What is Workers’ Compensation and how does it work in Massachusetts?

Workers' Compensation provides wage replacement coverage to Massachusetts workers who are injured in on-the-job accidents. Filing a workers' compensation claim can an extremely complicated process. Doing so without the help of an experienced Boston workers' compensation lawyer can be stressful and overwhelming, often resulting in delayed benefits, reduced benefits, or no benefits at all.

Most work-related injuries are eligible for workers' comp benefits, but employers and insurance companies rarely make the process an easy one. With the help of a skilled workers' compensation lawyer, your chances of receiving full benefits in a timely manner are significantly improved. If you've been injured on the job, and are not sure what to do next, give us a call and we will explain what benefits you should be receiving.

Although workers' comp effectively removes the employee's right to sue the employer, third-party claims may still be filed against a vendor or contractor if third-party negligence played a role.

Common Accidents Covered by Workers' Compensation:

Most work-related injuries are covered, even if the injury was the employee's fault. Some of the most commonly-cited workers' comp accidents include:

  • Crane accidents
  • Scaffolding accidents
  • Industrial accidents
  • Construction site blasting accidents
  • Trench and excavation accidents
  • Accidental electrocution

When a worker reports an on-the-job accident, an investigation by the Occupational Safety and Health Administration (OSHA) will usually follow. If the employer is found to be in violation of OSHA standards, fines and penalties may be imposed. Contact our Boston workers’ compensation lawyers at Altman & Altman, LLP today for a free and confidential consultation about your case.

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Workers' Compensation is supposed to guarantee certain benefits to workers who get injured on the job, including coverage of medical expenses, wage replacement, and additional compensation for permanent injuries and death. Unfortunately, receiving these benefits is not always an easy task. With the help of an experienced Boston workers' compensation attorney, your chances of receiving full benefits in a timely manner are greatly improved.

Workers' compensation pays benefits for work-related injuries that result in partial disability, disfigurement and/or loss of function, total disability, permanent disability, and death. At Altman & Altman, LLP, our knowledgeable legal team has an impressive track record of protecting clients from difficult insurance companies and employers. Our attorneys are skilled at negotiating for the highest possible settlements to be paid immediately.

In addition to ensuring you get the full benefits you deserve in a timely manner, Altman & Altman, LLP will fight to get additional benefits when appropriate. For example, if you have suffered a traumatic brain injury, spinal cord injury, or a serious burn injury, the "full" workers' comp benefits may not cover all of your costs. Further, if a third party, such as a machine manufacturer or negligent contractor, played a role in your injuries, you may be entitled to additional compensation.

At Altman & Altman, LLP, we will thoroughly examine all details of your case to determine the best method of recovery for your unique situation. We will file claims against any and all negligent parties so that you receive the highest settlement or verdict possible. If you've been injured in a work-related accident and need an experienced Boston workers’ compensation attorney, contact Altman & Altman, LLP today for a free and confidential consultation about your case.

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Disclaimer - By publishing this information on this Web site, the Boston, Massachusetts law firm of Altman & Altman LLP is not claiming to represent any clients or cases mentioned here. The content provided is designed to inform readers and is not intended as legal advice.

The waiting period built into workers’ compensation benefits functions as a type of deductible. If you are injured on the job, workers’ comp generally pays for associated medical treatment, a portion of your lost wages, and compensation for permanent disability. If you cannot work, these payments can mean the difference between financial disaster and financial stability.

Many workers’ comp applicants are surprised to discover that benefits rarely start immediately. In most cases, beneficiaries will be subjected to a waiting period. During this time, you will be unable to collect benefit payments, with few exceptions. A MA workers’ comp lawyer can help you determine how to move forward if you’ve suffered a workplace injury.

Waiting Period

A behavioral health care facility in Massachusetts is facing a proposed $207,690 penalty for violations discovered by the Occupational Safety and Health Administration (OSHA) during an inspection. UHS of Westwood Pembroke, Inc., which conducts business under the name Lowell Treatment Center, was issued a notification for failing to respond properly to incidents of workplace violence. The June 2017 notification followed a serious violation of a similar nature discovered by inspectors in May of 2015.

The 2015 violations resulted in the creation of a Formal Settlement Agreement in 2016 between OSHA and the facility. The agreement established a workplace violence prevention program, providing specific provisions or how the program should be implemented at the facility. Unfortunately, Lowell Treatment Center didn’t hold up its end of the bargain, failing to comply with requests for documentation showing that it had implemented the program. In addition, OSHA officials received a complaint that employees were still at risk. In response, the agency conducted a follow-up inspection on January 5, 2017. A Boston work injury lawyer can help you determine how to proceed if you’ve been injured on the job.

Employees are Still at Risk

During the inspection, OSHA discovered multiple violations, and that the facility had failed to comply with several aspects of its established agreement. ”Our inspectors found that employees throughout the Lowell Treatment Center continued to be exposed to incidents of workplace violence that could have been greatly reduced had the employer fully implemented the settlement agreement,” said Galen Blanton, Boston’s regional administrator for OSHA. A MA work injury lawyer can help you obtain the compensation you deserve if you’ve been injured in a work-related accident.

The Lowell Treatment Center is a 41-bed psychiatric hospital for adults and adolescents, and the UHS network is one of the largest health-care management companies in the country. UHS has notified OSHA that it intends to contest the agencies findings.

Common OSHA Violations

OSHA exists to enforce standards for safe working conditions, and to provide related training, outreach and assistance. In 2015, OSHA released its most recent top 10 list for frequently cited violations. These were:

  • Fall protection: Different fall protection systems are required for different jobs and situations.
  • Hazard communication: Employers are required to create a program for informing workers of on-the-job chemical hazards.
  • Scaffoldings: Having a competent person in charge of compliance and supervision is essential to scaffolding safety.
  • Respiratory protection: Toxic gases and fumes can make any workplace deadly without proper respiratory protection.
  • Lockout / Tagout : Workers can be killed when servicing equipment that starts unexpectedly. Lockout / tagout practices should be implemented to control the unexpected release of energy in machines.
  • Powered industrial trucks: These include forklifts, order pickers, and stand-up rider lift trucks.
  • Ladders: OSHA requires that ladders are well maintained to prevent structural defects and wear and tear, and that ladders are only used for their intended purpose.
  • Methods of electrical wiring: OSHA has established strict electrical standards to protect workers who are exposed to the dangers of electric shock, electrocution, explosions, and
  • Machine guarding: This general guarding standard also requires that machines are anchored to prevent dangerous movement.
  • General requirements for electrical work: Employers must install and care for equipment as the manufacturer intends.

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Massachusetts scaffolding accidents are extremely common. According to the Occupational Safety and Health Administration (OSHA), approximately 65 percent of construction workers use scaffolds regularly. The agency estimates that 50 workers die and 4,500 are injured annually in the U.S. due to scaffolding accidents. To combat this problem, OSHA releases workplace-accident information and safety standards every year. By maintaining standards that are at least as effective as OSHA’s, a workplace can dramatically reduce its risk of work-related accidents. Unfortunately, in an effort to save money and cut corners, these regulations are sometimes overlooked by employers and workers alike.

How to Prevent Scaffolding Accidents

Most scaffolding accidents are the result of user error, faulty equipment, improper construction of the scaffolding itself, or negligent maintenance. Workers can be seriously injured or killed when they are struck by a falling object, lose their footing and fall from the scaffolding, or when supports give way. The following tips can help you prevent injury or death in a scaffolding accident.

  • Inspect scaffolding prior to use. A daily visual inspection can help workers to more effectively detect damage, defects, or worn parts that should be replaced.
  • Follow manufacturer guidelines, such as specifications for set up and break down, and information about load capacities. A Boston work injury lawyer can help you determine how to proceed if you’ve been injured in a scaffolding accident.
  • Train workers regularly. Anyone working on or around scaffolding should receive proper training. In addition to general safety information, workers should be trained about that particular scaffold’s design, how to set it up and tear it down, and how to safely climb on and off the scaffolding.
  • Proper gear should be worn at all times. Safety gear, including hard hats, non-slip footwear, and harnesses should be well maintained and readily available for workers. Scaffolding should also be equipped with appropriate safety equipment, including toeboards, guardrails, and
  • Ensure that scaffolding is erected on stable ground. Never use unstable objects -such as bricks or concrete blocks – to support scaffolds.
  • Never exceed your scaffolding’s load capacity.
  • Keep scaffolding a safe distance – at least 10 feet – from power lines. A MA work injury lawyer can help you obtain the compensation you deserve if you’ve been injured in a scaffolding accident.
  • Clear debris and spills from scaffolding immediately. Falling debris can be deadly, and spilled liquids and other substances can result in slipping.

If you notice that any of the above guidelines aren’t being followed at your work site, speak to a supervisor immediately. If your supervisor doesn’t resolve the issue, you can always report the problem to OSHA. An agency representative will visit your work site to conduct a safety investigation. If violations are discovered, the company will need to immediately remedy the issue, and may be cited, fined, or both. Continue reading

Mesothelioma is a slow-growing cancer that forms in a thin layer of tissue surrounding certain internal organs, including the lungs, chest wall, and abdomen. Unfortunately, mesothelioma is often so advanced when discovered that long-term prognoses are rarely good. In fact, of the 50,000 people diagnosed with mesothelioma in 2013, approximately 34,000 succumbed to the disease. A skilled MA personal injury lawyer can help you determine how to proceed if you’ve been diagnosed with mesothelioma.

Causes of Mesothelioma

Prolonged exposure to asbestos is the number one cause of mesothelioma. Asbestos is a carcinogenic substance that was used as a type of insulation for years until a link to cancer and other respiratory illnesses was discovered in the late 1970s. That does not mean, however, that asbestos is no longer a concern. For starters, people who haven’t worked with asbestos in decades are still being diagnosed with mesothelioma annually. And asbestos remains a hazard of many occupations. The most common causes of mesothelioma include:

  • Occupational: Coal miners and construction workers have a significantly-higher risk of developing mesothelioma than other workers.
  • Environmental: Asbestos is a naturally-occurring substance. If you happen to live near a high concentration of asbestos, you have an increased risk of developing mesothelioma.
  • Exposure to asbestos in buildings: If you live, work, or attend school in a building that was built before 1980, asbestos may be present.

Symptoms of Mesothelioma

This particularly virulent form of cancer can grow for decades before being discovered. According to the Mesothelioma Center, there are four recognized stages of the disease.

  • Stage 1: Tiny tumors may develop within the lining of a lung. The disease hasn’t yet spread, so symptoms are generally non-existent at this stage.
  • Stage 2: As the tumors continue to grow, they may begin to spread to other parts of the chest cavity. Although symptoms may still be minor, or even non-existent, some symptoms may include chest pain, coughing, and difficulty breathing.
  • Stage 3: At this point, tumors may have reached the chest wall, diaphragm and heart lining. Cancer cells may have also spread to some, but not all, lymph nodes. Symptoms may still not be apparent. However, minor symptoms are likely to begin at this stage, and may include fever, difficulty breathing, coughing, weight loss, and chest pain.
  • Stage 4: By this stage, cancer cells have spread throughout the body. This is the most advanced stage of the disease and symptoms may include fever and night sweats, severe chest pain, difficulty breathing, weight loss, fatigue, abdominal pain, and a buildup of fluid in the abdomen or chest.

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Thousands of workers are injured every year due to becoming overheated at work. Some even die. Although these injuries spike during summer months, heat stress and heat stroke can occur throughout the year. The good news is that most of these injuries are entirely preventable. Read on for more information about workplace heat illnesses and how to dramatically reduce your risk of serious injury and death.

The body continuously regulates its internal temperature. When a person begins to overheat, the body attempts to cool itself through the process of sweating. When the air surrounding the person is cool enough, the sweating process is generally effective. But if the surrounding air is too warm, or the person’s clothing doesn’t allow the sweat to evaporate off the skin, the situation can become quite dangerous. This is a common hazard during summer months, but it can even occur in winter if indoor work environments have poor ventilation and air circulation. A Boston work injury lawyer can help you determine how to proceed if you’ve been injured on the job.

The four main medical issues that can arise when a person overheats are:

  • Heat cramps: When strenuous activity is coupled with a hot environment or clothing that prohibits proper sweating, heat cramps may occur. Heat cramps can be quite painful, and often result in muscle spasms. In addition to high internal temperatures, heat cramps can also be a result of dehydration and loss of salt in the body. If you develop heat cramps, immediately move to a cool place and rest. Drink plenty of fluids; sports drinks are good for replacing both fluid and If you are still experiencing heat cramps after one hour, contact your physician.
  • Heat rash: When the body sweats excessively because hot environmental temperatures or restrictive clothing prevent sweat from evaporating off the skin properly, the skin may become irritated. The small clusters of red pimples or blisters are often located on the neck or upper chest, under the breasts, in the groin, and on the inside of elbows. Heat rash can be treated by moving to a cooler area, and keeping the affected skin dry. Heat rash usually clears up on its own.
  • Heat exhaustion: When the body becomes unable to self-regulate its internal temperature, heat exhaustion may occur. Symptoms of heat exhaustion include heavy sweating, muscle cramps, weakness, dizziness, pale skin, severe headache, vomiting, and even fainting. The skin may actually feel cool to the touch. If you experience any of these symptoms, stop working immediately, move to a cool place, remove excessive clothing, and drink plenty of fluids. If the symptoms haven’t stopped within one hour, seek immediate medical attention. Heat exhaustion can turn into heat stroke if left untreated.
  • Heat stroke: When a person ignores the signs of heat exhaustion, or all attempts to cool down the body have failed, heat stroke may occur. In fact, the human body can rise to an internal temperature of more than 106 degrees Fahrenheit in less than 15 minutes. At that temperature, the brain and other important organs can suffer serious damage. Heat stroke can cause permanent disability. It can even be fatal. Symptoms of heat stroke include high body temperature, dry and red skin, absence of sweat, fast pulse, severe headache, dizziness, confusion, vomiting, and unconsciousness. If you suspect that you are suffering from heat stroke, move to a cool place and call for medical attention immediately.

A MA work injury lawyer can help you recover damages if you’ve been injured due to another’s negligence.

How to Prevent Heat Stroke in the Workplace

  • Workers should be made aware of the dangers of working in a hot environment.
  • Rotations and breaks should be used to prevent workers from remaining in hot environments for extended periods.
  • Cool areas and access to water should be made available to all workers.
  • Workers wearing protective gear that doesn’t breathe should be given more breaks and shorter rotations.
  • New workers should be gradually acclimated to higher temperatures.
  • Employers should consider the heat index – not just the temperature – when determining whether it’s safe to work outside, and for how long. Extreme caution should be used when the heat index reaches 90 degrees or above.

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Carpal tunnel syndrome (CTS) is a painful condition affecting the hand, fingers, and wrist. It occurs when the median nerve, which runs from the hand to the arm, becomes compressed where the hand and wrist meet. The condition is given its name due to the protective sheath covering the median nerve – the carpal tunnel. A person suffering from CTS may experience burning, tingling, numbness, and extreme pain in the palm of the hand.

Although CTS is often caused by work-related repetitive motions such as typing, proving that you have CTS – for the purpose of obtaining workers’ compensation benefits – is not always an easy task. If you are suffering from symptoms of CTS, the first step is to visit your doctor for an exam. CTS rarely gets better on its own. In fact, in most cases, symptoms will progress if left untreated. In addition to getting treatment for your CTS, a visit to the doctor will also establish a medical record of your condition, which can be immensely beneficial if you decide to file a workers’ comp claim. A Boston workers’ comp attorney can help you determine how to proceed if you are suffering from a work-related injury.

The Problem with Repetitive Stress Injuries

CTS injuries are often more difficult to prove than other work-related injuries. For starters, all repetitive motion injuries occur over time, rather than due to an isolated accident. Consider the following scenarios:

  • Bob falls from scaffolding and is knocked unconscious, prompting his co-workers to call an ambulance. At the hospital, doctors discover that Bob has a broken leg. As a result, Bob is unable to work for two months, incurring thousands of dollars in medical bills.
  • John works on an assembly line. After two years of assembling the same car parts over and over again, day in and day out, he develops extreme pain in his right hand. The debilitating pain makes it impossible for John to perform his job. John reports the pain to his supervisor who tells him to go to Rite-Aid and get a wrist brace if it’s bothering him.

Which of the above scenarios is more likely to end with a successful workers’ comp claim? The reality is, both Bob and John should be eligible for workers’ comp benefits. But Bob’s scaffolding accident and casted leg are easier to evaluate than John’s sudden complaint of pain in his hand. His employer might also argue that the wrist pain – even with an official carpal tunnel diagnosis – is a pre-existing condition. In either case, the help of a skilled MA workers’ comp attorney will help ensure that you get the benefits you deserve in a timely manner.

Carpal Tunnel Syndrome – Facts and Statistics

If you are suffering from CTS, you are not alone. It is the most common nerve disorder of the upper extremities.

  • Approximately five percent of the working population suffers from CTS.
  • CTS surgery is the most commonly-performed surgery of the hand and wrist, with more than 460,000 surgeries annually in the US.
  • According to the US Bureau of Labor and Statistics, almost two-thirds of work-related injuries to the upper body are due to repetitive trauma.
  • Women have twice the risk of developing CTS as men.

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Cranes are used on construction sites to move heavy objects. If not operated safely, they can be extremely dangerous. Crane accidents are a leading cause of serious injury and death in the construction industry. In fact, the most recent data available from the Bureau of Labor Statistics reveals that there were 818 crane-related fatalities in the 10 year period between 1997 and 2006. The reasons for these accidents vary widely, from mechanical failures to user error. Fortunately, most crane accidents are easily preventable. The following information looks at common causes of crane accidents and how to prevent them.

How to Prevent Crane Accidents

Because of their sheer size, weight and height, cranes can be deadly when misused or poorly maintained. Crane collapses, which may occur when weight limits are ignored or the crane is placed on an unstable surface, often result in death. According to the Occupational Health and Safety Administration (OSHA), the following conditions are crucial to the prevention of crane accidents:

  • All crane operators and related workers must receive proper training.
  • Crane equipment should be regularly maintained and inspected for the detection of equipment failures or defects.
  • Cranes and loads must be properly rigged.
  • Manufacturer-specified weight limits must be strictly observed.
  • Crane assembly and disassembly must be closely supervised.
  • Anyone working on or around a crane must be able to openly and effectively communicate with others working on or around the crane.
  • Cranes must be placed on stable ground.
  • Cranes must be a safe distance from power lines.

Electrocution

According to OSHA, nearly half of all overhead crane accidents occur when the crane makes contact with a power source. These accidents often result in the electrocution of anyone touching the crane when it comes into contact with a high-voltage power line. But even workers in close proximity to the crane can be seriously injured. In fact, nearly 200 workers die this way every year. A Boston work injury lawyer can help you determine how to proceed if you’ve been injured on the job.

Overloading

About 80 percent of all crane collapses can be attributed to overloading. When the crane’s operational capacity is exceeded, structural stress can result in structural failures and collapse. Swinging or suddenly dropping the load can also lead to collapse. Overloading is most often a direct result of human error, and can be prevented through proper training and supervision. Relying on instinct to determine whether a load is too heavy can lead to disaster. The use of load-measuring technologies can significantly reduce the risk of this potentially-deadly hazard. Continue reading

Serious construction accidents have been on the rise in recent years, especially in high-population areas, such as Boston, New York, and New Jersey. In response, safety advocates are pushing for increased training requirements for workers in the construction industry. New York City Mayor Bill de Blasio has announced his plan to implement additional construction worker training requirements, but the real estate industry has concerns. Why?

If de Blasio and New York union leaders achieve their goal and increase training requirements for the construction industry, workers will need to receive dozens of hours of additional training, which translates to higher real estate costs and less time to complete construction jobs. Politico reports that, “In response to a recent uptick in injuries and deaths, City Hall is proposing a requirement that all workers be trained between 54 and 71 hours.” And the extra training doesn’t stop there.

The “proposal would require an extra 30 hours of training for supervisors, and certain workers would have to undergo additional ‘task specific training,’ such as working in confined spaces and with scaffolding.” Extra training couldn’t be anything but positive for the safety and well-being of construction workers and the general public, but it’s evident why the real estate industry is concerned. Before the proposed deal is approved, however, it requires City Council approval. A MA work injury lawyer can help you determine how to proceed if you or a loved one has been injured in a work-related accident.

Construction Safety

It’s as-yet unknown whether the new proposal will pass. In the meantime, construction workers and employers can dramatically reduce the risk of serious injury or death by following the safety guidelines below:

  • Workers should always use personal protective equipment, such as safety goggles, foot protection, slip resistant, safety-toed boots, snug-fitting gloves, and a hard hat.
  • Scaffolds should meet all safety requirements established by the Occupational Safety and Health Administration (OSHA).
  • Where electrical work is being done, a lockout/tagout system should always be in place.
  • Extension cords should always have grounding prongs.
  • Multiple plug adapters should never be used at a construction site.
  • Where floor openings exist, a guardrail or appropriate cover should be used at all times.
  • Permanent floor openings should be framed with toeboards.
  • Where surfaces are elevated, post signs indicating a change in surface height.
  • Establish hazard communication protocol.
  • Only properly trained and qualified workers should operate cranes, and hoisting or rigging equipment.

In 2015, a total of 25 construction workers died on NYC construction sites, compared to 17 in 2011. Not surprisingly, undocumented immigrant workers have the greatest risk of serious injury or death on construction sites. A Boston work injury lawyer can help you recover damages if you’ve been injured in a work-related accident. Continue reading

Long term disability claims are made when you are injured and unable to perform your work duties without experiencing significant pain. It is not easy to obtain long term disability payments from an insurance company, and even if you are granted the benefits it does not guarantee that you will be able to keep them for an extended period of time.

You may lose access to your benefits for a number of reasons, including missed deadlines, a change in your disability, a change in your doctor’s opinion of what treatment you require or, possibly, the insurance company finding out that you don’t require the benefits consistently anymore.

In order to be eligible for benefits you must be able to prove that you require regular medical care in order to care for a disability that prevents you from performing your work duties. You must be able to prove that your injury or condition fits the insurance company’s definition of “disabled,” which may differ from your own definition or your doctor’s opinion. The insurance company’s definition is the only definition that matters.

Even if you are approved for benefits, this does not mean you are now free from continuing to prove your disability to the insurance company. You must continue to provide documentation to the insurance provider, in a timely manner, which proves you are receiving medical treatment for your disability or condition. In fact, the most common reason benefits are put on hold is because a deadline was missed to send documentation to the insurance company.

You may also have your benefits halted if the insurance company finds out that you no longer require the benefits. In some cases, insurance companies may actually hire or employ agents who check up on long term disability benefits recipients to see if they are truly disabled, and that they are truly encumbered to the level that their insurance claim reports them to be.

For example, if these inspections reveal that you were capable of raking your yard and digging a hole for a new mulberry bush, and you had been receiving long term disability claim benefits due to a back injury that prevented you from working your job as a landscaper, then the insurance company can use this as a reason to end your benefits package. They would, however, be required to notify you of this intention before cutting off the benefits.

If your benefits are suddenly ended

If you suddenly lose access to your long term disability payments, time is of the essence. You have a limited amount of time to file an appeal of this decision, and it will not be easy to prove that you deserve to keep the benefits once the insurance company has decided otherwise.

Certain cases, such as a missed deadline or a missing piece of medical documentation, may be easier to clear up than other cases, such as if the insurance company uncovers some type of proof that you were not as disabled as you once had been, or claimed to be.

The only way to ensure a good chance to continue receiving your benefits package is to consult with an attorney. A good attorney can pour over the details of your specific case, talk to your physicians and your insurance company and work out the specific reasons for why your benefits were cut off.

If there is an avenue to win your benefits back, the experienced legal team at Altman & Altman LLP will find it. We have over 40 years of experience going against insurance companies in court and advocating on behalf of our clients. We can take the necessary steps and time to make sure your case is properly argued and give you the best possible chance for success. Continue reading

Have you become injured and unable to perform your duties at work as a result? Did you apply for long term disability coverage through your insurance company only to be denied? What steps can you take from here? First, it is important to understand why your claim for long term disability may have been denied.

Your injury may not satisfy the insurance definition of “disabled”

Every insurance policy is different, especially policies that are intended to cover large bodies of people, such as a policy used by a workplace to insure their employees. Two common types of policies are “own occupation,” which define a disability by being medically unable to carry out the responsibilities of your specific job. “Any occupation” defines a disability as the medical inability to perform any job.

Certain policies carry certain exclusions as well. Pre-existing conditions are often excluded from long term disability coverage, and other disabilities that rely on diagnoses that aren’t quantifiable by proof – such as certain mental conditions – may only provide coverage for a limited amount of time.

You may not have provided enough evidence to prove your disability

To be granted long term disability benefits you must be able to prove that the benefits are essential to your continued livelihood. You must prove that the benefits will go towards necessary, continuous medical treatment. To do this, you must supply the insurance company with accurate, up-to-date medical records, such as test results.

Further, whether or not you receive benefits can hinge on a written statement of opinion from your physician. This statement should include all the medical reasons for why your disability impacts your ability to work, and how performing those duties would potentially cause you harm.

Appealing a denial

If you were denied a claim for long term disability but feel as though it was a wrongful denial, you may appeal the decision. You should review the insurance company’s long term disability police first and foremost, to make sure you didn’t miss a crucial element when submitting your claim. You can usually obtain a copy of the policy from your human resource department or from the insurer itself. Your right to obtain a copy of the policy is protected by federal law, so do not take no for an answer!

Look over the denial letter for the reason you were denied coverage. You may have missed important information or forgot to supply a key piece of information, like the opinion statement from your doctor. You should also hire an attorney at this point, who will help you organize your appeal. Additionally, hiring an attorney will show the insurance company that you mean business, and will not go away without a fight.

Working with an attorney, you may find that you have a limited time to appeal a decision, and therefore limited time to obtain any medical records, or undergo any additional necessary tests to prove the difficulties caused by your disability.

As with any case involving legal affairs, it is essential that you are working with consummate professionals who understand the law and treat your individual case with special care and attention. That is exactly the type of counsel we provide at Altman & Altman LLP. Continue reading

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