Read the article linked at the end of this post and you'll see why so many social security disability lawyers are against non-attorney disability representation companies that A) represent the interests of long term disability insurers and B) represent individuals applying for social security disability or applying for SSI disability.
As the article states, Charles Resendez became disabled and unable to work as the result of a physical illness. However, his long term disability insurer didn't pay the benefits it promised to pay him ($1700.00) because one of his doctors indicated the possible existence of anxiety and...conveniently enough, anxiety isn't covered by his policy.
Mr. Resendez paid his premiums and now the insurance company is looking for a way to renege. Let me tell you something. When they say that a doctor's records indicate "anxiety", that could simply mean that the word anxiety or the word "anxious" was written one time and one time only somewhere in the doctor's treatment notes. I know because, as a disability examiner, I was very often required to send a claimant to a social security medical exam simply because the word depression appeared a single
time in a lengthy file full of records detailing the treatment of lupus, or multiple sclerosis, or fibromyalgia or diabetes (you get the point). SSA Disability examinations, of course, don't have much to do with long term disability insurers but this example does illustrate how a rather insignificant piece of information can be used to hold up, delay, or deny a case.
Many holders of long term disability insurance policies would be shocked to learn that the policies they dutifully pay premiums on are relatively worthless when it comes to mental impairments. Many of them pay only a maximum of two years benefits for mental illness, which, honestly, should be a practive that's outlawed. In other words, if you're going to take people's money, give them honest and worthwhile coverage. It goes without saying that insurance companies should be regulated far more than they are.
And, if you're wondering what I was alluding to when I mentioned private disability representation companies that handle both long term disability and also represent social security disability claimants, well, think about it. If a company has access to a person's LTD file and their social security disability claim file, that means they can provide information to the LTD (long term disability) company regarding the claimant's mental illness. Which means, then, that the company may be able to limit the disability insurance benefits they pay out, usually (as far as I'm aware) to two years.
Should you ever work with a company that handles both LTD cases and social security disability cases? I wouldn't. Nor would I advise anyone who was a friend or relative to do that. Because I would hate to seem them screwed over by some greedy insurance company.
Injured man paid for disability insurance but isn't receiving benefits
