What is Your Occupation When Disability Began

Typical disability insurance policies state that the disability insurance covers you for your inability to perform the occupation you were doing when you became disabled, regardless of what you wrote down on the initial application for the disability coverage. When a claim for long-term disability is filed, the insurance company will have someone analyze and evaluate your job and occupation. This may be a quick analysis based on information provided by your employer, an internet search, or a more in depth review, including consultations with vocational personnel working for the insurer. It is very important that from the beginning of your claim you provide the most detailed and comprehensive job duty details so that when the insurance company compares the duties to your occupational restrictions and limitations, a match up results in an understanding of the “why” you cannot perform your occupational demands.

Our clients range from doctors and dentists who develop an essential tremor and cannot safely administer medical treatment, to the IT engineer who suffered from breast cancer and the chemotherapy treatments have impaired her cognitive abilities. We help lawyers who due to back conditions cannot travel to the courthouse or due to cardiac conditions cannot perform their job duties and trials. We help people of all backgrounds and experience, as there is no room for insurance companies to administer claims based on their own views of how disabled the individual truly is.

We assist our professional clients to navigate through the difficulties faced when determining to file for disability, what occupational and medical records to obtain, and file the claims for our clients so that they have the greatest chance of success from the outset. We believe it is enough of a burden to deal with a life changing disability. Leave the claim filing to an experienced disability attorney in New Jersey, Bonny Rafel and her staff

What Proofs are Necessary to Establish Your Occupation?

Definitions of Occupation

If the policy says “own occupation” as the definition of total disability, then the insurance disability company must determine if you can perform the duties of your job. Often the insurer ignores the specific job duties that you perform, instead focusing on the “national economy” analysis to determine how, on average a person performs an occupation. This often deprives you of a fair analysis of your disability claim. We focus our client’s cases on actual job duties, supported with performance assessments, detailed statements explaining the essential job duties, and citing the relevant law.

Medical Professionals: What CPT Production Data Should You Release?

Professionals purchased disability policies long ago based on sales pitches promoting the policies as a safety net in the event that disability strikes. But when a disabling condition occurs, insurers scrutinize and investigate new claims often delaying the claim for months before a decision is made. The insurers regularly tell us that they must “independently investigate” the claim, as they refuse to rely on the statements of our clients regarding their claim. You are suddenly placed under a microscope, where your business past is scrutinized, and the severity of your medical condition questioned.

Insurance companies demand that medical professionals produce production reports detailing your precise work for at least a year before your disability. They do not accept your job title as enough to establish the nature and extent of your work routine. Do not rush to provide this data, some of it is protected by HIPAA, and the formatting of the data can be tricky- since CPT coding does not always accurately depict the specific task performed. In order to anticipate problems with the data, we ask our clients to collect this data for our review so that we synthesize the data and coordinate it with our presentation to the disability insurance company.

Attorneys- What Court Documents and Office Records Must Be Released?

Attorneys often claim they are trial attorneys, and if they become unable to go to court, expect their private insurance policy will pay their benefits even if they can perform legal work from the office.

Most insurance companies require you to complete an Occupations Form, indicating what percentage of your time and duties are devoted to office work, meeting with clients, and court cases. Recent forms request exact details as to how many cases were filed in court, what courts, how often you appeared in court over the past year, how many cases were tried, and much more information. It is very tedious to re-create this information, and there is a temptation to rush through these questions and provide vague generalities. Be careful, because all claim forms contain a verification that the information provided is accurate and based on data. Collect the data first, and then do not be your own counsel, speak with a disability attorney to strategize the submission of the information.

We have handled claims for people of many diverse occupations. We handle the claim of an attorney or doctor with the same devotion to details as the person who works for a big corporation, or a small specialized IT practice.

How Does COVID and Remote Work Impact Claims

With our unique year of COVID 2020. millions of people are working remotely. This change in work environment will impact the disability claim. Disability insurance companies are gearing up to deny claims, asserting you can work remotely, doctors can perform tele-health and do not need to physically examine patients, an IT person can put in an eight- hour day, during a 12-hour period of time, given that they work from home and can take long breaks as long as they get the work done.