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	<title>Disability Happens &#187; Disability Insurance</title>
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	<description>And the journey to heal begins...</description>
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		<title>How &amp; Where to report VA abuse and fraud</title>
		<link>http://www.disabilityhappens.com/how-where-to-report-va-abuse-and-fraud.html</link>
		<comments>http://www.disabilityhappens.com/how-where-to-report-va-abuse-and-fraud.html#comments</comments>
		<pubDate>Mon, 24 Mar 2008 11:11:02 +0000</pubDate>
		<dc:creator>Richard Brassaw</dc:creator>
				<category><![CDATA[Disability Insurance]]></category>
		<category><![CDATA[Fraud]]></category>
		<category><![CDATA[Insurance]]></category>
		<category><![CDATA[Insurance Claims]]></category>
		<category><![CDATA[Veterans]]></category>

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		<description><![CDATA[War veterans who suffer physical and emotion illness frequently suffer financial hardships due to their inability to find suitable employment. Veterans Affairs (VA) offers substantial medical services and benefits to those who have suffered a disability. Unfortunately, the VA disability benefits can serve as an incentive to commit fraud and abuse. Psychiatric disabilities, like Post Traumatic [...]]]></description>
			<content:encoded><![CDATA[<p>War veterans who suffer physical and emotion illness frequently suffer financial hardships due to their inability to find suitable employment. Veterans Affairs (VA) offers substantial medical services and benefits to those who have suffered a disability.</p>
<p>Unfortunately, the VA disability benefits can serve as an incentive to commit fraud and abuse. Psychiatric disabilities, like Post Traumatic Stress Disorder (PTSD), is one area that has seen a substantial increase of claims. One study of veterans seeking a PTSD disability claim found that 69% of those veterans scored higher for symptoms of malingering than the control group of non compensation seeking veterans on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2).</p>
<p>Just because someone does not appear to have a disability does it mean their claim is fraudulent. Before acting on your instincts to report fraud it is best to find out why they are receiving those benefits. If you have ever thought that someone in a handicap parking space looks healthy, but later come to learn that they are waiting for a kidney transplant, you learn not to judge by appearances. Another example is someone who often experiences seizures.</p>
<p>Because PTSD is not a affliction that can be measured it is difficult to determine who is a malingerer and who legitimately suffers from the disorder. There are legitimate psychological and mental impairments for collecting disability.</p>
<p>Before reporting a fraudulent claimant you need to understand more about their exact disability and to become familiar with the conditions/symptoms of their disability. Once you are familiar with their diagnosis and the symptoms of their disorder, then you need to consider things that are incongruent between their behavior and their diagnosis. That in-congruency is something the VA wants to know about.</p>
<p>You can contact the Department of Veterans Affairs&#8217; hotline at (800) 488-8244, between 8:30 am &#8211; 4:00 pm EST, Monday through Friday&#8211;excluding Federal holidays. Write the VA hotline at: VA Inspector General Hotline (53E), P.O. Box 50410, Washington, DC 20091-0410. Or contact them by email: <a href="mailto:vaoighotline@va.gov">vaoighotline@va.gov</a></p>
<p>The types of complaints the VA hotline accepts:</p>
<ul>
<li>Employee misconduct.</li>
<li>Patient abuse.</li>
<li>Serious safety violations.</li>
<li>Theft from VA beneficiaries.</li>
<li>Theft or misuse of Government property.</li>
<li>False claims by beneficiaries, claimants, patients, employees, or contractors.</li>
<li>Systemic problems with VA programs or operations.</li>
<li>Gross waste of funds or official time.</li>
</ul>
<p>The VA hotline will want to know:</p>
<ul>
<li>The particular VA facility or office involved.</li>
<li>The identity of the wrongdoer(s) and victim(s).</li>
<li>The alleged legal or policy violation(s) or other misconduct.</li>
<li>The effect of the wrongdoing, such as dollars lost, delay produced, etc.</li>
<li>The date(s) when the event(s) occurred.</li>
<li>The identity of any witness(es) to the event(s).</li>
<li><strong>Copies</strong> of relevant documents that support the allegation.</li>
<li>Whether anyone else has already reviewed the allegation.</li>
<li>An address and telephone number of a named complainant and whether the complainant wishes confidentiality.</li>
</ul>
<p>The VA does <strong>NOT</strong> want to know about:</p>
<ul>
<li><a target="_blank" href="http://www.vba.va.gov/">Claim for VA disability and pension benefits, and ratings, appeals, or home loan issues</a>.</li>
<li><a target="_blank" href="https://www.gibill2.va.gov/vba/vba.cfg/php.exe/enduser/std_alp.php">Claim for VA education benefits</a>.</li>
<li><a target="_blank" href="https://iris.va.gov/Scripts/iris.cfg/php.exe/enduser/std_adp.php?p_faqid=556">Patient health care dispute</a>.</li>
<li><a target="_blank" href="http://www.va.gov/OGC/">Tort claim or other legal issue/case/claim</a>.</li>
<li>Litigation matters.</li>
<li><a target="_blank" href="http://www.flra.gov/">Employee grievances, unfair labor practices, union matters</a>.</li>
<li><a target="_blank" href="http://www.osc.gov/ppp.htm">Whistle blower retaliation issues</a>.</li>
<li><a target="_blank" href="http://www.osc.gov/wbdisc.htm">Whistle blower disclosures not related to the VA</a>.</li>
<li><a target="_blank" href="http://www.va.gov/orm/">Discrimination and EEO complaints for VA employees, former VA employees, and applicants for VA positions</a>.</li>
<li><a target="_blank" href="http://www.dol.gov/vets/aboutvets/contacts/main.htm">Discrimination and complaints related to the Uniformed Services Employment and Reemployment Rights Act (USERRA).</a></li>
<li><a target="_blank" href="http://www.mspb.gov/sites/mspb/default.aspx/">Personnel Actions/Adverse action appeals/MSPB matters</a>.</li>
<li>Disagreement with law or other political dispute.</li>
</ul>
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		</item>
		<item>
		<title>How you can unwittingly help disability insurance companies deny your claim</title>
		<link>http://www.disabilityhappens.com/how-you-can-unwittingly-help-disability-insurance-companies-deny-your-claim.html</link>
		<comments>http://www.disabilityhappens.com/how-you-can-unwittingly-help-disability-insurance-companies-deny-your-claim.html#comments</comments>
		<pubDate>Wed, 17 Oct 2007 11:15:42 +0000</pubDate>
		<dc:creator>Richard Brassaw</dc:creator>
				<category><![CDATA[Bad Faith]]></category>
		<category><![CDATA[Denied]]></category>
		<category><![CDATA[Disability Insurance]]></category>
		<category><![CDATA[Fraud]]></category>
		<category><![CDATA[Insurance]]></category>
		<category><![CDATA[Insurance Claims]]></category>
		<category><![CDATA[Workers Comp]]></category>

		<guid isPermaLink="false">http://www.disabilityhappens.com/how-you-can-unwittingly-help-disability-insurance-companies-deny-your-claim.html</guid>
		<description><![CDATA[You have probably seen surveillance footage of a fraudulent disability insurance claimant who claims to have a bad back, but is caught on camera lifting a heavy carton. What the cameras do not show is the legitimate disability claimant who is denied benefits by their insurance company. Unless you know someone personally who has been [...]]]></description>
			<content:encoded><![CDATA[<p>You have probably seen surveillance footage of a fraudulent disability insurance claimant who claims to have a bad back, but is caught on camera lifting a heavy carton. What the cameras do not show is the legitimate disability claimant who is denied benefits by their insurance company.</p>
<p>Unless you know someone personally who has been denied disability benefits from an insurance company, you might harbor a suspicion that claim denial is generally because the insurance company suspects fraud. After all, you never hear about the insurance company committing fraud on its own clients. However, voluminous court cases will attest that insurance companies are notorious for denying disability insurance. This is especially true when the claimant makes over $50,000 a year.</p>
<p>The reason you seldom, if ever, hear about insurance companies committing this type of fraud is commonly for one of 3 reasons.</p>
<ol>
<li>The claimant is broke and trying to keep food in their belly and a roof over their head. Dealing with both the financial cost and physical pain of their disability leaves little time, or energy, to fight the insurance companies.</li>
<li>Less than 6% of the people who have been denied their disability benefits will sue the insurance company. This might be due to the fact that the insurance companies have successfully lobbied many states to change their laws to favor the insurance companies.</li>
<li>Insurance companies have been known to offer a claimant a partial settlement, along with a warning, that if the claimant does sue (and is successful) it will be years before they see any money. For example, if they have a policy worth a half-million they might be offered $50,000 to settle now or wait for whatever money the suit will bring. The insurance companies have lobbied for laws that restrict any awards to the face value of the policy. All settlement payments are given with the stipulation that a non-disclosure form be signed. That is why you <em>never</em> hear about this type of settlement.</li>
</ol>
<p>A new wrinkle has surfaced in how insurance companies are taking the spotlight off of themselves for denial and have shifted it to a new group called Certified Rehabilitation Counselors (CRC).  <a target="_blank" href="http://www.crccertification.com/">The Commission on Rehabilitation Counselor Certification</a> (CRCC) certifies and sets standards for rehabilitation counseling in the United States and Canada. It is an non-profit organization with over 35,000 members.</p>
<p>When you file a disability claim one of the first things that will be requested by the insurance company is a list of skills required to do your job. What is not explained to you is that if you can do any one of those skills, that you have listed, you can be denied disability benefits.</p>
<p>The analysis of what marketable skills you have is often performed by a CRC member. It is their job to report to the insurance company if you can be employed with the skill set that remains available to you. It appears that the insurance companies are applying pressure to CRC members to help them in their denial of disability claims. At least that is indicated in a recent survey of 7,660 members.</p>
<p><a target="_blank" href="http://www.crccertification.com/downloads/30code/J-excecutive/Executive_Summary.htm">The CRCC survey</a> queried members about their perceptions of ethical dilemmas and implications for code of ethics revisions. At the top of the list, members were most concerned about being pressured by their employer, followed by confidentiality and exceptions to confidentiality. When members were asked about what concerns they foresee in the future they responded that their concerns for the future are the same as they are today&#8211;employer pressures and issues regarding confidentiality.</p>
<p>Some interpret the CRCC survey as further proof that the insurance companies are creating a firewall to burn their claimants. The insurance companies have taken the spotlight off themselves and shifted the attention to the certified rehabilitation counselors. A site that is pursuing this line of activity is <a target="_blank" href="http://www.thetsascam.com/">The TSA Scam</a>.</p>
]]></content:encoded>
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		<slash:comments>4</slash:comments>
		</item>
		<item>
		<title>Military denies benefits based on genetics</title>
		<link>http://www.disabilityhappens.com/military-denies-benefits-based-on-genetics.html</link>
		<comments>http://www.disabilityhappens.com/military-denies-benefits-based-on-genetics.html#comments</comments>
		<pubDate>Wed, 22 Aug 2007 09:59:07 +0000</pubDate>
		<dc:creator>Richard Brassaw</dc:creator>
				<category><![CDATA[Denied]]></category>
		<category><![CDATA[Disability Insurance]]></category>
		<category><![CDATA[Veterans]]></category>

		<guid isPermaLink="false">http://www.disabilityhappens.com/military-denies-benefits-based-on-genetics.html</guid>
		<description><![CDATA[Karen Kaplan&#8217;s August 18, Los Angeles Times article, U.S. military practices genetic discrimination in denying benefits, tells how the U.S. Military denies disability benefits to both active and veteran military personnel. The problem began in 1999, when the Office of Management and Budget (OMB) decided that soldiers with a genetic predisposition for a disease will be denied benefits for [...]]]></description>
			<content:encoded><![CDATA[<p>Karen Kaplan&#8217;s August 18, Los Angeles Times article, <em><a target="_blank" href="http://www.latimes.com/news/science/la-sci-genes18aug18,0,2650215.story?page=1&amp;coll=la-home-center">U.S. military practices genetic discrimination in denying benefits</a></em>, tells how the U.S. Military denies disability benefits to both active and veteran military personnel.</p>
<p>The problem began in 1999, when the Office of Management and Budget (OMB) decided that soldiers with a genetic predisposition for a disease will be denied benefits for that disease until they have served for a minimum of 8-years. The reasoning proffered is to discourage individuals with a probability of developing a congenital and/or hereditary condition from joining the services in order to receive medical and disability benefits when (and if) the disease develops.</p>
<p>Although someone might have a predisposition for an illness it is not always caused by genetic factors. For example, there is a genetic mutation carried in about 5% of Caucasians for developing blood clots, but individuals outside that genetic group can also develop blood clots in their legs (thrombophlebitis) after sitting for long periods. That is the main reason physicians recommend that you get up and stretch during long plane flights.</p>
<p>The situation has become so treacherous that some Army physicians recommend that soldiers refuse any and all genetic tests. In case the soldier thinks that he can by-pass the system by having a genetic test done through a civilian physician, they could easily find themselves in serious trouble. Turns out that a private genetic test violates military code and they could be court-martialed.</p>
]]></content:encoded>
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		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>What is new in Veterans disability benefits?</title>
		<link>http://www.disabilityhappens.com/what-is-new-in-veterans-disability-benefits.html</link>
		<comments>http://www.disabilityhappens.com/what-is-new-in-veterans-disability-benefits.html#comments</comments>
		<pubDate>Sun, 29 Jul 2007 05:34:20 +0000</pubDate>
		<dc:creator>Richard Brassaw</dc:creator>
				<category><![CDATA[Disability Insurance]]></category>
		<category><![CDATA[Veterans]]></category>

		<guid isPermaLink="false">http://www.disabilityhappens.com/what-new-in-veterans-disability-benefits.html</guid>
		<description><![CDATA[The U.S. Government Accountability Office (GAO) provides the most recent reports and testimonies related to military and veteran&#8217;s health care and disability benefits issued since March 2003. Currently there are 28 items listed related to veterans disability benefits. GAO Findings and Recommendations Regarding DOD and VA Disability Systems GAO-07-906R, May 25, 2007 Abstract   PDF    Veterans Benefits [...]]]></description>
			<content:encoded><![CDATA[<p>The U.S. Government Accountability Office (GAO) provides the most recent reports and testimonies related to military and veteran&#8217;s health care and disability benefits issued since March 2003. <a target="_blank" href="http://www.gao.gov/docsearch/featured/healthcaredisabilitybenefits.html#Disability_benefits">Currently there are 28 items listed related to veterans disability benefits</a>.</p>
<ul>
<li><strong>GAO Findings and Recommendations Regarding DOD and VA Disability Systems<br />
</strong><a target="blank" href="http://www.gao.gov/new.items/d07906r.pdf">GAO-07-906R</a>, May 25, 2007<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-07-906R" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/new.items/d07906r.pdf" class="result">PDF</a>   </li>
<li>Veterans Benefits Administration:<br />
<strong>Progress Made in Long-Term Effort to Replace Benefits Payment System, but Challenges Persist </strong><a target="blank" href="http://www.gao.gov/new.items/d07614.pdf"><br />
GAO-07-614</a>, April 27, 2007<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-07-614" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d07614high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d07614.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d07614.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Disability Benefits: Processing of Claims Continues to Present Challenges</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d07562t.pdf">GAO-07-562T</a>, March 13, 2007<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-07-562T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d07562thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d07562t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d07562t.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Disability Benefits: Long-Standing Claims Processing Challenges Persist</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d07512t.pdf">GAO-07-512T</a>, March 7, 2007<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-07-512T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d07512thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d07512t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d07512t.html" class="result">Accessible Text</a></li>
<li><strong>High Risk Series: An Update</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d07310.pdf">GAO-07-310</a>, January 31, 2007<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-07-310" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d07310high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d07310.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d07310.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Disability Benefits: VA Can Improve Its Procedures for Obtaining Military Service Records</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d0798.pdf">GAO-07-98</a>, December 12, 2006<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-07-98" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d0798high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d0798.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d0798.html" class="result">Accessible Text</a></li>
<li><strong>Military Personnel: DOD Needs an Oversight Framework and Standards to Improve Management of Its Casualty Assistance Programs</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d061010.pdf">GAO-06-1010</a>, September 22, 2006<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-1010" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d061010high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d061010.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d061010.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Disability Benefits: VA Should Improve Its Management of Individual Unemployability Benefits by Strengthening Criteria, Guidance, and Procedures</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d06309.pdf">GAO-06-309</a>, May 30, 2006<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-309" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d06309high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d06309.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d06309.html" class="result">Accessible Text</a></li>
<li><strong>Disability Benefits: Benefit Amounts for Military Personnel and Civilian Public Safety Officers Vary by Program Provisions and Individual Circumstances</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d064.pdf">GAO-06-4</a>, April 7, 2006<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-4" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d064high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d064.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d064.html" class="result">Accessible Text</a></li>
<li><strong>Military Disability Evaluation: Ensuring Consistent and Timely Outcomes for Reserve and Active Duty Service Members</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d06561t.pdf">GAO-06-561T</a>, April 6, 2006<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-561T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d06561thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d06561t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d06561t.html" class="result">Accessible Text</a></li>
<li><strong>Military Disability System: Improved Oversight Needed to Ensure Consistent and Timely Outcomes for Reserve and Active Duty Service Members</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d06362.pdf">GAO-06-362</a>, March 31, 2006<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-362" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d06362high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d06362.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d06362.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Benefits: Further Changes in VBA&#8217;s Field Office Structure Could Help Improve Disability Claims Processing</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d06149.pdf">GAO-06-149</a>, December 9, 2005<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-149" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d06149high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d06149.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d06149.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Disability Benefits: Claims Processing Challenges and Opportunities for Improvements</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d06283t.pdf">GAO-06-283T</a>, December 7, 2005<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-283T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d06283thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d06283t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d06283t.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Disability Benefits: Improved Transparency Needed to Facilitate Oversight of VBA&#8217;s Compensation and Pension Staffing Levels</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d06225t.pdf">GAO-06-225T</a>, November 3, 2005<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-225T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d06225thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d06225t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d06225t.html" class="result">Accessible Text</a></li>
<li><strong>VA Benefits: Other Programs May Provide Lessons for Improving Individual Unemployability Assessments</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d06207t.pdf">GAO-06-207T</a>, October 27, 2005<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-207T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d06207thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d06207t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d06207t.html" class="result">Accessible Text</a></li>
<li><strong>VA Disability Benefits: Routine Monitoring of Disability Decisions Could Improve Consistency</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d06120t.pdf">GAO-06-120T</a>, October 20, 2005<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-120T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d06120thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d06120t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d06120t.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Disability Benefits: VA Could Enhance Its Progress in Complying with Court Decision on Disability Criteria</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d0646.pdf">GAO-06-46</a>, October 12, 2005<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-06-46" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/new.items/d0646.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d0646.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Disability Benefits: Claims Processing Problems Persist and Major Performance Improvements May Be Difficult</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d05749t.pdf">GAO-05-749T</a>, May 26, 2005<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-05-749T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d05749thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d05749t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d05749t.html" class="result">Accessible Text</a></li>
<li><strong>VA Disability Benefits: Board of Veterans&#8217; Appeals Has Made Improvements in Quality Assurance, but Challenges Remain for VA in Assuring Consistency</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d05655t.pdf">GAO-05-655T</a>, May 5, 2005<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-05-655T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d05655thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d05655t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d05655t.html" class="result">Accessible Text</a></li>
<li><strong>VA Disability Benefits and Health Care: Providing Certain Services to the Seriously Injured Poses Challenges</strong> <a target="blank" href="http://www.gao.gov/new.items/d05444t.pdf"><br />
GAO-05-444T</a>, March 17, 2005<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-05-444T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d05444thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d05444t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d05444t.html" class="result">Accessible Text</a></li>
<li><strong>Veterans Benefits: VA Needs Plan for Assessing Consistency of Decisions</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d0599.pdf">GAO-05-99</a>, November 19, 2004<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-05-99" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/new.items/d0599.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d0599.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Benefits: More Transparency Needed to Improve Oversight of VBA&#8217;s Compensation and Pension Staffing Levels</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d0547.pdf">GAO-05-47</a>, November 15, 2004<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-05-47" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d0547high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d0547.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d0547.html" class="result">Accessible Text</a></li>
<li><strong>Veterans&#8217; Benefits: Improvements Needed in the Reporting and Use of Data on the Accuracy of Disability Claims Decisions</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d031045.pdf">GAO-03-1045</a>, September 30, 2003<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-03-1045" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d031045high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d031045.pdf" class="result">PDF</a>   </li>
<li><strong>VA Benefits: Fundamental Changes to VA&#8217;s Disability Criteria Need Careful Consideration<br />
</strong><a target="blank" href="http://www.gao.gov/new.items/d031172t.pdf">GAO-03-1172T</a>, September 23, 2003<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-03-1172T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/new.items/d031172t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d031172t.html" class="result">Accessible Text</a></li>
<li><strong>Veterans Benefits Administration: Process for Preventing Improper Payments to Deceased Veterans Can Be Improved</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d03906.pdf">GAO-03-906</a>, July 24, 2003<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-03-906" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/new.items/d03906.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d03906.html" class="result">Accessible Text</a></li>
<li><strong>Department of Veterans Affairs: Key Management Challenges in Health and Disability Programs</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d03756t.pdf">GAO-03-756T</a>, May 8, 2003<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-03-756T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d03756thigh.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d03756t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d03756t.html" class="result">Accessible Text</a></li>
<li><strong>Veterans Benefits Administration: Better Collection and Analysis of Attrition Data Needed to Enhance Workforce Planning</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d03491.pdf">GAO-03-491</a>, April 28, 2003<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-03-491" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/highlights/d03491high.pdf" class="result">Highlights-PDF</a>   <a target="blank" href="http://www.gao.gov/new.items/d03491.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d03491.html" class="result">Accessible Text</a></li>
<li><strong>Military and Veterans&#8217; Benefits: Observations on the Concurrent Receipt of Military Retirement and VA Disability Compensation</strong><br />
<a target="blank" href="http://www.gao.gov/new.items/d03575t.pdf">GAO-03-575T</a>, March 27, 2003<br />
<a target="blank" href="http://www.gao.gov/docsearch/abstract.php?rptno=GAO-03-575T" class="result">Abstract</a>   <a target="blank" href="http://www.gao.gov/new.items/d03575t.pdf" class="result">PDF</a>   <a target="blank" href="http://www.gao.gov/htext/d03575t.html" class="result">Accessible Text</a></li>
</ul>
]]></content:encoded>
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		<title>Bad faith insurance companies</title>
		<link>http://www.disabilityhappens.com/bad-faith-insurance-companies.html</link>
		<comments>http://www.disabilityhappens.com/bad-faith-insurance-companies.html#comments</comments>
		<pubDate>Thu, 26 Jul 2007 06:53:28 +0000</pubDate>
		<dc:creator>Richard Brassaw</dc:creator>
				<category><![CDATA[Bad Faith]]></category>
		<category><![CDATA[Denied]]></category>
		<category><![CDATA[Disability Insurance]]></category>
		<category><![CDATA[Fraud]]></category>
		<category><![CDATA[Insurance]]></category>
		<category><![CDATA[Insurance Claims]]></category>

		<guid isPermaLink="false">http://www.disabilityhappens.com/bad-faith-insurance-companies.html</guid>
		<description><![CDATA[Fight Bad-faith Insurance Companies (FBIC) is an excellent site on getting the low-down on your insurance company. In previous posts it has been mentioned that there are no Federal or State laws that specifically regulate insurance policies. Sure, there are rules and regulations on how insurance companies conduct business, but when it comes to how [...]]]></description>
			<content:encoded><![CDATA[<p><em><a target="_blank" href="http://www.badfaithinsurance.org/">Fight Bad-faith Insurance Companies</a></em> (FBIC) is an excellent site on getting the low-down on your insurance company. In previous posts it has been mentioned that <a href="http://www.disabilityhappens.com/how-erisa-makes-your-long-term-disability-policy-worthless.html">there are no Federal or State laws that specifically regulate insurance policies</a>. Sure, there are rules and regulations on how insurance companies conduct business, but when it comes to how policies should be written or enforced there are NO LAWS.</p>
<p>The worst insurance policy to have is a long-term disability (LTD) policy that falls under the guidelines of Employee Retirement Income Security Act (ERISA). If you make a claim on an ERISA covered LTD policy and have been denied benefits, you will be unlikely to find an attorney to pursue the matter. The major obstacles to finding an attorney to handle your lawsuit are that you must sue in Federal court, you are unable to collect attorney fees if you do prevail, and punitive damages cannot be awarded.</p>
<p>You will not have much luck with your state&#8217;s Department of Insurance (DOI) either. Of all the state DOI&#8217;s, California is probably the most effective one, and even it is powerless when it comes to a LTD policy covered by ERISA. In fact, no state regulates ERISA insurance policies. The state DOI&#8217;s only regulate how the insurance company conducts business in the state&#8212;not the policy itself.</p>
<p>What surprises most people is that no state will sue an insurance company on behalf of a policy holder. A state DOI will levy fines against an insurance company for fraud and criminal behavior, but even those fines are relatively rare.</p>
]]></content:encoded>
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		<title>Veterans file class action against Department of Veterans Affairs</title>
		<link>http://www.disabilityhappens.com/veterans-file-class-action-against-department-of-veterans-affairs.html</link>
		<comments>http://www.disabilityhappens.com/veterans-file-class-action-against-department-of-veterans-affairs.html#comments</comments>
		<pubDate>Wed, 25 Jul 2007 00:13:36 +0000</pubDate>
		<dc:creator>Richard Brassaw</dc:creator>
				<category><![CDATA[Denied]]></category>
		<category><![CDATA[Disability Insurance]]></category>
		<category><![CDATA[Insurance Claims]]></category>
		<category><![CDATA[Veterans]]></category>

		<guid isPermaLink="false">http://www.disabilityhappens.com/veterans-file-class-action-against-department-of-veterans-affairs.html</guid>
		<description><![CDATA[Veterans Adminstration (VA) Secretary Jim Nicholson has been accused by injured Iraq war veterans of denying them benefits. The class action suit was filed on behalf of hundreds of thousands of veterans. Attorneys filing the class action said that the objective is not monetary. What they want is for the VA to provide the mental [...]]]></description>
			<content:encoded><![CDATA[<p><a target="_blank" href="http://www.freep.com/apps/pbcs.dll/article?AID=/20070724/NEWS07/707240396/1001/NEWS">Veterans Adminstration (VA) Secretary Jim Nicholson has been accused by injured Iraq war veterans of denying them benefits</a>. The class action suit was filed on behalf of hundreds of thousands of veterans. Attorneys filing the class action said that the objective is not monetary. What they want is for the VA to provide the mental and physical disability benefits and treatments the veterans are already entitled to receive.</p>
<p>The complaint in part reads: &#8220;Unless systemic and drastic measures are instituted immediately, the costs to these [Iraq] veterans, their families, and our nation will be incalculable, including broken families, a new generation of unemployed and homeless veterans, increase in drug abuse and alcoholism, and crushing burdens on the health care delivery system.&#8221;</p>
<p>Earlier this month the 9th Circuit Federal Court in San Francisco issued a strong rebuke directed at the VA. The VA was ordered to provide retroactive benefits to Vietnam War veterans who were exposed to Agent Orange and contracted a form of leukemia.</p>
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		<title>Long-term disability claimants make perfect victims</title>
		<link>http://www.disabilityhappens.com/long-term-disability-claimants-make-perfect-victims.html</link>
		<comments>http://www.disabilityhappens.com/long-term-disability-claimants-make-perfect-victims.html#comments</comments>
		<pubDate>Tue, 24 Jul 2007 00:41:57 +0000</pubDate>
		<dc:creator>Richard Brassaw</dc:creator>
				<category><![CDATA[Bad Faith]]></category>
		<category><![CDATA[Denied]]></category>
		<category><![CDATA[Disability Insurance]]></category>
		<category><![CDATA[Insurance]]></category>
		<category><![CDATA[Insurance Claims]]></category>
		<category><![CDATA[Insurance Companies]]></category>

		<guid isPermaLink="false">http://www.disabilityhappens.com/long-term-disability-claimants-make-perfect-victims.html</guid>
		<description><![CDATA[A few years ago someone close to me became disabled. She had purchased a long-term disability (LTD) policy with CNA insurance and felt fortunate to have the policy. She was brought up with a strong work ethic, this, coupled with the fact that she immensely enjoyed her job, only increased the emotional pain of not [...]]]></description>
			<content:encoded><![CDATA[<p><iframe scrolling="no" frameBorder="0" src="http://rcm.amazon.com/e/cm?t=findingroma0d-20&amp;o=1&amp;p=8&amp;l=as1&amp;asins=1576753492&amp;fc1=000000&amp;IS2=1&amp;lt1=_blank&amp;lc1=0000FF&amp;bc1=FFFFFF&amp;bg1=FBFBFB&amp;f=ifr" marginHeight="0" marginWidth="0" style="width: 120px; height: 240px"></iframe>A few years ago someone close to me became disabled. She had purchased a long-term disability (LTD) policy with CNA insurance and felt fortunate to have the policy.</p>
<p>She was brought up with a strong work ethic, this, coupled with the fact that she immensely enjoyed her job, only increased the emotional pain of not working. Regardless of how much she wanted to return to work, the physical pain was too great to overcome. Eventually her injury required surgery which, unfortunately, only made matters worse.</p>
<p>For the first 3 months of her disability, she had short term disability insurance through her employer&#8217;s insurance.  For the balance of the first year, CNA&#8217;s LTD policy co-paid with the State of California&#8217;s Disability Insurance (SDI) benefits.  At the end of the year, when California&#8217;s State Disability Insurance was about to run out, she received a letter from CNA saying that they were denying her any future payments because they felt she should be better. It was odd that they said that because all 6 of her medical doctors said she was 100% disabled. Even odder still is that she was never examined by any represenative of CNA insurance.</p>
<p>She was not getting any better and, if anything, her situation was deteriorating under the stress of not knowing how she was going to be able to pay the rent and day-to-day bills. Fortunately, her car was paid for.  Unfortunately, like so many others faced with medical expenses she was using credit cards to live and eventually was forced into bankruptcy.</p>
<p>Like so many disabled individuals who find it difficult to muster the energy to fight a deep pocket insurance company, she needed help in working through the insurance company&#8217;s labyrinth of mythical proportions. </p>
<p>I tried to find an attorney who would be able to help her. Phone call after phone call to attorneys who handle insurance claims were met with the same response after telling them of my friend&#8217;s denial by the LTD insurance company&#8212;laughter. After a half-dozen phone calls, I found an attorney who didn&#8217;t laugh after explaining to him about her situation. I asked him why no one seemed interested in a case that was obviously a miscarriage of her legal rights.</p>
<p>He explained that chances are her LTD policy fell under the Employee Retirement Income Security Act (ERISA) and there wasn&#8217;t much that could be done. The only chance she would ever have of collecting any money was if the claim did not fall under ERISA guidelines and could be heard in California State Court. Even then, he was not in the position of mounting that kind of lawsuit against a deep pocket insurance company.</p>
<p>That happened several years ago. I was finally able to locate a law firm familiar with ERISA and after reviewing her case was willing to take on CNA. At first, after wading through the contracts, it seemed clear that her claim against CNA insurance actually did not fall under ERISA guidelines and that the case could and should be heard in a California state court. Unfortunately, the plaintiff&#8217;s lawyer&#8217;s were out maneuvered by CNA&#8217;s attorneys. Apparently, somewhere along the line, CNA provided new material that made references to ERISA. Though not the orignial contract which she possessed (which indicated that she, not the company, had purchased the LTD insurance from CNA) , the new material made references to ERISA. </p>
<p>This new material, and a case elevated to the 9th Circuit Court that was &#8216;similar&#8217; to my friend&#8217;s and which had just been denied the right to litigate in State Court, meant to her attornies, that the chances of recovery were slim to none. The law firm had forewarned her that they would not be able to handle the case if it was deemed to fall within ERISA&#8217;s guidelines because it would then fall under Federal Court which made no provisions for attorney&#8217;s fees.</p>
<p>Fortunately, after being turned down the first time (common practice) and obtaining a social security attorney, SSDI approved her claim for 100% disability. After filing for bankruptcy, and moving to a lower income area she was then able to keep from having to live in her car.</p>
<p>As Ray Bourhis says in his book, <em>Insult to Injury</em>, the last thing you want to think about is your long-term disability insurance. That is until you are permanently disabled, then it is the only thing you can think about.</p>
<p>The book tells the story of Dr. Joan Hangarter&#8217;s legal nightmare dealing with UnumProvident. Unlike my friend&#8217;s LTD, her policy was not subject to ERISA guidelines.</p>
<p>UnumProvident initially paid on Dr. Hangarter&#8217;s LTD claim, but after 2 years sent her a denial letter informing her that in the insurance company&#8217;s eyes she was better and was able to return to work. It didn&#8217;t matter that Dr. Hangarter was forced to sell her chiropractic office, that she would have to lose her car and be forced into bankruptcy. It didn&#8217;t matter that she no longer could perform the one thing that she loved 2nd only to her children&#8211;that is ability to help people heal as a chiropractor.</p>
<p>Penniless, on welfare, and with little hope, Dr. Hangarter sought out legal help. She was fortunate to find Ray Bourhis and partners. Through Bourhis&#8217; often sardonic wit he provides a real life example of how a non-ERISA LTD insurance claim is denied and why the insurance company is seldom forced to pay. Those who have policies that fall under ERISA have little hope of ever seeing a dime of benefits from their policy once it has been denied. It will not matter if they are parapalegic, suffering from Parkinson&#8217;s disease, even unable to walk across the room without assistance.</p>
<p>The reason you do not often hear about the problems with LTD claims being denied is that the insurance companies know that someone disabled, penniless and on welfare, is rarely going to pose a problem either legally or through bad press. Those that do make noise are sometimes offered a settlement. The policy might be worth over $500,000 over time, but the claimant is offered $50,000 and told to sign the agreement and not to discuss their settlement with anyone. They are told if they do not accept the $50,000 they risk getting nothing because, even if they do prevail in court, it will be appealed and they promise it will be a long time before they will see any money.</p>
<p>For those few lucky souls who do take their LTD insurance company to court on a bad-faith claim and prevail, they are often told to sign a non-disclosure form or the insurance company will appeal the case. Most people sign&#8212;and that is why you do not hear about these cases.</p>
<p>The insurance companies refute much of what is documented in Bourhis&#8217; book. The claim they make most often is that they pay out billions in disability claims. For the most part they do, but those payouts are mainly for short-term disability; like broken arms and legs. What they refuse to share publicly is the percentage of long-term disability claims that they deny. Although it cannot be documented, it appears that if your income is around $50,000 or above you are likely to be targeted for denial of a LTD claim. It is estimated that denying just 10% of those claims amounts to billions over a decade.</p>
<p>If you have a LTD policy you really need to read this book. If you have recently become disabled and are counting on a LTD policy you would be a fool not to read this book immediately.</p>
]]></content:encoded>
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		</item>
		<item>
		<title>How ERISA makes your long-term disability policy worthless</title>
		<link>http://www.disabilityhappens.com/how-erisa-makes-your-long-term-disability-policy-worthless.html</link>
		<comments>http://www.disabilityhappens.com/how-erisa-makes-your-long-term-disability-policy-worthless.html#comments</comments>
		<pubDate>Tue, 24 Jul 2007 00:00:37 +0000</pubDate>
		<dc:creator>Richard Brassaw</dc:creator>
				<category><![CDATA[Bad Faith]]></category>
		<category><![CDATA[Court Rulings]]></category>
		<category><![CDATA[Denied]]></category>
		<category><![CDATA[Disability Insurance]]></category>
		<category><![CDATA[Fraud]]></category>
		<category><![CDATA[Insurance Claims]]></category>
		<category><![CDATA[Insurance Companies]]></category>
		<category><![CDATA[Workers Comp]]></category>

		<guid isPermaLink="false">http://www.disabilityhappens.com/how-erisa-makes-your-long-term-disability-policy-worthless.html</guid>
		<description><![CDATA[Chances are if you have a long-term disability (LTD) insurance policy it falls under the Employee Retirement Income Security Act (ERISA) guidelines. If that is the case then know now that if you ever become disabled and file a LTD claim there is a chance you will be denied your benefits after a year or [...]]]></description>
			<content:encoded><![CDATA[<p>Chances are if you have a long-term disability (LTD) insurance policy it falls under the Employee Retirement Income Security Act (ERISA) guidelines. If that is the case then know now that if you ever become disabled and file a LTD claim there is a chance you will be denied your benefits after a year or so and there is nothing you can do about it. The ERISA facts governing LTD claims is truly stranger than fiction</p>
<p>According to <a href="http://www.amazon.com/gp/redirect.html?ie=UTF8&amp;location=http%3A%2F%2Fwww.amazon.com%2FInsult-Injury-Insurance-Business-Currents%2Fdp%2F1576753492&amp;tag=findingroma0d-20&amp;linkCode=ur2&amp;camp=1789&amp;creative=9325">Ray Bourhis&#8217; <em>Insult to Injury</em></a><img border="0" width="1" src="http://www.assoc-amazon.com/e/ir?t=findingroma0d-20&amp;l=ur2&amp;o=1" height="1" style="margin: 0px; border: medium none" /> in 1945 congress enacted the McCarran-Ferguson Act, which prevents the federal government from enacting <em>any</em> insurance consumer protection. Period! Out of the millions of pages of regulations and laws there is not one single word that regulates insurance practices.</p>
<p>Most states have enacted their own laws against unfair insurance practices that makes it illegal to:</p>
<ul>
<li>engage in unreasonable delay</li>
<li>underpay, terminate, or deny valid claims</li>
<li>put their financial interests above those of their policyholders</li>
<li>conceal benefits from claimants</li>
<li>interpret policy ambiguities against insured</li>
<li>use their superior size or wealth to intimidate or undersetlle claims</li>
<li>force policyhoders to sue them in order to obtain benefits due</li>
</ul>
<p><a href="http://www.amazon.com/gp/redirect.html?ie=UTF8&amp;location=http%3A%2F%2Fwww.amazon.com%2FInsult-Injury-Insurance-Business-Currents%2Fdp%2F1576753492&amp;tag=findingroma0d-20&amp;linkCode=ur2&amp;camp=1789&amp;creative=9325"><em>Insult to Injury</em></a><img border="0" width="1" src="http://www.assoc-amazon.com/e/ir?t=findingroma0d-20&amp;l=ur2&amp;o=1" height="1" style="margin: 0px; border: medium none" /> goes on to explain that not a single state has an insurance department that has the authority to sue an insurance company on behalf of a cheated claiment. What most state&#8217;s department of insurance (DOI) do is investigate whether insurers are violating unfair practice laws and fine them. It is rare that a state fines an insurance company.</p>
<p>In 1974 congress enacted ERISA and orginally was designed to protect retirement benefits against mergers, acquisitions, and other corporate activities that might endanger a retirement plan. ERISA, when originally enacted, had nothing to do with state regulations.</p>
<p>In 1987 Justice Sandra Day O&#8217;Connor wrote an opinion regarding the case <em>Pilot Life v. Dedeaux</em>. As a result the legal rights to protect policy holders from fraudelent and bad-faith insurance practices by the states was all but eliminated. It is an ironic twist that the McCarran-Ferguson Act that prevented federal regulation of insurance companies was extended by a Supreme Court ruling.</p>
<p>Currently ERISA eliminates all state insurance protections on all policies purchased at work. Because ERISA provides no remedies for misrepresentation the consumers who acquire their LTD policy through work have no anti-fraud or bad-faith protections under federal or state laws. <em><strong>None!</strong></em> </p>
<p>On April 7, 2003, the Supreme Court of the United States handed down a decision on <em>State Farm Mutual Automobile Insurance Company v. Campbell</em>, which restricted the amount of punitive damages that a state court could award. Punitive damages, said the Court, had to have a &#8220;single digit&#8221; relationship with actual (compensatory) damages awarded. That is, if damages range from $200,000 to $300,000 the punitive damages would be limited to $2 million or so.</p>
<p>On February 18, 2005, President Bush signed into legislation a law that he had personally proposed. The law effectively banned all state court class actions and forced them to be filed in federal court. He said that it would protect Americans from &#8220;frivolous litigation.&#8221; </p>
<p>Learn more about LTD claims made under both ERISA and non-ERISA. Read <a href="http://www.amazon.com/gp/redirect.html?ie=UTF8&amp;location=http%3A%2F%2Fwww.amazon.com%2FInsult-Injury-Insurance-Business-Currents%2Fdp%2F1576753492&amp;tag=findingroma0d-20&amp;linkCode=ur2&amp;camp=1789&amp;creative=9325">Ray Bourhis&#8217; <em>Insult to Injury</em></a><img border="0" width="1" src="http://www.assoc-amazon.com/e/ir?t=findingroma0d-20&amp;l=ur2&amp;o=1" height="1" style="margin: 0px; border: medium none" />.</p>
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		<title>Advice to doctors about their own disability insurance</title>
		<link>http://www.disabilityhappens.com/advice-to-doctors-about-their-own-disability-insurance-2.html</link>
		<comments>http://www.disabilityhappens.com/advice-to-doctors-about-their-own-disability-insurance-2.html#comments</comments>
		<pubDate>Sun, 22 Jul 2007 16:43:55 +0000</pubDate>
		<dc:creator>Richard Brassaw</dc:creator>
				<category><![CDATA[Disability Insurance]]></category>

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		<description><![CDATA[This is a brief article on the importance of doctors purchasing their own disability insurance. It offers some good advice on what to look for in purchasing disability insurance and may be useful if you are in the market. In no way does Disability Happens endorse the insurance agency who prepared this article. Just thought [...]]]></description>
			<content:encoded><![CDATA[<p>This is a brief article on the <a target="_blank" href="http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&amp;STORY=/www/story/06-26-2007/0004615170&amp;EDATE=">importance of doctors purchasing their own disability insurance</a>. It offers some good advice on what to look for in purchasing disability insurance and may be useful if you are in the market.</p>
<p>In no way does Disability Happens endorse the insurance agency who prepared this article. Just thought the advice is worth knowing.</p>
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		<title>Long-term disability insurance &#8212; fiction or fact?</title>
		<link>http://www.disabilityhappens.com/long-term-disability-insurance-fiction-or-fact.html</link>
		<comments>http://www.disabilityhappens.com/long-term-disability-insurance-fiction-or-fact.html#comments</comments>
		<pubDate>Fri, 20 Jul 2007 23:24:05 +0000</pubDate>
		<dc:creator>Richard Brassaw</dc:creator>
				<category><![CDATA[Bad Faith]]></category>
		<category><![CDATA[Court Rulings]]></category>
		<category><![CDATA[Denied]]></category>
		<category><![CDATA[Disability Insurance]]></category>
		<category><![CDATA[Fraud]]></category>
		<category><![CDATA[Insurance]]></category>
		<category><![CDATA[Insurance Claims]]></category>
		<category><![CDATA[Insurance Companies]]></category>
		<category><![CDATA[Social Security Disability]]></category>
		<category><![CDATA[Workers Comp]]></category>

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		<description><![CDATA[Benjamin W. Glass&#8217; book Robbery Without a Gun, is a thin book as books go. Even though modest in length the message speaks volumes&#8212;and one that you should seriously consider getting your hands on if you have a long-term disability (LTD) policy or have recently become disabled. If you are someone who has never been [...]]]></description>
			<content:encoded><![CDATA[<p>Benjamin W. Glass&#8217; book <em><a target="_blank" href="http://www.vamedmal.com/disability-secrets.cfm">Robbery Without a Gun</a></em>, is a thin book as books go. Even though modest in length the message speaks volumes&#8212;and one that you should seriously consider getting your hands on if you have a long-term disability (LTD) policy or have recently become disabled.</p>
<p>If you are someone who has never been denied a long-term disability claim or know someone who has had the unpleasant experience, then you might think that the book is sheer fantasy. Coming from the perspective of having someone close to me who has gone through the LTD grinder this book reads more like a Shakespearean tragedy that leaves you with a heavy heart. Just knowing that people across the U.S. are being denied LTD simply because someone in a nondescript office &#8216;feels&#8217; that the person filing a disability claim &#8216;should&#8217; be able to work is both disturbing and unconscionable.</p>
<p>Glass lists 15 common mistakes that LTD claimants make when filing a claim and 7 nasty things that LTD insurance providers plant in contracts to be used later to deny you benefits. The contract provisions mentioned are not required by any state or Federal law. Most employers are unaware of their existence or how they will be used against disabled employees who attempt to file a LTD claim.</p>
<p>The author advises you to get a copy of your disability contract (it must be furnished to you within 30 days of a written request to an employer) to see if any of these provisions are mentioned:</p>
<ul>
<li>The insurance company has the &#8220;discretion&#8221; to determine your benefits.</li>
<li>You only get paid benefits if you can&#8217;t perform &#8220;each and every&#8221; important duty of your job.</li>
<li>Your benefits are limited to 24 months if your disability is caused or contributed to in any fashion by mental illness, depression, or anxiety.</li>
<li>You benefits are not payable, or are limited, if your illness is fibromyalgia, chronic fatigue, chronic pain, or any illness where the symptoms are &#8220;self reported&#8221; and thus not &#8220;verifiable&#8221; by a blood test or other diagnostic study.</li>
<li>Your benefits will be terminated if the insurance company says you could work part time in any job, but don&#8217;t.</li>
</ul>
<p>If you find any of those provisions in your contract seriously consider purchasing your own LTD insurance policy. Tip: don&#8217;t go through an employer and if you have your own company do not use any company funds to purchase the policy. If your employer or company becomes involved, in any way, when you acquire a LTD policy, the plan may fall under the ERISA guidelines. This even means if you found an advertisement for a LTD plan stapled to a bulletin board at work.</p>
<p>If your LTD benefits fall under ERISA you should be aware that any money paid to you is taxable income. On the other hand, if the LTD policy falls outside of ERISA&#8217;s oversight, then the benefit paid to you will be tax free. That is something to consider when most disability policies provide coverage that ranges from 60%-66% of your income.</p>
<p>It is worth mentioning that 99.9% of all LTD claims that are denied fall under the Federal ERISA guidelines. If your policy does fall under ERISA, then see ONLY an attorney that specializes in ERISA. These attorneys are extremely difficult to find, but do not give up until you do find one.</p>
<p>One thing that Glass dispels is the false belief which most of us have&#8212;that what an employer (or Human Resources employee) says means something to the insurance company. However well meaning your employer or HR person is, it means absolutely nothing to the insurance company. Insurance companies do not care if the owner of the company &#8216;knows&#8217; that you are disabled, much less what someone from HR &#8216;thinks&#8217;. [In <em>Robbery Without a Gun</em> you'll learn that insurance companies care even less about what your doctor has to say about your condition---and the courts support this thinking.]</p>
<p>He also advises you to be cautious when the insurance company provides a &#8216;free&#8217; consult to help you with your Social Security Disability claim. It only helps the insurance company to move you into a position where they can later deny your claim. Another important point is that some insurance companies will deduct the legal fees for the services they provided you in obtaining your SSDI benefits from future payments.</p>
<p>As mentioned previously, this is not a thick book, although I&#8217;d suggest that you read it with a pad and pencil by your side because you will want to take notes. There are a lot of nuggets of knowledge to mine and any one of them you might find priceless.</p>
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