by Cody AllisonI’m Getting Paid Under “Reservation of Rights” — What does this mean?
When you review your policy prior to filing a claim, you are probably going to run into terms in the policy that you don’t understand. One of the terms that we get asked about most is the “reservation of rights” clause in a policy, although this is not the only “legalspeak” term you are going to run across. Below is an explanation of what this term means. This illustrates the point that it is important to get a competent professional to review your policy and give you advice about your rights under the policy, and also to explain the meanings of these terms. At Cody Allison and Associates, we stand ready to help you.
If you are receiving long-term disability benefits and have been told it’s under “Reservation of Rights”, this means that while the insurance company is still reviewing your claim to approve benefits or deny benefits, they will pay you under Reservation of Rights. After the insurance company reviews your claim and makes a decision, they will either start paying your claim normally and no longer under Reservation of Rights or they can deny your claim and you will receive no more benefits.
If you are getting paid under Reservation of Rights, please call Cody Allison & Associates at (615) 234-6000 and we will be happy to go over your claim with you free of charge. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com.
by Cody AllisonWill my long-term disability claim be denied if I do not have surgery?
Occasionally, we get clients or callers who are worried because their Dr. has recommended surgery and they just don’t want to have surgery. This can be for various reasons. They are worried that if they don’t follow the course of treatment recommended by the Dr. by not having the surgery, their coverage will be denied. Below is the answer to the question of what happens if an insured chooses not to have surgery. Remember, here at Cody Allison and Associates, we are available to help you and answer any question you may have. If you have questions or concerns about your disability claim, give us a call today.
Our office gets asked this question often. My doctor has recommended surgery and indicates that other than surgery, there is nothing more he can do for me. Will my long-term disability claim be denied if I do not have surgery?
The disability carrier cannot force you to undergo surgery. For example, if you have back problems and have seen an orthopedic and a neurosurgeon, and the neurosurgeon is recommending surgery, and you do not want to undergo surgery for several reasons, the carrier cannot deny your claim for not going through with the surgery that your neurosurgeon has recommended. You can continue to treat with other conservative treatments.
If you have any other concerns or questions regarding this matter, please call Cody Allison & Associates at (615) 234-6000 and we will be happy to answer any other questions you may have. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com.
by Cody AllisonIf your doctor has not released you to go back to work, your disability claim can still be denied.
There are certain rules that every claimant must know when making a disability claim under a policy. These rules are usually outlined in your policy. It is important to know them and abide by them to not give the insurer an excuse to deny the claim. However, there are some things that you may not really have any control over. In this instance, a disability claim may be denied even though your treating physician has not released you to return to work. Below is an explanation of how this can be done. If you need help with your case or feel that your claim has been wrongfully denied, please contact us to discuss the matter.
If your doctor has not released you to go back to work, your long-term disability claim may still be and can be denied. After the insurance company receives your claim, they will review your medical records and will start their own investigation of your claim. In this process, the insurance company may send your medical records to their own independent doctors to do a peer review. If any of these doctors conclude they don’t find any restrictions or limitations that prevent this individual from working, the insurance company can and most likely will deny the claim. They can deny your claim based on their independent peer review doctor’s opinion, regardless of what the treating physician or physicians who treat you regularly state.
If your treating physician states that you cannot work, or hasn’t released you to go back to work yet, and you received a denial from your long-term disability carrier, please call Cody Allison & Associates at (615) 234-6000 and we will provide you with a free case analysis.
by Cody AllisonHow do I obtain a copy of my long-term disability policy?
This is probably one of the most common questions we are asked. Your disability policy is absolutely necessary to have because it contains the full agreement between you and your plan provider. It will tell when things need to be filed, and define terms that are going to become very important in your case. As soon as possible, you need to request a copy of this policy. Any attorney you contact will need a copy of this policy up front in order to be able to know what must be done in your case so you can recover under your policy. Below is concise information about how to get a copy of this policy. Remember, if you have questions or need help, Cody Allison and Associates stands ready to assist you. Call us today!
If your long-term disability policy is an ERISA plan, through your employer, than you need to request a copy of the policy to the plan administrator. This is usually the employer in most cases. The request needs to be in writing and send the request certified return receipt mail via United States Postal Service. Failure by an administrator to provide you with a copy of your long-term disability policy within 30 days of your written request could subject the administrator to a civil penalty of $110.00 per day. However, the administrator would only be subject to this penalty if a federal lawsuit is filed and the Judge agrees to fine the administrator.
There are many details and definitions in your long-term disability policy, so you want to make sure you receive a copy of the policy and not just a summary plan description of your policy.
If you have received your long-term disability policy and need help understanding what you may be entitled to, please call Cody Allison & Associates at (615) 234-6000, and we will review your policy free of charge.
by Cody AllisonFibromyalgia and Long-Term Disability
The link below carries you to a NOLO article regarding the intersection of fibromyalgia and LTD claims. The article makes the very important point that many insurance companies almost automatically deny claims related to this debilitating disease and that it may be necessary to bring in an experienced attorney to handle a long-term disability claim based on fibromyalgia. Here at Cody Allison and Associates, we have experience with these kinds of claims and we stand ready to help you recover the benefits that are due to you. Contact us today!
http://www.nolo.com/legal-encyclopedia/long-term-disability-benefits-fibromyalgia.html