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Why Some Long-Term Disability Claims Are Denied

On employer-provided long-term disability (LTD) claims, there can be numerous issues surrounding a denial of a claim. It is common for disability applications to be evaluated by claims administrators usually working for your insurance company. Therefore, some deserving claims can get denied even when the evidence of disability appears to be clear. Understanding why claims are denied will help you present your best case possible at the administrative level.

One of the most common reasons for denial is insufficient medical evidence. Having detailed and supportive medical records are important in receiving LTD benefits. When you go for your regular medical treatments or physician appointments, be sure to discuss any important medical issues with your physician. Additionally, the physician probably will be ordering certain medical tests, including x-rays, MRIs, or CT scans, when necessary.

Another common reason for LTD claim denial is missing medical records. The insurance company may have failed to obtain all of your necessary medical records. Be sure that you ask your disability carrier for a list of the records it has requested and those it has received. If some records are missing, be persistent and make sure that your insurer requests the appropriate records.

A third reason you may be denied for LTD benefits could be related to your physician’s statement. Your insurance company may not have the correct statements from your physician so be sure that your physician’s office writes a letter that details how your impairment limits your work abilities. Then make sure that the insurance company receives that letter, and any other important documents or subsequent letters that come from the physician.

Submitting all medical evidence as soon as possible in the appeals process is important because federal courts typically are limited to considering only evidence contained in your administrative record. Your medical records or other evidence needs to have been submitted to your insurance company, prior to any federal court date.

Another common reason your LTD claim may be denied is related to your plan’s precise definition of ‘disability.’ Some plan policies define it as being medically unable to carry out the duties of your certain occupation. Other plan policies define disability as the inability to perform duties of any job. It is best to check with your LTD plan policy to avoid any unexpected issues.

It is important to check with your policy’s summary plan to look for any excluded medical conditions. Any medical impairments that may be related to substance abuse or pre-existing conditions are sometimes excluded from coverage. There also may be benefits that are limited when conditions are based on subjective complaints rather than objective testing. Some examples of these conditions are fibromyalgia, chronic fatigue syndrome, or depression.

Also, if you miss any important deadlines when filing and appealing your claim, it could cause more complications for your claim. Most group plans give you 180 days to appeal an initial denial. At this point, it would be best to hire an LTD attorney who can assist in obtaining your medical records and other important documentation to help get a favorable response for you.

Suspect in Cook County Judge Murder Could Go Back to Prison For the Second Time

Citizens in cook county in Illinois on April 10th woke up without a county judge. Early that morning around 5 a.m. 66-year-old Judge Raymond Myles was fatally shot outside of his home. His girlfriend, 52, was wounded but is thankfully not in critical condition. I would describe this as an attack on the justice system I participate in. But it also highlights a fundamental flaw in the correctional prison system. This is not the prime suspect, Earl Wilson’s first altercation with Illinois law. Having already served 12 years back in 1992, Wilson shows how certain prisoners should have changed through the correctional system but have found themselves in a loop instead.

This story gained national recognition as the first murder of a judge from the Chicago-area in thirty years. Wilson is being charged with 27 counts including attempted murder, first-degree murder, aggravated battery, armed robbery, and unlawful restraint. Bruno Law Offices states that the potential punishment for first-degree murder is anywhere from 20 years to life in prison. Joshua Smith, 37, is a suspected accomplice in the case as the getaway driver Wilson supposedly used to escape the crime scene. All in all, Chicago saw 762 total murders back in 2016. This number is higher than 2015 but lower than 1992, the year Wilson first faced criminal charges which saw 943 murders. Wilson’s first charge in 1992 was an attempted murder and his release was back in 2004. Something failed Wilson the first time he found himself blown through the correctional system and now he’s back on the loop of unresolved conflict and potential crime. The National Institute of Justice states that back in 2011 approximately 1,900 prisoners were released daily back into American society. The hardest thing for a former convicted person to accomplish post release is finding work. Research from the Urban Institute indicates that only about half of all released prisoners find work in the first year they are released. Earl Wilson was officially arrested on April 26 of this past year.

The Judicial System in America may not be perfect but the murder of a county judge will never change anything. Grief and anguish can only follow such acts of violence. If found guilty Wilson should spend long years in prison to reflect on his life and hopefully grow wiser with age. The point of the prison system is to reform convicts back into law-abiding citizens so that they can go back to work, and fuel the ever running economy. However, when people like Wilson slip through the cracks good people can pay with their lives.

Whether or not the court finds Wilson guilty, a larger problem rests under the surface of the legal system. Unless some reform is done throughout the entire correctional system, many more people like Earl Wilson will continue to be stuck in a feedback loop of being forgotten and a life of crime.