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What to do after you have been found disabled

By Scott B. Elkind, Esq.

As much of a relief it may seem once you have been found disabled and are receiving benefits, this is only the start of another phase of your life. Although you are no longer engaged in your old line of work, your new “job” is that of a disabled person which entails several important activities.

First, and foremost, you must keep seeking medical treatment. Though you have found disabled for the time being, it remains your burden to keep proving that you remain disabled. Even if you have a permanent, chronic condition, you need to keep being documented. No exceptions. If there is a gap in your treatment, the insurer will pounce at the opportunity.

Second, the spectre of surveillance does not go away. This means that if you engage in outdoor activities, you can be videotaped. So, engaging in yardwork, a father-son softball game, jogging in the park, etc. are not recommended. The insurers are all too glad to latch onto the “gotcha” videotape and turn down your claim. Do not put it pass them to mischaracterize what the video reveals. Their investigators are more than happy to state you have shown the abilities to bend over, walk, and move without evidence of pain. This includes your slowing walking to a local grocery store and returning with a single small grocery bad. These people have no morals. Their job is to get the insurer the evidence they need to turn down your claim in order that the insurer keeps its contract with the private investigation company.

Third, you need to be very careful concerning any work activity. The benefit plan contains very definite clauses concerning deductions for any paid work. Unfortunately, any back to work attempt is fraught with peril. It is very difficult to prove that you are able to work only part-time than not at all. Again, this only empowers the insurer to state that you could work full-time and should be denied benefits all over again.

If you engage in other work during an “own occupation” period of disability, you must be extremely careful that the work activity you undertake in no way is similar to your past prior work. Before undertaking any such endeavor, you should consult with counsel to make certain that you are not running afoul of the policy/plan prohibitions in this regard.

Lastly, your social activities are subject to scrutiny as well. I wish I could tell you how many times an insurer has picked on one of my clients for their travels. The insurer does not need to know about your vacations, so such a report to these companies is unnecessary. The reality of travel is that you are shuffled about from car to bus to train or plane and exert little in terms of energy or thought. This, of course, will not stop the insurers from stating that you have demonstrated physical activities which resemble work. Travel and participation in family gatherings

Always keep in mind that your new “job” is to maintain your right to benefits. You need to take this job seriously and be vigilant in its pursuit. Even given your best efforts, an unscrupulous insurer will deny your claim for little or no reason. There is little to stop them from doing so. Therefore, consultation with counsel during a period of disability may give you greater peace of mind. I am always fond of saying that “there is never too much supporting evidence of disability.” In many cases, I have been able to gather additional supporting evidence that my client would not have though to assemble and made their lives much easier.

In the end, I liken my representation in continuing disability cases to that of “mafia protection.” Sometimes, it just pays to have the bigger, badder guy on your side to prevent another menace from harming you.

Posted in General Disability Issues | Tagged , , |


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