Over the decades I have handled Short Term Disability and Long Term Disability benefit claims, I have watched the definition of “disabled” or “disability” change quite dramatically. Back in the 1980s and ‘90s, it was fairly routine for the definition to be whether you were disabled from your “own occupation.”
Then, insurance companies have been tweaking the definition of disability ever since. The first change was to “any occupation” after a stated period, generally two (2) years.
The next change was the effort to require “objective” findings to support a claim. The courts quickly pointed out that some conditions, especially those considered mental or nervous in nature, do not have any objective findings. Moreover, the concept of what is an objective finding is a topic covered in other blogs on this site. My purpose today is to get to the most recent bit of treachery I have uncovered. It is truly a trap for the unwary.
Standard Insurance Company now has a requirement that the claimant see a physician within ten (10) days after the date last worked. Suppose the claimant saw their physician the day before he or she last worked and stopped working because of the conversation he or she had with the physician that previous day who set a routine follow up of say, a month. No appointments within those supposedly critical ten (10) days could be fatal to the claim for strictly procedural reasons, procedural reasons which have no purpose but to trap the unwary. I am already thinking about how to approach this newest of problems, expecting benefits will be denied on this most “ticky-tack” basis. “Ticky-tack” is not an actual legal term but it fairly describes this bit of chicanery.
If you have any questions about your short term disability or long term disability claim, please give Herbert M. Hill, P.A. a call and we would be glad to answer any questions you may have. We are available at 407-839-0005 or, toll free, 844-454-59995, If you would like, after discussing your case, we can set a conference. In most circumstances, that conference would be free of charge but in no circumstance would you be under any obligation to hire me nor would you feel any pressure from me to do so.
Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida. While the vast majority of cases handled are for disability insurance benefits, areas of practice include employee benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (“ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.