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Insurance Denial

Mental Health, Bipolar 1 & Long Term Disability Denials

Mental Health, Bipolar 1 & Long Term Disability Denials In our experience, when Long Term Disability (LTD) insurance companies evaluate mental health cases, such as Bipolar 1, they typically attempt to redefine the illness and ignore their own definition of disability under the disability insurance policy. Nearly all long-term disability (LTD) policies cover mental health …

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Injured Victims Suffer Twice Under McCutchen Ruling on ERISA Subrogation Claims

INJURED VICTIMS SUFFER TWICE UNDER McCUTCHEN RULING Congress needs to fix resulting unfair outcomes under ERISA subrogation claims (Yes, the tail finally does wag the dog!) On April 16, 2013, the United States Supreme Court issued its long awaited decision in the case of U.S. Airways v. McCutchen,  (No. 11-1285).  The case involved a subrogation …

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Long Term Disability – Defining “your job” vs. “your occupation”

Long Term Disability Insurance – “your job” vs. “your occupation” – understand the difference: THE VOCATIONAL SIDE OF LONG-TERM DISABILITY Frequently, long-term disability contracts provide us with definitions for disabling conditions.  These definitions embrace the idea that your illness or disability affects your ability to perform “your job.”  Occasionally, policies also refer to “your occupation.”  …

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Surveillance and the Functional Capacity Evaluation

This has been on my mind for some time and I have been trying to let my clients and perspective clients know about this so they can respond appropriately.  Many insurance companies use vendors to conduct video surveillance while the disability claimant is at their home.  There is simply no way to tell which files …

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Fibromyalgia Disability Advice: How to avoid Long Term Disability Claim Denial

Choosing the wrong type of Doctor to treat your fibromyalgia could cause insurance to deny your disability claim. What type of Doctor should I see for fibromyalgia? Fibromyalgia is a disease that does not offer any objective evidence or test results, therefore the clinical notes recorded by the treating physician become very important to diagnosing …

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