refer Long Term Disability applicants to the Social Security claim assistance program. While we at The Law Offices of Nancy L. Cavey recognize a Social Security Disability claim can provide monthly income to a Long Term Disability applicant and Medicare entitlement, many times this referral is done for the purposes of reducing your Long Term Disability benefits. There are many Long Term Disability policies that have a clause in it that allows for Social Security Disability benefits that you receive for your family members including what your children receive to be subtracted from your Long Term Disability benefits.
The Social Security claim assistance group will also have you sign a release that will allow the Long Term Disability carrier to raid your bank account when the Social Security Administration issues a retroactive check for back benefits. More often than not, Social Security claims assistance hired by the Long Term Disability carrier will also give out the wrong medical condition that will allow the Long Term Disability carrier to limit the amount of benefits.
For example, your Long Term Disability policy may have a clause that limits the payment of mental benefits under the mental nervous claim to two years. If you suffer from fibromyalgia, the Social Security claim assistance group may very well develop your depression as the cause of your disability as opposed to your fibromyalgia. That will allow the Long Term Disability carrier to stop paying you Long Term Disability benefits under the mental and nervous limitation while we all know that depression is just one of the many side effects of fibromyalgia, more often than not it is the fibromyalgia itself that it disabling.
Don’t set yourself up for a claim’s denial or limit benefits by allowing the Long Term Disability carrier to use a Social Security claims assistant. At The Law Offices of Nancy L. Cavey we assist you with both your Social Security and Long Term Disability claim to maximize your entitlement to both benefits and to make sure that you get all the Long Term and Social Security disability benefits that you are entitled to. The law firm of Nancy Cavey has written two free consumer guides that will explain to you the Long Term Disability and Social Security Disability process “Robbed of Your Peace of Mind,” and “Your Rights to Social Security Disability Benefits.” Get your copies today!
