How Often Do I Have To Prove That I’m Disabled To Receive Benefits In Houston, TX?

Getting a determination of disability isn’t the end of your journey. Once you’re declared disabled, you’ll be subject to periodic reviews, depending on your condition. But reviews are part of the process and part of continuing to receive disability payments.

How Often Do I Have To Prove That I'm Disabled To Receive Benefits In Houston, TX?

What Type Of Disability Do You Have?

When you’re approved for disability, your caseworker will set dates for future disability reviews. Generally, these reviews are every three to seven years. However, it also depends on the severity of your disability.

There are three categories of disability conditions:

·         Medical Improvement Expected—if your disability is one that you’ll recover from, you can expect to have a review within six to eighteen months of your original determination

·         Medical Improvement Possible—for conditions from which you are reasonably expected to improve (such as mental illness), reviews are generally conducted every three years

·         Medical Improvement Not Expected—if you’re rated for a condition for which a recovery is not expected, reviews are conducted about every seven years. These conditions can include:

  • Autism
  • Blindness
  • Multiple Sclerosis
  • Deafness
  • Parkinson’s Disease
  • Some Cancers
  • Cerebral palsy

Children who receive SSI will have a review every 3 years. Children approved for low birth weight will be reviewed around their first birthday, and all children will be reviewed at the age of 18 regardless of what type of disability they have.

Navigating the CDR

Social Security is required by law to perform periodic reviews of individuals who receive disability benefits. This includes gathering medical records for review. The CDR, or Continuing Disability Review, is the process for determining your continuing disability.

When the time comes, Social Security will send you one of two forms to fill out and return:

·         If the likelihood of your recovery is low, you will be sent Disability Update Report (SSA-455-OCR-SM, or “the short form”

·         If your recovery probability is higher, you’ll be sent Continuing Disability Review Report (SSA-454-BK, or “the long form.”

From there, they will examine your medical records, any treatments, improvements in your medical condition and any other determining factors, such as vocational training that allows you to begin doing “substantial gainful work.”

Without any improvements, and the inability to return to “substantial gainful work,” your disability payments will likely continue. However, if they are changed, you do have the right to appeal any decisions.

What Can Affect Disability Benefits

Any major change in your medical condition, income, resources, living arrangements and other circumstances (such as marriage or divorce) can change your eligibility. Disability is need-based with limits on assets and income, so periodic “re-determinations” are regularly conducted. If you’re found to exceed the “allowable limits,” your benefits will be suspended or terminated.

Scheduled For A Review? We Can Help

Regular reviews for disability cases are common, they occur every three to five years, and don’t always mean your benefits will end. Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and we’ll take your case on a contingency fee basis, with no up-front charges.

If I’m Partially Disabled In Houston, TX, Do I Have To Accept Any Job I’m Able To Do To Collect Benefits?

You may have a sense of relief when you finally get your long-term disability benefits. But now that the initial trial is over, there is still the matter of complying with the policy’s rules. One of those rules may be working to keep your benefits.

Disability insurance is intended to protect you from financial risk if you become disabled or sick to the point where you are unable to work. The policy itself contains the definition of “disability”, and whether you qualify depends on what your policy terms as “disabled.” You will have to be “disabled enough” according to the policy’s definition in order to receive benefits. But everything comes down to the type of LTD policy you have.

If I'm Partially Disabled In Houston, TX, Do I Have To Accept Any Job I’m Able To Do To Collect Benefits?

Own Occupation Vs. Any Occupation

There are two basic types of LTD policies:

  • Own Occupation, in which you receive benefits when you are no longer able to work in your current vocation (more expensive)
  • Any Occupation, where you are able to work in a different occupation, but can no longer work in your current vocation (less expensive)

For instance, if you are a firefighter, and are injured on the job, you can no longer work in that occupation. Under an “own occupation” policy, you would receive benefits because you were totally disabled and could no longer perform “material and substantial duties” for that job. It would not matter that you could have a second career that was related to your work as a firefighter.

However, under the “any occupation” policy, the same firefighter who was injured on the job may be able to perform “material and substantial duties” for another occupation, i.e., a “desk job,” and will not be considered “disabled.” Only if the firefighter was unable to work in any occupation would the individual be considered “disabled” enough for the policy. “Any occupation” work may also mean workplace accommodations, which can also be used to deny benefits.

Most courts hold to the standard that if an individual is capable of any kind of work, even part-time, the individual is not truly disabled, and can be gainfully employed in any occupation, not just their own. This means that you would not meet the standard of disability.

Unfortunately, there are no standards for income disparity. This means that if you were working in a profession that paid $100,000 per year before your disability, you might still be able to work at a job that paid $15,000 or less, and therefore not be considered disabled. Under an “any occupation” policy, you would be required to work any job you could get, regardless of the salary.

Many LTD group policies provide benefits under the “own occupation” clause for the first two years of disability. After that, the benefits are under an “any occupation” clause.

Contact Houston’s Premier Disability Law Firm

Not many attorneys understand disability filings and appeals, but we specialize in it. With over 4,000 successful cases, we focus on helping disabled people receive the benefits they need. We’ve handled multiple situations that are similar to yours, and have the experience to help you through the process for a successful outcome.  The Herren Law Firm can help you with your application, appeals and legal action to help you get the disability benefits you need. Contact us today at 713-682-8194 to schedule your free consultation. There’s no obligation and no up-front fees.  We only collect if we win your case.

What Are My Options If My Disability Insurance Policy Denies My Claim In Houston, TX?

After paying your premiums for many years, now you need to use your disability insurance. You’ve done what you needed to do. Saw your doctor, got testing and treatments, filled out all the forms, and did everything they asked. But your claim was still denied. Now what?

What Are My Options If My Disability Insurance Policy Denies My Claim In Houston, TX?

Denial Is Not Final

The denial letter you receive is not the end of your claim, only an obstacle. You have options and can appeal the denial. Review your policy’s documents to understand what your next steps are.

A claim denial can happen for a number of reasons:

  • Inadequate or incomplete medical records
  • Written opinions from your treating physicians (this can be added during an appeal)
  • Incomplete medical testing and/or treatments

Your application should contain as much favorable information as possible for a positive decision. Adding as much as you can in the claim application ensures that if during an appeal, no additional evidence can be added, you have more than enough evidence to begin with.

If your insurer has wrongfully denied you benefits based on an individual disability policy, you (or your family) may be able to recover lost benefits, wages, pain and suffering and other, similar damages.

Bad Faith

Insurance companies are in the business of making money, not paying it out. Disability insurers use a number of notorious tactics they use to prevent the payment of a claim, including:

  • Policy termination without notice
  • Long delays in their review process
  • Mis-classifying injuries in order to deny a claim
  • Hiding benefits from policyholders
  • Excessive requests for documentation
  • Complicated forms with badly defined terms
  • Delaying your claim
  • Changing due dates

The idea is that you will, after the first denial, simply give up your claim and leave them alone, or at least settle for less than you thought you would receive.

Options

If you’ve received a denial letter after applying for the first time, you are entitled to an appeal. This should be described in your denial letter. Pay attention to any dates or time period mentioned in the letter, because if you miss them, your appeal will be dismissed.

You have the right to ask for any and all documentation and expert advice that was used to decide your claim, without charge. You’ll be able to determine what information might have been missed, and hiring an experienced disability law attorney can give you the best chance of winning on appeal. Working with an attorney who understands the application and appeals processes will make sure that your application and any appeals will be completed, giving you the best chance of a successful outcome.

It’s never too early to contact a disability attorney for help. Whether you’ve just become disabled and are wondering about your options, have been denied benefits, are appealing, or just don’t have the stamina to deal with an insurer while you take care of yourself, contact a disability law attorney to help you stand a better chance of winning.

Let Herren Law Increase Your Chances Of A Win

If you’ve become disabled and unable to work, the last thing you need is to worry about how to pay your bills and keep your household going. Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and we’ll take your case on a contingency fee basis, with no up-front charges. You don’t owe a fee until we win your case.

Can You Get Long Term Disability for Migraines in Houston, TX?

If you’re one of the 28 million Americans who suffer with migraines, you know the signs when you’re getting one. Lethargy, increases in pain and the so-called “auras” are sure indicators that it’s about to happen. You may have stressors or triggers that bring on a migraine (like a smell or bright light) that tell you it’s coming. Once that happens, you know you’re down for the count until it passes.

Can You Get Long Term Disability for Migraines in Houston, TX?

You may have relatives, friends or coworkers who don’t offer support. You may even hear the comment, “but you don’t LOOK sick.”  You know you’re in pain, even if they don’t. Medications have varying degrees of effectiveness; some don’t help at all. And if you go to work anyway, instead of staying home, you know your quality of work will suffer until it passes. Meantime, you manage the best you can.

What Is A Migraine?

A migraine is a headache and condition that can seriously impact your quality of life. According to Migraine.com, migraines are the 7th leading cause of disability worldwide. Common symptoms include:

  • Light and/or sound sensitivity
  • Throbbing headaches
  • Blurred vision or other visual disruptions
  • Nausea
  • An “aura”—visual disturbances that includes blind spots, flashing lights, zig-zagging lines, and/or “seeing stars”

There may be other accompanying symptoms, such as fatigue and/or lethargy. Migraine episodes typically last 4 hours to 72 hours. These symptoms can also make work, social events and other everyday activities difficult or impossible to engage in.

Proving The Disability

Getting disability for migraine conditions can be difficult, even though one in four households are likely to have someone who suffers with it. As a neurological condition that’s not visible or diagnosed by a regular blood test, filing for long-term disability can be more difficult.

Note that “self-reporting” your condition may severely limit your benefits, or see them declined Migraines aren’t obvious or detectible through conventional medical testing. Supplying sufficient evidence to prove your inability to work is essential, so you’ll need to use other means of reporting to support your claim. Insurance companies want objective evidence for your diagnosis. A series of documentation will be required to successfully defend your claim, including:

·         Your own journal: record everything related to your condition truthfully and thoroughly—pain, frequency, intensity, severity, treatment, and your level of difficulty. Include dates, times, duration, and other relevant details, i.e., hospital visits, treatments given, side effects of medicines, etc. Your physician may include a review of your notes in your patient record, making it part of any claim evidence.

·         Work with your doctor: you’ll need your doctor’s support for your claim, so you’ll need to follow his or her instructions, including taking prescribed medications. If you’re unable to comply with your physician’s instructions (i.e., side effects of medication) make sure to inform him or her of these difficulties. Their records should indicate that you are doing your best to follow their instructions.

·         Other documentation to support your disability claim: this should include days missed from work, test results taken to rule out any other conditions, any treatments or medications you tried, their effectiveness, and any side effects

·         Testimony from family/friends supporting your activities that are limited by the headaches

·         Your doctor’s notes about your migraines (intensity, frequency, severity, etc.), and if these headaches are compounded by other illnesses or injuries.

·         Records of any hospital visits (including ER) related to your migraines

·         If you’re a veteran, medical evidence verifying the service-related connection, such as an incident that occurred during service time, or that it’s related to another service-related condition.

Migraines As A Catalyst

As painful as migraines are, they can also be a catalyst for additional conditions, such as fatigue, depression, sleep disorders, additional pain as well as other conditions.  If you also experience the “aura” symptoms, you may also be at increased risk for strokes and heart attacks.

Houston’s Attorney For Long-Term Disability Help

Filling for LTD can be a chore under the best of circumstances. With a condition like migraines, it’s more complicated, and of course, can be more difficult. But an attorney experienced in disability filings and appeals can help you gather the necessary information needed to file and increase your chances for a successful outcome.

Over 4,000 Houstonians have received the LTD benefits they need, and we can help you too. The Herren Law Firm can help you with your application, appeals and help you through the process so you can concentrate on getting better. Contact us today at 713-682-8194 to schedule your free consultation. There’s no obligation, and no up-front fees.  We only collect if we win your case.

What Kind Of Disability Benefits Can You Expect In Houston, TX?

If you’re applying for disability for the first time, you may be wondering what to expect after your application is approved and you’re successful. Of course, every case is different, and we can’t give specific legal advice here. But if you’re getting ready to apply for disability benefits, we can offer a general idea of what you might be able to receive.

What Kind Of Disability Benefits Can You Expect In Houston, TX?

Two Types Of Disability

Disability comes in two versions: SSDI and SSI. While they’re both commonly called “Social Security,” they’re slightly different, but use the same means for determining disability.

  • Supplemental Security Income—for those who have never worked, and/or have limited income. SSI is need-based, and is not related to work history. To apply, you must have less than $2,000 in assets of any kind (cash, stocks, bonds, life insurance, etc.) as an individual, or $3,000 as a couple.
  • Social Security Disability Insurance—for those who have worked and earned enough “work credits,” this program is paid into through payroll taxes (visible on your paycheck stub and W-2.) SSDI pays you or certain members of your family if you worked long enough and paid Social Security taxes through regular payroll deductions. You’ll also need to be “medically eligible,” that is, have a long term severe and total disability that keeps you from doing “substantial gainful activity.”

It’s also possible to receive both SSDI and SSI at the same time, depending on your situation. The current maximum federal benefit rate is $750. Should your SSDI fall below that, SSI could make up the difference, depending on what other incomes you may have. However, if you are living with someone, and they are providing food and/or shelter without charge, these “in kind” benefits can be subtracted from your monthly benefit checks.

Texas Disability Benefits

Once you’ve applied for either SSI or SSDI, your claim file is sent to the Texas’s Disability Determination Services (DDS) agency, part of the state’s Department of Assistive and Rehabilitation Services (DARS). DDS claim examiners will review your file, including medical information, and decide whether you meet Social Security’s disability definition. If your claim is denied, you can request a DDS reconsideration.

If you’re eligible for SSI in Texas, you are automatically eligible for Medicare, and should be automatically enrolled. If you’re not automatically enrolled, you should contact your local Social Security to ask about it. You may also be eligible for SNAP benefits (also known as “food stamps.”) These depend on where you live and what your monthly income is.

For disability recipients in who receive Medicare-paid institutional care, Texas adds $60 for those with “countable income” of less than $60 per month. Additionally, as a resident in institutional care, you would only be able to keep $30 of your federal SSI payments.

While Texas doesn’t award additional disability benefits, the state offers additional resources and programs for individuals who are on disability. You can find some Texas disability resources here.

The Texas Health and Human Services Commission is also available to help with applying for SSI, SSDI and SNAP benefits, as well as independent living services. You can call 211 from anywhere in Texas, or go to Your Texas Benefits website to find a local office.

Assistance is available in the City of Houston through The Houston Mayor’s Office For People With Disabilities. You can contact them by calling 832-394-0814, or email at mopdmail@houstontx.gov.

Waiting Periods

SSDI has a five-month waiting period to begin benefits. Even if your disability is approved on the first try, you won’t be receiving checks until at least the fifth completed month after you become disabled. However, it’s more likely that approval will take six months to a year. Once your payments start, you’ll also receive a “backpay” lump sum for the months you were eligible but weren’t paid.

Your Houston LTD Disability Attorney

Most attorneys aren’t familiar with the intricacies of disability filings, but we are. With over 4,000 successful cases, we focus on helping disabled people receive the benefits they need. We’ve handled multiple situations that are similar to yours. We have the experience to help you through the process for a successful outcome.  The Herren Law Firm can help you with your application, any necessary appeals and help you get the disability benefits you need so you can live your life. Contact us today at 713-682-8194 to schedule your free consultation. There’s no obligation, and no up-front fees.  We only collect if we win your case.

 

Is It Worth Hiring A Houston Attorney For Long-Term Disability?

Filing for long-term disability is a long and challenging process. It’s more than filling out a few forms and checking items on a list. Medical evidence, information from your employer and other documents are part of what will win or deny your case. Insurance companies have strict deadlines, and one small mistake can see your entire claim denied.

Is It Worth Hiring A Houston Attorney For Long Term Disability?

They Don’t Want To Pay You

Insurance companies would rather you didn’t realize that even though you’ve paid into their policy, they’re not interested in helping you. Paying claims is not a good business model, so insurers make sure that there are multiple ways to deny your claim. Short deadlines, excessive or duplicate paperwork, delaying claims or payments or giving lower payments than indicated in the policy are all ways insurers stall. Legitimate claims for disability are increasingly denied for the slightest reason. Knowing that most people don’t have the means to fight back, these “bad faith” practices continue with little pushback.

ERISA

The Employee Retirement Income Security Act of 1974 was enacted to protect employees, but ends up protecting insurance companies. Instead of protecting you, ERISA gives insurance companies greater freedom to deny your claim. Although the Department of Labor says that it “protects retirement savings from mismanagement and abuse,” insurers are free from many state-level restrictions on bad-faith insurance practices. Insurers are then are free to decide who is approved for LTD benefits, and who isn’t.

The deck is actually stacked against you as an applicant, and it’s up to you to be able to make sure your claim is completely correct. This is where an attorney can help make sure your application is not only correct, but more than sufficient to prove your claim and make it harder to deny.

If you decide to handle your ERISA appeal without an attorney, you’ll more than likely be denied, and you could lose any additional opportunities to appeal or file a suit. You may only have one chance at an appeal.

Hiring An LTD Attorney

Of course, you want to find an attorney in Houston who has experience with both LTD claims and with ERISA appeals. He or she will understand the process and know exactly how to follow the rules.

If you hire an attorney at the beginning of your application process, he or she knows that ample evidence in your administrative claim will help meet and exceed the insurer’s requirements. If you just fill out the paperwork on your own, and depend on the insurer to find all the evidence it needs, there’s a strong chance your claim will be denied because of insufficient information, or even a mistake.

Once a decision has been made, no new evidence is allowed. An experienced LTD attorney will know exactly what to add to the claim to increase your chances of approval. Should your claim be denied, having an attorney will increase your chance of winning an appeal, and you’ll have a good stack of evidence available to better prove your claim.

Your Houston LTD Disability Attorney

ERISA claims are a complex area of the law, and there aren’t many attorneys in Houston—or Texas—that handle it. The Herren Law Firm can help you with your application as well as any appeals to help you get the long-term disability benefits you need to take care of yourself. Contact us today at 713-682-8194 to schedule your free consultation. There’s no obligation and no up-front fees.  We only collect if we win your case.

Can You Get Long Term Disability for PTSD in Houston, TX?

Long-term disability can be a difficult journey, from an illness that keeps you from working to the extensive medical appointments and paperwork involved before you start receiving benefit payments. But if that disability is PTSD, it can be even more difficult.

Can You Get Long Term Disability for PTSD in Houston, TX?

What is PTSD?

PTSD, or Post Traumatic Stress Disorder, is a condition seen in individuals who have witnessed or lived through a traumatic event. It’s a type of anxiety disorder that’s triggered by a traumatic event.

While PTSD is commonly associated with combat veterans who have spent time in war zones, PTSD can also occur in civilians. Natural disasters (like last year’s Hurricane Harvey), becoming a crime victim, receiving a diagnosis for a serious medical condition, car crashes, domestic violence, and other unexpected traumas can give someone this disorder.

Post-traumatic stress is commonly grouped into three types:

  • Intrusive memories—i.e., “flashbacks,” re-living the event or having recurrent nightmares
  • Avoidance/numbing—or avoiding thinking about it, as well as hopelessness, memory and concentration problems, difficulty with close relationships and no longer enjoying previous activities
  • Hyperarousal (or increased anxiety or emotional arousal), increased irritability or anger, shame or guilt, insomnia, self-destructive behavior (alcoholism, drug use, etc.) and being easily startled.

PTSD can cause problems in your job, your relationships, your marriage, as well as everyday activities. It also put you at risk for additional mental conditions, such as depression, eating disorders, suicidal thoughts, and other anxieties. The side effects of PTSD have also been shown to be linked to physical illnesses such as cardiovascular disease, autoimmune diseases, and chronic pain.

Treatments for PTSD can include various forms of psychotherapy, and psychiatric medications, short-term or long-term.

Policy Limits On Mental Illness

Because it isn’t something that can be detected with an X-ray or a blood test, insurance companies have additional restrictions on claims for mental conditions. The first step is to review your LTD policy, find out what they do cover, and see if there is a specific exclusion for PTSD or other mental illnesses.

Many LTD policies put a two-year limit on claims for mental illnesses, so it’s important to know what you need and what you can get before you start your application.

Review your policy to find out exactly what requirements you need to meet to file your claim. If your PTSD is the result of another medical condition, such as injuries after an accident or a disease diagnosis, you may be able to qualify.  In order to do that, you’ll need to collect enough evidence to prove that your physical condition that caused PTSD could render you disabled on its own. This is where an attorney can guide you through the process and increase your chances of proving your claim and having it accepted.

Your Houston LTD Disability Attorney

PTSD is a particularly difficult illness, but applying for LTD can make things even worse. We can help you through the long process of getting long-term disability benefits.

Over 4,000 Houstonians have received the LTD benefits they need, and we can help you too. The Herren Law Firm can help you with your application, appeals and help you through the process so you can begin healing. Contact us today at 713-682-8194 to schedule your free consultation. There’s no obligation and no up-front fees.  We only collect if we win your case.

 

Houston Attorney for CIGNA Disability Claims

Most people don’t expect to become disabled. But in the US, one in five individuals is considered disabled, enough not to work. Some need time to recover from an illness or injury. Some may never return to work, and will be on disability for the rest of their lives. But in many cases, part of their journey to disability involves long-term disability insurance. And for many, that insurance company is CIGNA.

Houston Attorney for CIGNA Disability Claims

Who Is CIGNA?

It’s one of the largest healthcare insurance companies in the world, for both companies and individuals. Whether you’re buying on your own or through your company, CIGNA offers health and dental insurance, Medicare, and supplemental coverage to augment your regular insurance policies. These include accident insurance, two types of cancer insurance, heart attack/stroke insurance and “whole life insurance” for final expenses.  Companies can also choose from supplemental group plans, wellness programs, cost control options and benefit technology solutions.

If your company offers short- and long-term disability insurance, there’s a good chance it’s also through CIGNA.

CIGNA is also one of the world’s largest group disability insurance companies. Calling itself a “global health services company,” CIGNA was ranked #97 on the Fortune 500 list in 2014. The company has more than 37,000 employees worldwide, has over $35 billion in revenue and $10.8 billion in shareholder’s equity.

While CIGNA offers a wide range of related services worldwide, they are also in business to make money. Denying claims is part of their business.

What CIGNA Is Really Like

Company literature touts their slogan, “Together, all the way.”  But policy holders who have CIGNA will tell you that once you file a disability claim, it’s not always like that. For a vulnerable person who needs help, CIGNA turns their back on many of their policyholders.

The company has a reputation for denying claims immediately, with little or no investigation, and only minimal documentation is used to deny claims. They also have a reputation for ignoring policyholders, not responding to phone calls and emails, and issuing multiple requests for the same information.

The company is governed by ERISA guidelines, but uses them to its advantage. CIGNA’s deadline for deciding your claim is 45 days, but the company routinely asks for 30-day extensions to delay that decision. They also continually ask for additional bits of information to further delay decisions—every request stops the time, and then starts it over. When you receive these requests, answer them immediately. The initial claim decision generally takes about 105 days with the extensions.

If your claim is denied, you’ll have 180 days to appeal. Don’t wait—begin your appeal immediately (and if you have a disability attorney, he or she will know what to do.) Your appeal will take time to prepare—don’t wait. CIGNA will take 45 days to respond to your appeal, but may also request a 45-day extension, making it 90 days.

Another tactic CIGNA uses is to continually ask for information and stalling their decision. You may also be told by one of the many “case workers” you speak to that if you’ll just write a simple letter, your claim will be approved and your checks will begin right away. This is another stalling technique, and can be used to deny your claim. Talk to your attorney if you’re being ignored or treated badly.

Don’t Ignore Appeals

Appeals are essential to getting your claim approved if you’re denied the first time. Pay attention to the deadlines given—if you miss it, you’ll lose your ability to appeal, and possibly your entire claim to long-term disability.

CIGNA allows two appeals before either approving your claim. If you’re still denied, you may opt for a lawsuit. If you don’t have an attorney at this point, you’ll need one now.

Are You Fighting With CIGNA?

Fighting with your insurance company can be worse than having a disability. It doesn’t have to be that way. A thorough and complete application is the best way to start, and we can help.

We understand the process of applying for disability and dealing with appeals—we do it every day. The Herren Law Firm in Houston, TX can assist with your application, appeals and all documentation. Contact us today at 713-682-8194 to schedule your free consultation. We’ve helped over 4,000 Houstonians get their disability benefits, and we only collect a fee if we win your case. Don’t fight alone—call us today.

Can You Get Long Term Disability for Anxiety in Houston, TX?

Nearly everybody goes through difficult times. Some may find themselves with depression and/or anxiety until things get better. But is your anxiety bad enough to warrant long-term disability? It can be, if it prevents you from working, and inhibits nearly every part of your life.

Can You Get Long Term Disability for Anxiety in Houston, TX?

Anxiety, like most mental illnesses, is difficult to positively diagnose, and therefore harder to claim. Unlike an injury, such as a broken leg, or a condition like cancer, anxiety doesn’t have symptoms that are readily obvious or detectable with a blood or other medical test. But living with a physical disability can also trigger concurrent mental disabilities, including anxiety.

What Is Anxiety?

Anxiety is usually defined as a chronic fear or worry about something that could happen, but hasn’t happened yet, and may never happen. There are many factors that can trigger this fear or worry, such as work-related issues, relationship problems, or other problematic situations (i.e., a car accident, chronic pain, etc.) A shortage of oxygen in some areas can contribute to anxiety, as well as brain chemistry. Certain medications can also cause anxiety, as well as withdrawal from some substances.

Mild cases may remedy themselves, but severe cases can be debilitating and prevent you from working and living your life. There are multiple variations of anxiety:

A mental health professional (i.e., psychiatrist) can identify the cause of the anxiety. A physical exam, including medical testing, can identify any physical symptoms that may be causing the anxiety.

A positive diagnosis includes consistent worry for more than six months, difficulty in controlling that worry, and that the symptoms severely impact everyday life, interfering with work and/or school, etc.

Check Your Policy First

The first thing you’ll need to review is your LTD policy. What does it consider a “disability?” Does it cover mental illnesses? More importantly, does it exclude mental illnesses?

Check to see how your policy defines “disability.” Many LTD policies put a two-year limit on mental illness benefits. Anxiety may develop for any number of reasons, but it’s important to note if it develops in someone who is living with a physical disability that prevents them from working. Your LTD policy will tell you if mental illnesses are limited, or outright excluded.

You’ll need to meet all the other requirements of your LTD policy to be able to file the claim. If your anxiety was caused by an underlying physical condition, you may be able to collect benefits beyond the two-year standard for mental illnesses. But in order to do that, you’ll need to curate enough medical evidence that demonstrates your physical illness qualifies you as disabled on its own. This is where an attorney can help you.

The Human Factor

Always remember that disability insurance claims processors aren’t medical professionals. They’re not trained to offer medical advice or opinions, only to examine claims to see if they’re properly supported and submitted. They’re looking for anything that positively proves your disability, be it mental or physical.

Don’t rely on the insurance company to get everything. The more documentation you can submit that supports your claim, the better your chances of approval. Providing copies of physician’s notes, additional medical records, prescription records, therapy notes, and anything else that might be relevant can be submitted to support your claim.

Also be careful of any questionnaires or other documentation the insurance companies send to you. Some of the questions may be carefully written to intentionally disqualify your claim when you believe you’re answering truthfully to better support your claim. Having a disability lawyer review documentation before it’s sent to the insurer will help prevent automatic disqualifications for these kinds of questions, and make sure your claim is thorough and complete.

Surveillance

It’s not uncommon for insurance companies of all kinds to conduct surveillance on someone filing a claim, whether it’s LTD, for a car accident or a personal injury claim. (This is also common in divorce cases.) You may be followed, or your social media may be examined for evidence that you’re not as disabled as you claim, so be cautious about your activities and postings. Be aware that any evidence that is gathered can be used to deny your claim, even if it’s misrepresenting.

Your Houston LTD Disability Attorney

Nobody wants to suffer from chronic anxiety, but applying for long-term disability can be difficult. It’s important not to give up. We’re ready to help you through the long process of getting long-term disability benefits.

Over 4,000 Houstonians have received the LTD benefits they need, and we can help you too. The Herren Law Firm can help you with your application, appeals and help you through the process so you can concentrate on getting better. Contact us today at 713-682-8194 to schedule your free consultation. There’s no obligation and no up-front fees.  We only collect if we win your case.

 

Can You Get Long Term Disability for Fibromyalgia in Houston, TX?

After months of wondering, you’ve finally received a diagnosis for your chronic pain: fibromyalgia. Maybe you have increasing symptoms, or you’re taking off a little more work than you’d like because you’re in pain and tired all the time. Or you need to take some time off to take care of yourself.  Is it time to retire and take long-term disability? Or have you reached the point where you can’t get through the day at work anymore?

Can You Get Long Term Disability for Fibromyalgia in Houston, TX?

Fibromyalgia afflicts as many as an estimated 10 million Americans but doesn’t have a specific diagnostic (like a blood test.) Characterized by widespread chronic pain, fatigue, and sensitive sore spots, the causes and workings elude doctors and refuse to be nailed down.

People who have fibromyalgia live with varying degrees of pain, fatigue, difficulty concentrating (called “fibro-fog” by patients), depression, and other symptoms that leave them eventually unable to work. It’s known as an “invisible illness” because of the difficulty of diagnosis. Fibro is also thought of as a “women’s disease,” since women are more likely to be diagnosed with it than men.

So what makes fibromyalgia so difficult? And why do insurers turn down claims for fibromyalgia so often?

Mental or Physical?

As anyone with fibromyalgia will tell you, they frequently hurt all over, and they’re tired, but they’re not crazy.

Even with repeated trips to their physicians, there’s no way to definitively diagnose fibro, unlike diabetes or cancer. Insurers tend to think of it as a mental illness that manifests itself physically rather than a specific illness with obvious physical causes. Many label fibro as a “subjective” illness, and therefore mental. Most policies cap mental illness benefits at 24 months, leaving you without benefits after that point.

Proving Your Claim

If fibromyalgia can’t be diagnosed with actual physical proof and standard medical testing, how do you prove it?

  • Relevant medical records—fibromyalgia is an illness with symptoms that are self-reported; there is no medical testing available. Your doctor will have to make a clear diagnosis in the records, not vague like “reporting symptoms of fibromyalgia.
  • In addition to your regular physician, a rheumatologist can also give a positive diagnosis for fibro, which includes testing “tender points.” If you have 11 of the 18 points, you’ll usually receive a positive diagnosis.
  • Repeated occurrences of at least six fibromyalgia symptoms (fatigue, memory problems, depression, anxiety, muscle weakness, dizziness, abdominal pain, etc.)
  • Lab tests—while there are no specific diagnostic tests for fibro, any tests taken to rule out other conditions (i.e., hypothyroidism) should be documented with results.
  • Doctor’s opinions—any additional opinions you get should also be in writing.
  • First-hand statements from family and associates—these are strong evidence that you are having difficulties in everyday life because of fibro.
  • Keep a diary of all your symptoms, physical and mental, and use it both in doctor visits and in your claim file.

Increasing Your Chances Of Approval

While there are no guarantees, there are some things you can do to improve your chances of getting long-term disability payments for fibromyalgia.

  • A confirmed diagnosis from your rheumatologist
  • Relevant related medical records (lab tests, prescriptions, hospital visits, etc.)
  • Dates of visits and contact information for doctors, therapists, hospitals, etc.
  • Doctor’s report on the extent of your work-related limitations
  • Any treatments you are currently receiving

A lawyer should supply you with an assessment form for your doctor to complete that asks for greater detail of your limitations than an insurance company might provide.

Hiring a Houston lawyer experienced in long-term disability claims and who understands the law around long-term disability claims can help ensure that you’re following the process properly. He or she can also work with you to submit any appeals that you’re allowed to.

Don’t Let Fibromyalgia Stop You

If your insurance company has denied you benefits based on fibromyalgia, we’re ready to help you. The Herren Law Firm in Houston, TX can assist with your application, appeals and help you get the long-term disability benefits you need so you can get the help and medical care you need. Contact us today at 713-682-8194 to schedule your free consultation. There’s no obligation and no up-front fees.  We’ve helped over 4,000 Houstonians get their disability benefits, and we only collect a fee if we win your case.