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Bay Area Disability Insurance Blog

Signs of bad faith in an insurer's response

So many of our readers are ready for the weekend. Memorial Day marks the unofficial start of summer, and while some commemorate it by remembering those who lost their lives defending our freedom, others will gather with family and simply enjoy quality time together.

For those suffering from debilitating injuries and are waiting on an insurer to make good on their promise, holiday weekends can be particularly disappointing. It may be especially poor when you have not heard from your insurer or receive terse or ambiguous answers to your questions. Unfortunately, delays and distractions are common business practices for insurers. Sometimes these tactics violate state and federal law, but it is not always easy to know when legal action should be taken.

LTD insurance sounds like a good investment. Should I buy it?

Advertisements are the lifeblood of American businesses. If you consider some of the most successful corporations and small businesses across the country, they all have one thing in common: they get the word out about their products and services to consumers.

Long term disability insurers are no different. You may be entertained by the catchy commercials and catchphrases, and your employer may persuaded by the coverage offerings and supporting numbers, such as how many people may become disabled for an extended amount of time before reaching retirement age. 

Turning the sum of all 'ifs' into a 'win'

Many people are dismayed when long term disability insurers essentially invent ways to deny legitimate claims. But unfortunately, initial denials are part of the twisted games that insurers play in order to convince their customers to give up on claims. While treating vulnerable consumers horribly would doom most businesses, it actually works to an insurer’s benefit. Why? Because the sum of all “ifs” work towards an insurer’s benefit.

Basically, claimants must overcome a gauntlet of uncertainties in order to receive benefits after a denial. Insurers bank on the notion that one of them will work out in their favor. Once that happens, the insurer wins. For those not familiar with those “ifs”, this post will highlight them. 

Can I hire an attorney to manage my initial claim?

From time to time we are asked about when is the right time to hire an attorney for assistance with long term disability claims. This is probably because they have been led to believe that a claim must be denied before a disability rights lawyer can help.

Fortunately for you, it’s never too early to hire a skilled attorney to help you with your claim. In fact, an insurer would rather have you strike out on your own so you can strike out on your claim, thereby limiting your ability to recover what you are legally entitled to. With that, this post will focus on how we can protect your interests. 

Is Lyme disease getting the 'fibromyalgia' treatment?

It may seem like only yesterday, but it’s been nearly 20 years since insurers began accepting fibromyalgia as a debilitating condition that would justify payment of long term disability benefits. But let’s not act like insurers had a sudden, altrusitic epiphany and decided to support claimants suffering from this condition. That would be revisionist history at its greatest. Instead, insurers fought tooth and nail to prove that those suffering from fibromyalgia were either making their conditions up or had psychological problems.

Is it a coincidence that fibromyalgia became a regularly accepted condition after Pfizer introduced a drug (Lyrica) that could treat its symptoms? It’s a question worth debating; but consider this: if drug manufacturers were making money of treating fibromyalgia, chances are that insurers would be compelled to see it a legitimate condition. But this does not prevent insurers from being ridiculously skeptical about other conditions with the same characteristics

Arthritis FAQ: When do functional limitations become disabling?

If you are struggling with arthritic pain, you've got lots of company.

Nearly 23 percent of adults report doctor-diagnosed arthritis, according to the Centers for Disease Control (CDC). Nearly 44 percent of those people have activity limitations due to arthritis.

When do those limitations become so severe as to be disabling? In this post, we will use a Q & A format to address that question.

Are your LTD benefits taxable income?

With the federal income tax deadline passing, most people won’t think about next year’s taxes until next January. But if you anticipate receiving long term disability benefits over the next 12 months, you should think about how your 2017 tax return could be affected. Essentially, knowing what benefits are considered taxable income (as opposed to tax-free) is critical for a number of reasons.

Generally speaking, the question of whether your benefits will be taxable depends on how you paid your insurance premiums. If you used pre-tax dollars to pay them, chances are that the benefits you receive will be considered taxable income. If you used after-tax dollars to maintain premiums, chances are that your benefits will be tax free. 

Three things an LTD insurer may not want you to know

We know long term disability policies are sold on the auspice that high-earning professionals should be covered if they can’t work anymore; but they are really sold to make the insurer money. Selling the “image” of security in tough times is one of the many things insurers may not want you to know about.

Why is this? You just have to follow the money. If a customer knew in advance how difficult it would be to get paid after submitting a claim, would he or she really buy the insurance? In fact, there are a number of things long term disability insurers may not want you to know. This post will highlight a few of them. 

Are independent medical examiners actually 'independent?'

If you follow our blog or have previously dealt with long term disability insurers in the past, you already understand how getting benefits can be such a frustrating process. Yes, insurers don’t really care about your pain or inability to work, but you would expect that doctors would, right?

So when an insurer has your records reviewed by an independent medical examiner (IME), you may feel like the doctor will understand, and the insurer will follow suit. But when your claim is denied (despite evidence indicating that you are entitled to benefits), is the medical examiner actually “independent?”

Are disability benefits available for those with fibromyalgia?

Fibromyalgia is defined by the medical experts at Mayo Clinic as a "disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues." The disorder is believed to be an amplification of the sensation of pain. A publication in The American Journal of Medicine notes that the disorder results in a "heightened state of pain transmission."

This syndrome can be debilitating. It can result in symptoms so severe that the person suffering from the syndrome is unable to work.

In these cases, those with fibromyalgia may be eligible for disability benefits.


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