Top 5 Reasons for Disability Insurance Denial

Nationwide disability attorneys Gregory Dell and Rachel Alters discuss the top five reasons for a Disability Insurance Claim Denial. The information in this video applies to both ERISA and Non-ERISA disability insurance policies. The top reasons for a long term disability insurance denial are:

1 - Claimant is videotaped by the insurance company's private investigator

2 - Claimant is sent to a Compulsory Medical Exam by Insurance Company

3 - Claimant has a change in Disability Definition from Own Occupation to Any Occupation

4 - Treating Physician does not properly document Claimant's Medical Condition in Medical Records

5 - Treating Physician or Claimant Makes a Mistake with a Claim Form

6 - Change of disability claim rep handling the claim

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6 WAYS WE CAN HELP YOU







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Our nationwide disability insurance attorneys have represented thousands of disabled claimants with their claims for either short term disability, long term disability, or long-term care benefits against every major disability insurance company. We do not charge any fees or costs unless we are able to recover benefits.


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[melissamariewarner]

i am glad that they investigate people.there are so many people on disability that can work and shame on those who can and get disability benefits.when people like us, who really are disabled.get denied.good for them for investigating crooked people.

[darrenfonzseau]

Thanks for fighting for the injured and disabled. Peace 

[thehunterofdeath]

I work all my life I have being whit diabetes for the pass 10 years so this year i became disable wit neuropathy in both feet and hands plus I suffer from panic attack toodisc in the back mess up n the neck too I have work for 19 years I became homeless because I lost my job because of my illness they cut my en Health insurance I depend in a lots of medication I was denial for social security health insurance that really mess up think happen in life so fight it for my case whit a attorney they're out people then never work no pay no tax and then get health-insurance that's messed up and the workingman n woman we get sick and they put difficult for us the working people is a shame

[EKEACRES]

I'm 51 and have MANY serious health problems, including Dupuytren's Contracture of both hands & Plantar Fibroma in both feet, along with Spinal Stenosis, Spondylosis and a C5-6 Fusion with screws and bone graff. I am under review with the IMA and if I'm denied, I'm going homeless because I no longer wish to fight and constantly play their BS games, period.

[QuantumOfSolace]

These insurance companies force you to see an IME doctor that they are paying - who in turn writes a false report blaming your injury on another medical cause or saying you are fine but they won’t sign off on clearing you back to work. Its just so the insurance can stop paying your claim. Yep my exam was 20 minutes.

[notupwthit]

They sent me a 100 miles to a smaller city than we I live for a CME. I called and advised I couldn't make that drive. They advise no problem we'll get you there and back. So at 10:30 Monday a Toyota Corolla arrives to take me to my appointment, I've got spondylitis and sacrialitis arthritis In my spine. So he drives me there and by time I get there I can hardly feel my legs. I try to gimp around and walk it off. I get a 15-20 minute exam. My right leg was completely non responsive to the reflex test with the little hammer rt below the knee. He didn't say a word just went to my other leg that had a more normal response he tried my right leg again and nothing. I'm just now getting back to "my normal" 3 days latter. He spoke like he was going to put all these restrictions on me ect ect. I just have a very bad feeling about the whole thing. Why would they subject me to a ride in a little car they knew would beat me to death ? I've never heard of such a thing. Does this make sense to you ?

[Cookefan]

I just kinda found myself here at this channel. I am a retired physician and I did my share of DI work. One thing I found missing from this discussion with this very good attorney was this: if you expect the doctor to help you then help them. What I mean by this is there is a very, very simple step that you as the patient have to ensure happens. That step is to make sure the physician has a job description or description of what’s expected of you at a particular work site. Otherwise we are left in the dark and cannot be specific enough. It’s a very simple process. Yes we are rushed and yes paperwork can be overwhelming at times but don’t ever think that you physician has no interest in really helping you. Just remember to try and help them complete as much of the paperwork as possible. I remember a dozen or so cases where I fought tooth and nail to help a patient get their DI completed. I also remember cases where the patient was expecting me to make legal moves for them and I’m no lawyer. So be proactive. This process moves a lot faster when you provide the people you’re asking to help you with the needed documentation on your part. One last bit of unsolicited advice: keep hard copies and electronic copies of EVERYTHING. If you can keep all of your records in a Cloud memory bank you will always have them available on your phone so you don’t have to lug them around but it’s also a good idea to keep paper copies at home on a filing cabinet that are neat and organized. Thank you

[Madronaxyz]

The PI filmed me picking up dog poop.

I did go to an IME. I hired a PhD RN to be an observer. She cost $200 per hour but it was worth it.

Next the disability co. tried to claim that my franchise policy was an ERISA policy. It as a policy that I initiated through my professional
organization and for which I paid all 25 years of premiums. Fortunately I had a good attorney and the judge did not classify my franchise policy as an ERISA policy.

[AlSmith]

great job s Gregory Dell and Rachel Alters

[randadawli]

my sister got a brain damage that left her disabled since August of 2014 and she is still waiting to get paid... she got nothing yet

[Thlite]

What I don’t understand is how you can say that the doctor could be paid by the insurance company to falsify the IME or medical report when the insured has the choice of doctor they want to work with.

[denzilritchie]

This is a very long post, but you need to read it and think about it, this will likely be you one day! Sorry in advance for all the type O's, Ididn't send allot of time on this one, but I hope I get my point across? If I sound pissed off you can bet your ass I am! Please allow a seriously injured man that was recently denied a BWC disability claim to talk about these five reasons for a few minutes. Before I start with the five things I just heard, please keep in mind that I do use a power chair and I do spend a great deal of my time in it, not always, but allot. This is because I had a horrible injury many years ago and I have endured nineteen horrible spinal surgeries because of this injury. My spinal X-rays now look like a God Damn titanium junk yard. I"m fused from L5-S1 up to my T-12 vertebra which is my "entire" 100% lumbar area. My spinal condition has also forced me to be numb in my groin area and I've lost control of my bowels. For many years now I have had to use incontinent products 24-7. OK, do we have my medical condition pretty much clear before we start talking about these fucking cameras? NO, not yet, I need to add that I also have a horrible cancer that is in it's late stages and radiation won't touch it. I'll likely be fucking dead in a few years. Now are we clear about my medical condition? OH NO, not yet, I still need to add that I've undergone a quad bypass and I have a bad heart valve with Afib that absolutely can't be regulated it's so bad. Now are we clear about my medical condition? I just wanted everyone to be perfectly clear about my medical condition, because some of the people out there might feel that I'm not a disable person that can't work. OK, now less address these five things they were talking about. The things I have mentioned above are absolute facts.

1. Less talk about all these fucking cameras and all you pieces of shit that judge people that are being seen on these cameras: You know what I needed at the store yesterday, and I didn't have one damn person to help me get it? I had to have a bag of ICE MELT SALT to put down on the iced up areas where my crippled ass has to run a power chair? You know what I did, I manned up and took my crippled ass to the store myself, I leaned on a shopping cart, picked up a few groceries and and got the salt my damn self. Did I like? Hell no I didn't like, but I fucking did it because I didn't have a choice. I was in much worse pain for the next few days as usual but that's the way it is for many of us disable people. I also at times try to exorcise our legs and try to see how much strength I have left. It's always a constant battle trying to do things for yourself knowing in the back of your mind that your going to eventually lose the fight. Even knowing I'm losing the battle at times, If I'm having a decent day I'll still try to suffer and do some walking trying to regain some strength in my legs and arms. But many of you dumb fuck can't see anything but a man that isn't sick or injured, all you see is a fraud case. Why don't you look at your mother or father that's in medical rehabilitation centers the same way as you do the people in these cameras that are possibly trying to do the best they can? How many of your sorry ass people are worried about disabled people like me enough to stop judging and offer your God Damn help once in awhile. Very God Damn few of you will try to help anyone, your just assholes that are ridiculously judgmental. For those of you that judges people like me, on or off these cameras? FUCK YOU! If a turd had a asshole, that's how low you would be! Wait until you get disabled and it's your sorry ass that's in this situation having to constantly fight for your strength every day trying to do things for your self while losing the battle. I suppose it's just to easy to be a total self-righteous dickhead and just move on down the road, right?

2. Medical Examiners: I swear to God this is true! I was sent to medical examiner recently, the bastard Doctor that was brought in from out of town let it slip that he had to put on my paper work exactly what the BWC expected from of him before he even examined me. I then ask the stupid fuck if he had even look at my medical records and he said no, but that he was going to take a look later. I then very politely asked the man why he was prejudging me if he hadn't looked at my medical record or examined me. Of course I knew it was the BWC's money, but I still ask him why he would put on paper work what the BWC wanted to hear before he had even examine me? He realized what the had said and it was horribly sad to listen to this fucking idiot trying to get out of what he had said. The more he said the more he just made himself look like bias ignorant fool. It would have been funny as hell watching him squirm if it wasn't such a serious issue for me. Yes, I still got the horrible report that he promised, but at least the dumb bastard was honest from the beginning, even if it was a accidental slip from his lips. Please people, don't ever be naive or stupid and ignore about what I'm saying, all of these medical examiner are loyal to whoever it is that's paying them the money. This is just the facts of the horrible county we live in anymore. There is not one ounce of compassion or empathy left in this countries population anymore, politically or otherwise. They don't even care about their own families anymore, let alone their neighbors, the disabled, elder, or disadvantaged. Wait and watch, this will be the total destruction of America. What this county has become has already totally destroyed me! And yes, the stupid ass cold hearted people are the ones that allow their states to do this sort of thing to injured people. It's just to easy to be a total assholes and dismiss the disabled people as being lazy, fraud cases, right! Did you realize that in Ohio the work injured people can't even have their day in court against the state or their guilty employers? I guess the public voted for this one, I heard it was buried deep in some other bill that passed, but this part wasn't advertised or seen by the public.The public is ignorant as hell anymore, they need to admit it, they have no clue what they're even voting for anymore. They just pull a level and hold their heads up in pride and smile while they're wearing their little smiley face sticker that says (I VOTED TODAY). But again, they didn't know shit from shampoo about what they even voted for, and didn't give shit one way or the other about the ramifications of their vote!

3. No documents? This is very important, but the people that paid for me to go to the damn medical examiner had all my medical files right in front of them on their damn computers, they knew perfectly well everything I had medically gone through due to my injury over the years. It's not about the medical injuries people, its simply all about the greed and protecting and hording damn money, never forget that. No one gives a shit when or if you take your next fucking breath. Not unless your one of the very few people that has been lucky enough to have had a good person dealing with your case, but that is very rare to have had this in today's society. The people that have compassion and empathy aren't usually found working on the good side of the personal injury cases, specially in the insurance offices or as State IC Hearing Officers!

4. Hmm, can the inured person do sedentary work? With all the fraud cases today, I'm sure something needs to be done to determined this, specially with the cases that are weak in the medical documentation area. But in my case, anyone that looks at my medical record and question if I should be working with my bad health is totally brain dead. If you think I should be working after reading my heath issues, please get your boss to hire me and put me in the chair right next to yours. That way you can get the full benefit of the smell when my bowels lets go! But that dumb fuck hearing officer at the Ohio Industrial Commission office thought I was able to work and he knew this! Yea, I wish they would put me to work right beside his ass, but you can bet that won't happen!

5. Mistakes: I'm sorry folks, if a person is injured badly enough to receive benefits, it would have to be a whopper of a mistake for a decent sane person not see through it. However, I suppose these crooked and cold hearted assholes working for these insurance companies will use a simple mistake to fuck over people. I will say this, I'm a very spiritual person, but I'm not much on organized religion, having said that I still hope God finds a hot corner in hell for all the people that have fuck over the sick, elderly, disabled, seriously injured and disadvantaged people. If I believe anything at all, I believe that hell is going to be a very crowded place that's full of these people. All of the people that are in these horrible jobs are being pick from the pool of children we raised? What does that tell you! And you might want to go look in the fucking mirror and think about what I've said.

[whenufirstrealized]

Does it make sense to buy short term disability insurance if you have 90 day of employer sick days and an LTD policy? What if the employer decides home many of those days you can take consecutively and has been know to deny many reasonable requests for sick leave? What happens if terminated while on sick leave but before filing for STD or LTD claim? What constitutes the start date for your disability? You can't file a claim or retain coverage once terminated right?

[laurens.]

If that is the case, and they are following these people around, why are there so many fraud cases.

[WonderfulAkari]

I worked for a disability law firm but I handled hearings not entry so I am embarrassingly unsure how to handle my own disability.

[eduardosantacruz]

what can i do about my claim denied, my claim was ilegally deneid by employer and insurance companies. with zero compliance do you may help?

[mirta.queloquetengoquehace]

Imc retired Dont have disability some time I have to use de cane because the pain I on may back an my right jeg and sometimes I feel better.and I not use..I dot like the cane.

[lilli]

I was sent to a medical assessment by the insurance company, I got sick during the assessment I was not able to walk, I lied down and I started to throw up, I was there for several hours before to be able to go home, a friend of mine came to pick up me later. I have a rare genetic muscle disorder and with very mild activity I have episodes like the one happened during the assessment. What are the chance they will deny my income protection plan? My specialist filled the form for the insurance where he said I will not able to work never again, he is one of the most important doctor regarding metabolic genetic disorder. My condition is not invisible I can show I sick I am if I have to. It doesn't take so much to get sick, actually my full time job now is trying not to get that sick. My employer knows how sick I am, he had to send me home by taxi so many time when I was sick

[suem]

Can one record medical exams to counter claim?

[CN-yflr]

does the dissability pay usually starts when? is there any elimination period if so why?