Although you may be allowed to choose a doctor for the IME, it will be from a list of doctors that The Hartford provides. The chance that you will know anything about their doctors is slim, but assuming the doctor is objective and qualified, remember that he/she can only make a recommendation based on the information they: (1) get from your records, (2) their understanding and knowledge about your particular type of illness or injury, and (3) what they see as most important. Here are tips on protecting yourself and why you may need a disability lawyer.
Dr. Jeffrey E. Budoff, a respected board certified orthopedic surgeon in Houston, TX, who specializes in hand, wrist, elbow, and shoulder treatments states: “Carpal Tunnel Syndrome is mainly a work-related, repetitive motion injury and is defined as a compression of the median nerve. If you suffer from pain or numbness in the hand or forearm region, you can conclude that you have Carpal Tunnel syndrome.”
Many high-income professionals decide to purchase private disability insurance for their own specific occupation. The goal is to protect themselves in the event they become disabled and are not able to work in their current occupations.
These professionals, such as doctors, dentists, and lawyers, pay a high premium for the peace of mind and protection of this insurance. Insurance coverage is supposed to be there for them, however, if they become disabled.
There are many valid reasons for an insurance company to deny a disability claim for benefits, but insurance companies can and do make mistakes that result in wrongfully denied claims. Oftentimes, a wrongful denial is based on an honest mistake or misinterpretation of information about the policyholder, but that is not always the case.
Fibromyalgia and chronic fatigue syndrome are two frequently misunderstood medical conditions. According to the National Institutes of Health people often think they developed overnight and exist only within a person’s mind. The truth is that these diseases have been around for centuries, although they were commonly believed to be a single condition known as muscular rheumatism.
Have you been diagnosed with fibromyalgia? Are you looking for help making a disability insurance claim? Perhaps you have already made a claim and your insurance company has denied it, despite the fact that it is a legitimate claim and you have diligently paid your premiums. Maybe your insurance company has underpaid your disability claim, or is unreasonably delaying your claim.
The insurance companies that issue occupational accident insurance policies to semi-truck drivers often do not understand California laws. They think they can administer claims as if they were workers’ comp claims. They look for loopholes that they might be able to use under workers’ compensation laws. However, the California laws that apply to these types of policies do not have those loopholes. In other words, the insurance company may have denied your claim illegally. This is a wrong that we know exactly how to right.
If your insurance company has underpaid your disability claim, or if it is attempting to do so, we can help. Our first step will be to review your claim and make certain that you are asking for exactly what your claim is worth. Simultaneously, we will review your disability insurance policy to make note of any applicable policy limits and restrictions, and to find out exactly how much you are entitled to. With that information, we will take action.
With as much information at our disposal as possible, we will guide you through the process of appealing your denial. There is a special process designed to allow you a chance to have the insurance company’s original decision reversed. Our attorneys have a thorough understanding of this process, and will stand by you every step of the way while we fight to ensure you receive the benefits you deserve.
While many people purchase disability insurance through their employer, others purchase their policies directly through an insurance company. These private disability insurance policies are popular for professionals, such as doctors and medical professionals, who are self-employed, as well as for individuals whose employers do not offer coverage.
Many people do not realize at first that they are being victimized by the insurance company. That is because delay tactics may look like legitimate requests. The insurance company may contact you and ask you to provide supporting evidence of your disability. This may seem reasonable, except that such evidence may be completely unnecessary. Similarly, the insurance company may ask you to see their doctor, which may not be necessary.
If you have been denied disability benefits, it is important not to give up. Our Glendale denied disability claims attorneys are skilled at uncovering the reasons your claim was denied and quickly acting to rectify errors, and negotiate with the insurance carrier to ensure you receive the proper benefits. Contact our firm today to discuss your situation through a free consultation.
It is increasingly commonplace for disability benefits applications to be initially be denied. If your disability claim was denied, it can be a frightening and frustrating experience. You are concerned about paying your bills and avoiding financial devastation. There is hope — our experienced attorneys can carefully examine your situation and provide valuable legal advice regarding your best course of action.
The attorneys at the Los Angeles area law firm of Donahue & Horrow, L.L.P., are available to you to assist with claim preparation questions and monitoring insurance claims through the process, even before a disability claim is denied.
Insurance carriers routinely include language in their policies designed to limit coverage in the event of a disability. For example, insurance companies may include a provision that a disabled person must first be receiving “appropriate care” for the condition causing the disability. It is how the insurance companies interpret the wording of “appropriate care” that has been the source of conflict between many claimants and their insurers.
When you purchase disability insurance, you are purchasing a promise to pay in the event you become disabled or unable to do your own occupation or any occupation. These special insurance policies help pay your rent or mortgage, or your grocery bills, clothes and other expenses when you are unable to work. But if your insurer denies your disability claim, you may feel that you have nothing to fall back on.
We will review your disability insurance claim free of charge. If your claim has been denied, your case will be handled on a contingency basis, which means you pay nothing and we receive nothing unless you win your case by way of settlement or verdict. Call us toll free at 877-664-5407 or e-mail us to schedule a consultation with our California disabling conditions insurance claims attorneys.
Attorney Michael Horrow has substantial experience in disability insurance matters and can help you with any California disability claim or insurance appeal. If your disability insurance claim was denied on the basis that you do not meet your insurance company’s definition of disabled call today for your free legal consultation.
You might think that simply being disabled entitles you to disability benefits, but most initial applications for disability insurance claims are denied. Even if your own doctor has determined that you are disabled, insurance companies will still look for ways to delay, or deny paying on claims.
“Diagnosis does not equal disability.” That’s something that insurance defense lawyers often say as they attempt to avoid paying a disability claim. What they mean is, just because you are diagnosed with a medical condition does not mean you are disabled. While this may be true, what they do not understand is that the disabling condition may not be the medical condition itself, but the medication taken to treat the condition.
All cases are taken on a contingency basis. We represent individuals disabled by back, neck and other injuries, medical conditions such as fibromyalgia, chronic fatigue syndrome, lupus, cancer, migraines, severe depression.
People who do not suffer from rheumatoid arthritis rarely understand how disabling the condition truly is. Disability insurance companies frequently deny claims, simply because they do not consider rheumatoid arthritis a disability. They do not know the pain that is associated with the condition, not to mention the fact that it can make it virtually impossible to do your job. Do you have rheumatoid arthritis in your hands, shoulders, hips, knees or any other joint?
It is possible that the insurance company made a mistake. Maybe a piece of documentation was missing or they misinterpreted your claim. Such mistakes are possible, and our attorneys have the ability to quickly resolve them. However, many denied claims are the result of the insurance company’s failure to fulfill their duty of good faith and fair dealing. If your insurer fails to investigate your claim appropriately and to give as much consideration to your needs as it does its own, you may be the victim of insurance bad faith.
Computer and IT professionals are forced to sit for great lengths of time. In a profession that essentially requires an employee to sit and face a computer screen for weeks, months and years, these individuals put stress on parts of their bodies that can have devastating results. If you are a computer or IT professional, it is wise to have one of our experienced lawyer carefully examine your disability policy to ensure you are properly covered.
If you have been the victim of a denied disability insurance claim on the basis that you do not meet your insurance company’s definition of disabled, our attorneys can help. Our law firm features former insurance defense attorneys and we understand the loopholes insurers will try to use to avoid having to pay your claim, and all of the other underhanded tactics they may employ.
In case after case going toe-to-toe with some of the largest disability insurers in the nation, including UNUM, Cigna, Hartford, MetLife and many others, Donahue & Horrow, LLP has established itself as the “go to” firm for own-occupation disability insurance issues and recovered tens of millions of dollars for its clients.
Financial advisers absorb a great deal of stress and worry from their clients. The very nature of the job and its responsibilities lead to extreme emotional and physical challenges. When those challenges begin to take a toll on the human body, it might be necessary to file a disability insurance claim.
Carpal tunnel syndrome is not only painful, it can decrease the ability to grasp and hold onto small objects, or perform other fine motor skills involving fingers and the hand. This can be particularly problematic for professionals who rely on dexterity and fine motor skills to perform their jobs, including doctors, surgeons and dentists, but can also become so severe that mechanics, typists, machine or other industrial workers may no longer be able to safely or adequately perform the same job.
Insurance companies are allowed to deny disability claims; however, they must first give your claim proper consideration and have a valid reason for denying the claim. And, they must also do so within a reasonable time frame and tell you the reason for the denial. Specifically, Subsection 790.03(h) of the California Insurance Code (called the Insurance Unfair Practices Act) defines a number of actions that are considered unfair practices by insurance companies.
There are a number of reasons disability claims are initially denied including the nature of the claim, and whether or not the claim was properly documented and filed. These denials are often due to human mistakes or a lack of proper documentation, that insurance companies hope for so that they can deny your claim. However, denials are not always based on claim mistakes; sometimes, insurance companies deny your claim without a valid reason.
There are two other main reasons disability insurance companies look for ways in which they can deny a claim that have nothing to do with your individual claim itself.
Unfortunately, for many who suffer a disability — even a disability that has been medically proven, initial claims are more often denied than approved. This sounds like a terribly unfair situation, and until 2012, insurance companies were allowed to simply deny your claim based on “discretionary clauses” that allowed an insurer to simply claim a policyholder was not disabled and therefore, not entitled to their benefits. This sort of disability insurance claim practice was entirely legal – and unfortunately all too common in the state of California, and so in the fall of 2011, California passed a law outlawing “discretionary clauses” in disability and life insurance policies.
There are many legitimate reasons for an insurance company to deny a claim for benefits. Often, the denial is based on an honest mistake or misinterpretation of data. If, through our investigation, it is determined that the insurance carrier acted in bad faith — or an unreasonable refusal of benefits — we can file a lawsuit and hold it accountable for its actions. Through this type of lawsuit, you might be entitled to recover monetary compensation for emotional distress and any other financial harm you might have suffered through the process. You can trust our Ventura County disability insurance claims attorneys to explore every legal option at their disposal to ensure you receive the benefits you deserve.
It is possible that your claim was denied due to the insurance company acting to simply protect its bottom line. In these situations, an unreasonable denial can be considered insurance bad faith.
Our attorneys can file a lawsuit against the insurance company if it acted in bad faith when denying your disability benefits claim. You might be entitled to additional money through a bad faith lawsuit. This additional compensation might include attorneys fees or damages for emotional distress caused by the denial and subsequent lawsuits. Trust our Los Angeles-area lawyers to guide you through the process.
The summary plan description (SPD) is a document that provides a detailed overview of your disability insurance plan – how it works, what benefits it provides, and how to file a claim for benefits. It should also layout limitations and restrictions. For example, you may have to wait a certain amount of time before filing a claim, or be of a certain age.
Our lawyers can assist in making a claim. As part of this service, we will educate you about the definition of disability on your insurance policy. We will strive to make certain that your medical documentation makes it clear that your condition meets the insurance company’s definition of a disability. Making certain that everything is presented correctly to the insurance company can prevent hurdles further down the line.
If you have been denied disability benefits, it is important not to give up. An experienced attorney can guide you through the appeals process and ensure you have a fighting chance at recovering the money that is owed to you. If we can determine, through a thorough investigation, that your insurance carrier acted in bad faith — by denying your claim without proper consideration — we can explore the option of filing a bad faith lawsuit. In these situations, it might be possible to recover even more compensation than was stated in your policy due to the addition of emotional distress.
Our law firm features former insurance defense attorneys. This unique quality can be very beneficial in helping spine injury victims take advantage of their disability insurance policies. It means we understand the viewpoint and methods of “the other side.” We know just how they might try to undermine the severity of your neck or back injury in order to avoid having to pay your claim. Not only do we know how to overcome their methods, we are litigators, willing to fight to get you the money to which you are entitled.
In most cases, initial disability claims are denied. More often than not, disabled individuals might struggle through the appeals process before they receive the benefits they may actually be entitled to receive. Fortunately, our law firm has the necessary expertise to guide you through the process of filing a disability claim appeal. At Donahue & Horrow, L.L.P., our Los Angeles denied disability claims lawyers have more than 40 combined years of experience representing injured clients. We understand the stress and frustration that follows receiving a denial letter. You want your insurance carrier to uphold your policy and help you stabilize your finances. Our thorough understanding of the insurance disability claims process bolsters our experience representing clients through both negotiation and litigation.
In some cases, our clients have contacted us after receiving benefits for a period of time, usually 24 or 36 months. Their disability insurance carrier has informed them that they are no longer eligible to receive benefits because of a “change in definition.” Essentially, after a period of time, the insurer will refer to the policy that requires that you must be disabled from any occupation, not just your previous occupation, to continue to be eligible to receive disability benefits.
It is the goal of an experienced attorney to determine if the denial was based on policy exclusions, misinterpretation of data, processing error or bad faith. Whatever the case, our lawyers will diligently fight to ensure you receive your disability benefits.
We can guide you through the arduous and potentially lengthy process of appealing a denial of benefits. We have assisted clients who have employer-provided disability insurance policies governed by Employee Retirement Income Security Act (ERISA) law in addition to clients who have selected a private disability insurance policy. Through careful and thorough examination, we can advise you regarding the obstacles you might face and what your next steps should be.
It is increasingly commonplace for disability benefits applications to be initially be denied. This is due in large part for the economic benefit of the insurance company, but it can also be the criteria used to determine whether or not your disability prevents you from working. For example, some people suffer from an occasional migraine, but for some, chronic migraines can be incapacitating.
Often, insurance companies will act in their own best interests before considering the needs of their policyholders. In fact, most often, an initial claim for disability benefits will be denied. Individuals must then struggle through a potentially lengthy and costly appeals process. With our experienced lawyers on your side, it is possible to guide you through this process toward a successful resolution.
It is more common to be denied disability benefits than having your initial application approved. If you are denied, though, you still can appeal the decision and fight for the compensation you are owed. Contact our experienced attorney to learn more about your options; unlike the insurance company, we will only seek a course of action in your best interest.
Whether you have an employer-provided disability insurance policy that is governed by Employee Retirement Income Security Act (ERISA) law or you have selected a private disability insurance policy, our attorneys can guide you through the process of appealing a denial. Immediately after accepting your case, we will perform a thorough investigation of your situation and provide an honest case assessment and a clear description of your best course of action.
Disability insurance claims for business owners can be challenging to navigate when certain special provisions are often written into group disability policies. For example, CPAs might include specific provisions that allow for more hours during the busy tax season. Retailers — manufacturing, distribution and sales — might include special provisions that take into account extended work hours during the holiday season.
If, through our investigation, we believe that your insurance company acted in bad faith in denying your claim, we will pursue an insurance bad faith lawsuit. Through this type of lawsuit, you might be entitled to recover monetary compensation for emotional stress and any other financial harm you might have suffered through the process. Trust our Los Angeles and San Diego-area attorneys to explore every legal option at their disposal to ensure you receive the benefits you deserve.
If the insurance company does not give your claim the proper consideration and thorough investigation, the company is not acting in good faith. When an insurance company does not act in good faith and unreasonably refuses to pay policy benefits, you are a victim of insurance bad faith. Our Riverside and Los Angeles-area attorneys can explain the situation and your options for compensation during a free consultation.
In this day and age, it is more likely that your initial application for disability benefits will be denied before they are approved. This denial, though, should not be taken as a final decision. There is an entire process designed to allow individuals to appeal the denial and work toward receiving their full and fair benefits. An experienced attorney can guide you through the process and answer your questions along the way.
There are many legitimate reasons for an insurance company to deny a claim for benefits. Often, the denial is based on an honest mistake or misinterpretation of data. If, through our investigation, it is determined that the insurance carrier acted in bad faith — or an unreasonable refusal of benefits — we can file a lawsuit and hold it accountable for its actions. Clients rely on our Los Angeles-area lawyers to explore every legal option to ensure they receive the benefits they deserve.