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Wednesday, February 28th, 2007
CHANGE TO ANY OCCUPATION
Virtually every long term disability (“LTD”) plan changes the definition of disability after a short period of time, which is usually two years. After that time, instead of having to prove that you are unable to do you own job, you now have to show that you cannot do any work for which you are reasonably qualified. The insurance companies that administer LTD plans frequently terminate monthly benefits when this change in definition occurs.
A claimant retained me after CIGNA terminated his LTD benefits and had denied his appeal twice. The claimant had submitted narrative reports and records from several treating medical specialists as well as a report from a vocational expert. Despite a claim file of nearly 1,000 pages, the question was a simple one: did he have the functional capacity to perform sedentary work.
Courts had specifically instructed CIGNA that sedentary work requires the ability to sit for at least 6 hours a day and walk and stand for two hours during a work day. The claimant’s pain management specialist completed a report specifying the claimant was limited to sitting for only 1-2 hours, and standing less than 1 hour. Nonetheless, CIGNA denied the appeal because the pain management specialist previously had said that the claimant had “5/5 motor strength.” Among the many things that I pointed out on appeal is that CIGNA had approved benefits despite that finding, which showed it was not a valid excuse for terminating benefits.
When the sole basis for a denial or termination of benefits is exposed as patently invalid, insurance companies frequently develop a new reason for their decision. To avoid CIGNA from concocting a new rationale, and because no new evidence could be submitted in federal court if the final appeal were denied, I had the claimant seek updated and additional reports detailing his functional capacity from seven different physicians. The goal was to overwhelm CIGNA with the new evidence and my 15 page letter demonstrating the flaws in the termination decision.
The strategy was successful. A week earlier, after having submitted my appeal three and a half months earlier, I faxed CIGNA a demand for an answer or advised I would proceed to federal court promptly. Apparently CIGNA was so overwhelmed by all the new evidence and the detailed attack of its decision that it sent a check for all retroactive benefits without any explanation.
Unfortunately, unless an LTD appeal is overwhelming, the insurance company will usually risk going to court, where it realizes that the deck is stacked against the claimant.
Previous Next- SSA - Is Anyone Listening?
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- 6 Years for Approval
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- Borderline Age
- The Wait Is Killing Them
- IMA
- Erythromelalgia
- Limbic Encephalitis
- Government Shutdown & SS
- Consussions
- Migraines
- Physician Assistants
- SSA Stay Denied
- Advanced Practice Registered Nurses
- Bipolar Disorder
- SS Benefits Increase
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- Young Person Granted OTR
- Earnings After Onset
- Patchogue Obstruction
- Washington Times Article
- Medical Sources
- Lourdes Marasigan
- Lump Sum Settlements
- Partially Favorable Decisions
- No Help for SSD Backlogs
- Fast SSD Approval
- Vocational Experts
- Disability and Medicare
- IMA Disability Services
- NYSLERS & SSD
- Help for SSD Benefits?
- Vocational Expert
- Supporting Records
- Budget Cuts Increase Wait Times
- Support Letters
- SSD For MS
- Misconceptions About SSD Continue
- Patchogue Fails Again
- Myasthenia Gravis
- Lupus
- SSD Delays
- WC Medical Opinions
- Government Targets the Disabled
- Another SSD Myth Busted
- The Truth About SSD
- SS Benefits 101
- Increase in SS Denials
- Best Time to Apply for SS
- Parkinson's Disease
- SSA in Crisis
- SSD Reform Needed
- Applying for SSD Benefits
- Headaches
- Disabling Fibromyalgia
- Garnishing SS Benefits
- Nurse Practioners
- Trump Hurt Disabled Workers
- Expediting Hearing
- Social Security Fraud
- Congress Can End SSD Backlog
- Tips for Retirement Benefits
- Social Security Backlog Continues
- Income and Disability
- ALJ Found Scleroderma Disabling
- More SSD Delays
- ODAR Rumor
- SSD Approval Rates
- National Adjudication Team
- Second Circuit Case
- Prudential LTD Fraud
- District Court Rejects SSA Denial
- Work Record
- Macroprolactinoma
- Jerome Caiati
- Importance of Diagnostic Testing
- SSD Approved In 2 Months
- Unemployment Benefits Do Not Preclude SSD
- ALJ Relies On Disgraced “Medical Expert”
- SSD Approved for Crohn’s Disease
- NYSLERS
- Claimant Credibility and Work History
- NYS OTDA Fraud Update
- SSD Approved in Less Than Months
- Combined Disabling Conditions
- Lymphedema
- Significant Weight Suffices
- Combined Disabling Conditions
- Cancer Claims
- Deceptive Insurance Practices
- Cyclic Vomiting Syndrome
- DDS Continues to Purge Evidence
- Proposed LTD Regulations
- Reliance Approves LTD After Deadline
- Approval for Toll Collector
- The Consequences of SSD Delays
- Acupuncture
- SSA Continues Prejudicial Policy
- Psychotherapy Notes
- Vocational Evidence Determinative
- Treating Doctor Testimony
- IMA Notices
- SSA Delays
- SSA INTENTIONALLY INCREASING DELAYS
- New IMA Fraud & Worse
- Mental Health Records
- CROM Testing
- Padro: Relief too little, too late
- IMA Evading Law Again
- SSD for School Custodian
- 28 Months For Approval
- SSD With No Hearing
- State Agency Analyst Lied
- Social Security Backlog
- Social Security Backlog
- Chronic Fatigue Syndrome Renamed
- Go Figure
- IMA Disability Services
- Sadistic IMA Conduct
- A Padro Success
- Disability for Breast Cancer
- Continuing Disability Review
- CIGNA Reverses LTD Termination
- Disability Hearing Witnesses
- The State Agency Concedes
- Social Security Fraud
- Congress Killing Disability
- Binder & Binder Bankruptcy
- SSD In Less Than A Month
- Hearing Wait Gets Worse
- Internists’ Disability Opinions
- Binder & Binder Goes Bankrupt
- SSA Form 821
- Dementia
- Sensorineural Deafness
- CIGNA Says Claimant Cannot Do Any Work
- Biased SSA Review Policy
- Pseudarthrosis
- Proper Hearing Notice
- Video Taping Consultative Examination
- Antiphospholipid Syndrome
- Non-Hodgkin’s Lymphoma
- SSA Still Not Using eCAT Properly
- Supplemental Hearing Cancelled
- Establishing Mental Disability
- Passive Income
- Langerhans Cell Histiocytosis
- SSD For Landscaper
- Disability Retirement Approved Without A Hearing
- SSD for Cement Truck Driver
- USDC Reverses ALJ Wolfe
- Disability Etiology
- Unum Field Visit
- Disability Benefits for Truck Driver
- Autoimmune Hepatitis
- Establishing Mental Disability
- Unum Reapproval
- Medicaid Disability Determinations
- Patchogue Problems Persist
- Benefits Turned On Vocational Error
- SSA Staff Attorneys
- Disability Benefits While Working
- Scleroderma
- Agoraphobia
- Padro Deadline
- State Agency Reports Misrepresentations
- Amending Onset To Avoid Hearing
- Carpenter Avoids Disability Hearing
- Brugada Syndrome
- Disabling Mitral Valve
- SSA Secret Rule
- The Electronic Claims Analysis Tool (eCAT)
- If You Die Before Benefits Are Approved
- Media Deception
- CIGNA Reverses STD & LTD Decisions
- Disabling Sleep Apnea
- Padro Settlement Agreement A Joke
- Appealing Partially Favorable Decisions
- Social Security in the News
- Hoppenfeld Refused To Comply With Padro
- Social Security Benefit Increase
- Reopening Prior Application
- Wegener's Granulomatosis
- SSA “Quality” Review By QRB
- Dire Need
- Padro Settlement Approved
- Social Security Increase
- Government Shutdown
- Reviewing An Employer’s Work Description
- Podiatrists
- Off Task
- Social Security Reconsideration
- Fully Favorable Decisions
- Operative Reports
- Unusual SSD Approvals
- Risky Side Effects
- ALJ Strauss Claimants
- Unsuccessful Work Attempt
- Unum Pressures Doctors
- Patchogue Continued Ineptitude
- Is Strauss Serious?
- Is It The New Commissioner?
- Padro Class Action Problem
- Padro Class Action Hearing Next Week
- Replace UNUM
- Expediting SSD Hearings
- Court Said IME Doctor Lied
- Continuing Disability Review
- Podiatrists
- Connect The Dots
- Unum Ordered To Produce Witnesses For Depositions
- Social Security Form DDD-3883
- Acceptable Medical Sources
- Petition Regulators About Unum
- Consultative Exam Withdrawn
- Padro Class Action Notices
- Rejecting SSA Remand Offer
- CIGNA Regulatory Settlement
- Polymyositis
- NOSSCR Conference
- SSA Misinformation
- Padro Class Action Settlement
- DDS Actually Listened
- Padro Class Action Update
- Same Day SSD & DI Award
- SSD for Letter Carrier
- Illusory Unum Approval
- Work History & Credibility
- Lupus
- Thank You Judge Irizarry
- Crohn’s’ Disease
- Work History
- Eliminate the SSD Waiting Period
- Urinary Incontinence
- SS Retirement or Disability?
- Ignoring Unreasonable Requests
- Officer Approved in 2 Months
- PADRO Class Action
- Updating Evidence
- SSD & Chiropractors
- SSD Approved In Under 2 Months
- Hypertrophic Cardiomyopathy
- Queens ALJ Bias Plaintiff
- Breast Cancer
- CIGNA LTD Fraud Template
- Unsuccessful Work Attempt
- Why DDS Denies SSD Claimants
- Partially Favorable Onset Appeal
- Treating Physician Rule
- FCE Spurs Unum Approval
- Commendable Action By ALJ
- ERISA Exception
- Importance of Vocational Evidence
- State Agency Exam Notices
- SSD Approved In 3 Months
- Social Security Myth
- Subpoena Leads to SSD Award for Rheumatoid Arthritis
- Another CE Problem
- Appeals Council Remands
- Social Security & The Presidential Election
- SSD Claimants Need To Review Their Efolders
- Firefighter Awarded SSD
- Obesity & Disability
- Videotaping IMA Consultative Examinations
- Biased Hoppenfeld Decision Reversed
- IMA Disability Services
- Carpenter Wins SSD For Wrong Reason
- Padro ALJ Bias Class Action To Be Settled
- Binder & Binder Replaced
- If at first …
- IMA Disability Services
- The Office of Medical and Vocational Expertise
- Newsday Article
- The SSD “12 Month Rule”
- Medical Expert Interrogatories
- Patchogue Ineptitude
- Emphasizing Work History
- Reopening Disability Applications
- What is NY Waiting For?
- When Objective Evidence Isn't Enough
- Disability Benefits For Nurse
- Bench Decision
- Hearing Avoided
- Disability Pension Award From Union
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- How Much Will Social Security Pay You?
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- Why Bother With An Exam By IMA?
- Workers Compensation & SSD
- Hoppenfeld Bias
- Veteran Gets SSD for Memorial Day
- Vocational Evidence
- Establishing Mental Disability
- IMA Exam Is Not Required
- Postherpetic Neuralgia
- Multiple Sclerosis
- Disabling AION
- Proof of Birth for SSD
- Corroboration is not Superfluous
- Social Security Listings
- CIGNA CONTINUES ILLEGAL CONDUCT
- Fast SSD Approvals
- Impaired Use of Hands
- Representative Payee
- Onset Appeal
- Amending SSD Onset Date
- State Agency Vocational Experts
- Causation and Social Security Disability Benefits
- Alport Syndrome
- David Nisnewitz Found Unfit To Be ALJ Again
- Reopening SSD Applications
- Another Example of ALJ Fier's Bias
- Physician Specialty
- Medical Source Statements
- Podiatrists and Disability Benefits
- Retaining Social Security Experts
- Transparent Hoppenfeld Bias
- State Agency Disability Analysts
- SSD & WC
- SSA Should Reimburse Travel
- Disability Benefits For Carpenter
- Carpal Tunnel Syndrome
- SSD Approved in Two Months
- Reflex Sympathetic Dystrophy
- Veterans Medical Source Statements
- Disabled by Schizophrenia
- Receiving SSD Benefits and an Income
- Vocational Credibility
- SSD For Police Officer
- Kienbock's Disease
- Patchogue Incompetence
- Binder and Binder
- Appeals Council Doltishness
- NYCERS Disability Pension
- Can You Receive SSD If You Have Income?
- Rheumatoid Arthritis
- Multiple Impairments
- Adverse Evidence
- Cerebrovascular Accident & SSD
- Was A Video Hearing Needed?
- NOSSCR Conference
- SSD Approved in 2 Weeks
- SSD Approved In 2 Months
- Disability and Diabetes
- Social Security Benefit Increase
- Vocational Experts
- IMA Consultative Examinations
- Hoppenfeld & The Rotation Policy
- Alzheimer’s
- Federal Court Reassigns Nisnewitz Case
- Approval After Federal Court Remand
- Abusive Hoppenfeld Conduct
- Rheumatoid Arthritis
- SSD Overpayments
- LTD Approved In Less Than A Month
- Maximizing Disability Benefits
- Mixed Connective Tissue Disease
- When To Amend The Disability Onset Date
- Right To Cross Examine Post Hearing Experts
- Commissioner’s Statement Is Offensive
- Gilding the Lily
- SSD Approved in 2.5 Months
- When to File for SSD
- Disability & Incontinence
- Hoppenfeld Fibromyalgia Bias
- On The Record Requests
- LTD Approved In Two Months
- Work History
- Relocating While Disabled
- Carpal Tunnel Syndrome
- Getting Disability Benefits Quickly
- SSD Approved in 3 Months
- SSD Approved In Two Months
- SSD & WC Offset
- Disability Analysts
- Federal Court Decision
- Social Security Depravity
- Depression and Anxiety
- Fully Favorable Appeals Council Order
- Erythema Multiform Major
- SSD in Three Months
- Lincoln Life Pays LTD Benefits
- Acquiring Work Skills
- Court Rejects CIGNA LTD Termination
- Disability Benefits & Substance Abuse
- Endometriosis
- SSD Approved In 2 Months
- Raising The Retirement Age
- No More Paper Checks
- Treating Doctors
- SSA Prehearing
- Disability Redefined
- Consultative Examinations
- Evidence of Hoppenfeld Bias
- ALJ Nisnewitz Rejected Again
- ALJ Bias Class Action
- Working And SSD
- ALJ Bias In Queens
- Federal Court Decision
- ALJ Strauss Rejected Again
- Seven Year Wait Over
- Lyme Disease
- ALJ Strauss Reversed Again
- Remand To A New ALJ
- “Secret” Child’s Benefits
- Unfair CIGNA Tactics Detailed
- LTD Policy Offsets
- Partially Favorable Decisions
- SSD While Working
- Expediting Disability Benefits
- Multiple sclerosis
- Date Last Insured
- Radiculopathy
- Videoconference Hearings
- Expediting Disability Benefits
- Patchogue Incompetence
- Federal Court Decision
- Union Disability Approved
- SSA Notice of Awards
- SSA Doctors
- Protective Filing Date
- SSA Delays
- On The Record Requests
- Dialysis & Disability
- Disability Opinions & Medical Tests
- LTD and SSD
- CIGNA Sued For Surveillance
- Attorney Advisors
- Social Security Doctors
- Unum Reverses Termination
- Electronic Records Express
- Multiple Impairments
- Income Doesn't Bar Disability Benefits
- Celiac Disease
- Proving Disabling Pain
- EAJA Fees
- IMA Disability Services
- Self Employment
- Medical Listing Opinions
- Treatment Records
- Avoiding SSD Hearings
- Federal Court Remand
- The MTA & SSD
- When Work Doesn’t Count
- Gastroparesis
- Sjogren's Syndrome
- Benefits After A Federal Court Remand
- Firefighter Gets SSD Benefits
- Prudential Approved LTD, For Now
- Chronic Fatigue Syndrome
- Getting Benefits While Working
- EAJA Fees
- Stroke
- New Jersey District Court Remand
- District Court Remand
- ALJ Hoppenfeld Overtly Acts Biased
- Veterans
- NYCERS & SSD
- Medical Evidence and Functionality
- Deceptive SSA Notices
- Onset Date
- Queens ALJs
- When Can You File For SSD Benefits?
- Parkinson’s Disease
- Consultative Exam (“CE”) Ruled Improper
- EAJA Fees
- Consultative Examinations
- New Office
- Complaining About Biased ALJs
- IMA Disability Services
- Multiple Impairments
- NYCERS
- Primary Care Physicians
- Social Security Rulings
- Anxiety
- Fibromyalgia
- Retrospective Medical Opinion
- Disability For Federal Employees
- The Grids
- Chronic Fatigue Syndrome
- Adult Disabled Children
- Charcot-Marie-Tooth
- Depression and Anxiety
- RSD/CRPS
- Getting SSD Even If You Can Work
- Health Insurance For Children
- Health Insurance For Children
- Settling With CIGNA
- Avoiding An Improper Consultative Exam
- Multiple Sclerosis
- Protective Filing Dates
- SSD Delays
- Reopening Past SSD Denial
- ALJ Strauss’ Reliance On ME Cohen’s Testimony Proves She Is Biased
- Listed Impairments
- Multiple Medical Sources
- Attorney Advisors
- Avoiding Consultative Examinations
- Atypical Parkinson’s
- Chondromalacia
- Subpoena The SSA Doctor
- Prudential Reverses Fibromyalgia STD & LTD Denial
- ALJ Nisenewitz: Stupid or Biased?
- LTD & Health Insurance
- Courts Rules CIGNA Is Biased
- SSD & Taxes
- ALJ Hoppenfeld Must Be Barred From FMS Cases
- Don’t Believe Everything You Read
- On The Record Request
- Avoiding SSD Remand Hearing
- NYCERS Disability Retirement
- Submitting Medical Records
- CIGNA Ordered To Pay For Its Actions
- Oops, CIGNA’s Done It Again
- Hearing Office Attorneys
- Hearing Notice
- Appeals Council Rebukes ALJ Fier
- Unsuccessful Work Attempts
- Medical Assessments
- Disability & Downsizing
- Consultative Examinations
- Obama Disability Benefit
- Court Blasts CIGNA LTD Benefit Termination
- Obama and Social Security Benefits
- “Fully Favorable” Decisions
- SSD Secret
- Notice of Dismissal
- Initial SSA Decisions
- Appeals Council Scolds ALJ
- Unum Cases In New York
- Medical Evidence
- Prior Applications
- Disability is Functionality
- Medical Records & Reports
- Social Security Files
- Applicaiton Filing Date
- Representing Yourself
- Disabled Voters
- Vertigo
- Multiple Impairments
- Myasthenia Gravis
- More Is Better
- Disability Benefits & Work
- SSA Medical Reports
- Negotiating Disability Benefits
- Consultative Examinations
- GMA Exposes CIGNA
- Work History
- Onset and Application Dates
- Supreme Court Helps LTD Claimants
- Expediting SSD Cases
- Two Heads Are Better Than One
- LTD Litigation
- Retrospective Medical Opinions
- Establishing An Onset Date
- Field Visit
- Multiple Attorneys
- Self Employment
- Special Accommodations
- Multiple Disability Benefits
- Clarifying Objective Evidence
- “Fully Favorable” Decisions
- Treating Sources
- SSD & Mental Disability
- Using Vocational Evidence To Expedite Benefits
- Attorney Adjudicator
- Past Earnings
- Benefits Without A Hearing
- Irrelevant Medical Conditions
- Establishing Credibility
- Medical Updates
- No Health Insurance
- Application Dates
- Possible Delay Remedy
- Unum Reassessment Loophole
- Benefits Despite Income
- Consultative Examinations
- “Accentuate The Positive, Eliminate The Negative”
- Dire Need
- How To Avoid Hearing Delays
- Police Disability
- Seminar
- Expediting LTD Benefits
- Uveitis
- TBI and Vocational Evidence
- Failure To Receive Notice
- Mental Disorders
- Inability To Speak English
- Discovery In ERISA Cases
- Don’t Be Intimidated By DDS
- Multiple Sclerosis
- Avoiding Hearings
- Working Does Not Preclude Benefits
- Be Wary of Forms
- Exam Secrets
- SSD for Firefighter
- Consultative Examinations
- Purpose of SSD Hearing
- Why Wait?
- Insurance Department Complaint
- Overreach For Disability Retirement
- Vertigo
- No Objective Testing Required for Chronic Fatigue
- Non-binding Disability Decision
- Always Check The Listings
- LTD & SSD
- Avoid Early Retirement
- Getting Benefits Faster
- Medical Records & Reports
- Corroborating Physicians
- Unemployment Benefits
- Miano v. Barnhart
- Benefits Despite Working
- Work History Credibility
- Reflex Sympathetic Dystrophy
- Arthritis Foundation
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