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Why an insurer may ignore a treating doctor’s opinion.
Many people, as well as their doctors, believe that when they file a claim for disability benefits their disability insurance company has to accept the medical professional’s opinion that they are disabled. Common sense suggests this is a reasonable assumption – but it couldn’t be further from the truth. Why? Because many insurers simply do not want to pay disability claims and, when armed with discretionary language in the policy, the insurer has the final say as to who is “disabled”, not the treating doctor. Making matters...
read moreReducing work hours may imperil disability coverage.
Many people who are struggling to work due to an acute unexpected medical condition do not have the opportunity to prepare or plan for filing a short and or long term disability claim. My experience is that most people who eventually file disability claims have chronic medical conditions which have been ongoing for months and even years. During this difficult period disabled people often find themselves engaged in an heroic effort to continue working. People engage in this long battle for many reasons, one is often financial, and the other...
read moreShort term disability approved, but long term disability denied.
One issue I see all too frequently in my practice is the situation where an insurance company approves a short term disability claim for a period of time (perhaps the maximum time frame, usually no more than 180 days) but then turns around and denies the long term disability claim. Most individuals do not understand how the same insurance company, reviewing essentially the same evidence, and using what is frequently the same definition of disability, can make such contradictory findings. After reviewing hundred of disputed disability claims...
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