This Friday and Saturday, May 16-17, Comitz | Beethe will have a booth in the exhibitor hall of the Arizona Society of Anesthesiologists 40th Annual Scientific Meeting at the Scottsdale Resort and Conference Center. Attendees are invited to stop by our booth for information about our law firm, what doctors can expect when filing a disability insurance claim, and how our firm may be able to assist you.
UPDATE: Since this story was originally posted in 2008, the insurance regulators of Maine and Massachusetts initiated targeted market conduct examinations of CIGNA’s disability claims handling practices. The concerns raised by Maine and Massachusetts prompted the insurance commissioners of Connecticut and Pennsylvania to also open market conduct examinations and for the California Insurance Commissioner to reopen his previous examination of CIGNA. In 2013, the examinations resulted in fines against the CIGNA companies, corrective actions being required in its handling of disability claims, and for CIGNA to reevaluate certain claims that were denied or terminated. Information on the CIGNA Multi-State Regulatory Settlement Agreement can be found here.
ABC News/Good Morning America‘s investigation by Chris Cuomo into CIGNA disability claim denials has uncovered some disturbing stories. In the video above, claimants describe some of the hardships they have been forced to endure due to denials of their claims or unreasonable delays in having their claims paid.
One breast cancer survivor, who eventually was paid on her claim with the assistance of a disability insurance attorney, describes her two-year ordeal with CIGNA as a “daily, eight-hour job just to fulfill the information that CIGNA was requesting.” The tactic of wearing down a disabled claimant with repeated requests for documentation that has already been provided multiple times — thereby deliberately delaying payment of the claim — is called “slow walking” by some in the industry. While CIGNA denies engaging in this practice, many claimants who are already emotionally and physically vulnerable due to their disability will eventually quit pursuing benefits to which they are entitled in this battle of attrition that is widespread in the disability insurance industry. In this situation, it is often necessary for a claimant to retain the services of an attorney, not only to take on legal issues with the insurance company but also to shoulder the burden of the excessive and repetitive requests for documentation.
Other claimants in Chris Cuomo’s GMA piece describe (a) three years of fighting CIGNA for their benefits, all the while sinking deeply into debt and losing everything; (b) being caught between a rock and a hard place when told by an employer that he could not return to work due to his disability, but simultaneously having CIGNA deny disability benefits; (c) purchasing insurance to protect herself and her family, only to have her business destroyed, savings depleted and fighting to keep her family home when benefits were denied or delayed.
Another of the claimants profiled, Ursula Guidry, a young wife and mother with advanced breast cancer, initially had her benefits paid by CIGNA, but after awhile, they terminated her benefits and told her she could return to work full-time. Eventually CIGNA settled the claim with her. She passed away three months later. As her husband says, it is tragic that her last year on earth was spent being in a panic over financial issues and fighting an unethical insurance company instead of enjoying as much time as possible with her husband and children.
CIGNA did not respond to GMA re any of the specific claimants profiled, but their Chief Medical Officer stated they pay 90% of disability claims filed and that the majority of their customers are satisfied.
Disability Insurance Q&A: How Should Doctors Approach Their Treating Physicians About a Disability Claim?
Question: How should doctors approach their treating physicians about a disability claim?
Answer: Your treating physician’s support can often be critical to getting your claim approved. A hurried, uninterested physician may not have time to devote to your claim. In addition, fully discussing your condition with a professional, compassionate treating physician will help ensure supportive medical records. When to discuss your potential claim with a physician is an important timing issue. Also, when the time comes to speak to the treating physician about the claim, a disabled dentist or doctor should ensure that the treating physician understands the definition of “disability” under the insurance policy, so that he or she can accurately opine as to the inability of the doctor or dentist to work.
Comitz | Beethe To Be Exhibitor at the Arizona Society of Anesthesiologists Scientific Meeting in Scottsdale
Disability attorneys from the law firm of Comitz | Beethe will be available to speak with anesthesiologists attending the 39th Annual Scientific Meeting of the Arizona Society of Anesthesiologists this Friday and Saturday at the Scottsdale Resort and Conference Center. If you have questions regarding your disability insurance policy or filing a disability claim, please feel free to stop by our exhibitor table for informative materials and/or to talk with one of the attorneys at our booth.
Americans have always understood that each of us is entitled to a set of fundamental freedoms and protections under the law, and that when everyone gets a fair shot at opportunity, all of us do better. For more than two decades, our country has upheld those basic promises for persons with disabilities through the Americans with Disabilities Act — a sweeping civil rights bill that moved our Nation forward in the journey to equality for all. And from making health care more affordable to ensuring new technologies are accessible, we have continued to build on that progress, guided by the belief that equal access and equal opportunity are common principles that unite us as one Nation.
On the 20th International Day of Persons with Disabilities, we reaffirm that the struggle to ensure the rights of every person does not end at our borders, but extends to every country and every community. It continues for the woman who is at greater risk of abuse because of a disability and for the child who is denied the chance to get an education because of the way he was born. It goes on for the 1 billion people with disabilities worldwide who all too often cannot attend school, find work, access medical care, or receive fair treatment. These injustices are an affront to our shared humanity — which is why the United States has joined 153 other countries around the world in signing the Convention on the Rights of Persons with Disabilities, which calls on all nations to establish protections and liberties like those afforded under the Americans with Disabilities Act. While Americans with disabilities already enjoy these rights at home, they frequently face barriers when they travel, conduct business, study, or reside overseas. Ratifying the Convention in the Senate would reaffirm America’s position as the global leader on disability rights and better position us to encourage progress toward inclusion, equal opportunity, full participation, independent living, and economic self-sufficiency for persons with disabilities worldwide.
We have come far in the long march to achieve equal opportunity for all. But even as we partner with countries across the globe in affirming universal human rights, we know our work will not be finished until the inherent dignity and worth of all persons with disabilities is guaranteed. Today, let us renew our commitment to meeting that challenge here in the United States, and let us redouble our efforts to build new paths to participation, empowerment, and progress around the world.
NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim December 3, 2012, as International Day of Persons with Disabilities. I call on all Americans to observe this day with appropriate ceremonies, activities, and programs.
IN WITNESS WHEREOF, I have hereunto set my hand this third day of December, in the year of our Lord two thousand twelve, and of the Independence of the United States of America the two hundred and thirty-seventh.
The Arizona Assistive Technology Exchange is an online resource where Arizonans with disabilities can buy, sell, exchange, or donate assistive devices/durable medical equipment so that it is in the hands of those who can benefit from the equipment. At the time of this blog post, there were 81 pages of items available, ranging from a free talking watch for the visually impaired to an electric patient lift being sold for a couple thousand dollars.
The program is for the use of individuals with disabilities, not for the use or profit of vendors or equipment distributors.
The site also has a section where “Items Needed” can be posted. The Arizona Technology Access Program can be viewed at this link.
Obstacles in the form of steep ramps, narrow doorways, inadequate signage, etc. continue to vex voters with disabilities. In the U.S. District Court of New York, testimony is underway from a plaintiff, Denise McQuade, who alleges that she encountered an array of difficulties attempting to vote in previous elections and even had to be carried up and down stairs.
As we have blogged previously, even absentee ballots can present difficulties for some voters with disabilities. As described in our post last election season, in Oregon, where voting can only be done by absentee ballot, Apple has tested innovative means of making voting easier for people with disabilities.
The U.S. Department of Justice has a detailed ADA Checklist for Polling Places that contains many solutions for making polling places more accessible for the disabled. The checklist is available at this link.
While the litigation in New York is still pending, counsel has requested that the Board of Elections implement short term remedies prior to the November election.
We have blogged previously about the NHTSA’s recommendations for adapting a motor vehicle with wheelchair ramps and similar equipment for person with disabilities. For some people with disabilities, though, while a wheelchair ramp is not necessary, assistance is needed for routine tasks such as getting in and out of a vehicle, reaching the pedals and handling the keys. The American Auto Club has information on several simple, easy-to-install devices, including:
- Key Extender – For those with limited hand mobility or arthritis, key extenders offer more leverage for turning keys in the door and ignition.
- Panoramic Rearview and Safety Mirrors – For drivers with limited mobility in their neck, these mirrors can assist with seeing in the “blind spot.”
- Pedal Extenders – If a disability results in not being able to reach the pedals at a safe enough distance both for maintaining control and for safe deployment of airbags, pedal extenders can provide an extra 1″ to 4″. These devices should always be installed in a vehicle by a professional.
- Leverage Devices – For persons whose disability affects their core strength and balance, a stainless steel leverage device provides a secure platform for getting in and out of the car and can support up to 350 lbs. These devices (pictured above) lock securely into position utilizing the vehicle’s U-type striker plate where the door latches.
- Leg Lift Straps – For those with limited strength in the lower extremities, these bands, which are typically wrapped around the shoe, allow the upper body to do the work of lifting and lowering legs in and out of the car.
AAA, in conjunction with the American Occupational Therapy Association and the American Society on Aging, also has an educational program called “CarFit” designed to help drivers find out how well they fit into their personal vehicle. Further information on this program is available here.
The Life and Health Insurance Foundation for Education (LIFE) published a disability insurance consumer guide for those with, or looking for disability insurance. LIFE is a nonprofit organization whose mission is to educate people about the importance of health, life and disability insurance. It does not endorse any particular product or company.
The LIFE consumer guide, What You Need to Know about Disability Insurance, gives an overview of different disability insurance plans and explains important disability insurance concepts you should know, such as the difference between social security and private employer-sponsored disability insurance plans. Did you know that 3 in 10 workers will become disabled for three months or more during their career? This statistic is unsettling, but it becomes even more unnerving when you compare it with the fact that less than 1/3 of workers in the private industry even have long-term disability insurance plans. In the brochure, LIFE explains the implications of this data and provides other statistics regarding disabled persons. The disability insurance consumer guide also offers a worksheet to help you assess the income you would need to sustain your current standard of living if you were to become injured or disabled. This information can be helpful for those looking to modify or purchase a private disability insurance plan.
Choosing an appropriate plan that is tailored to your needs can save you money and help you avoid litigation. Disability insurance attorneys at Comitz | Beethe can answer your questions about private disability insurance claims and disability insurance bad faith. We make sure disability insurance companies honor their agreements when they evaluate your disability insurance claim. For more resources about disability insurance plans and disability insurance bad faith, and for answers to common questions about disability insurance claims, be sure to check out the resources tab on our website.
Private investigators use a variety of tactics to produce evidence that may be used to deny your disability insurance claim. Below is a list of different private investigator surveillance methods and terms.
Disability Surveillance – refers to the monitoring, recording and documenting of activities or behavior of another. In the disability context, this surveillance is called sub rosa surveillance. Sub rosa, a Latin phrase which translated means “under the rose,” denotes the secretive and clandestine nature of private investigator actions.
Disability Stake outs – according to Shannon Detective Service, Inc.—a private investigation company whose client list includes Arizona Counties Insurance Pool, CNA Commercial Insurance, Danielson Insurance, Farmers Insurance, Federated Mutual Insurance Company, Hartford Insurance, Insurance Company of the West, Liberty Mutual Insurance, Nationwide Insurance, Progressive Insurance, Seabright Insurance Company, Sedgwick Claims Service, Travelers Insurance and Westfield Insurance—this is a stationary surveillance method by which a private investigator documents and records a claimant’s activities. The hallmark feature of a stake out is that the private investigator does not move or follow the disabled claimant. In a typical stake out operation the private investigator may station in front of your home or office and record you as you come and go. The goal of the stake out is to produce evidence that will enable the insurance company to deny your disability insurance claim. An ABC News story shows how an insurance company successfully denied a doctor’s disability claim with evidence produced during a stake out.
Disability Pretexting – the Federal Trade Commission (FTC) defines pretexting as “the practice of getting your personal information under false pretenses.” Private investigators are engaging in illegal conduct when they use pretexting to obtain your personal information from a financial institution. See 15 U.S.C. § 6801, et seq.
Here’s an example of how this works: someone pretends to be you and calls your bank. The person claims to have forgotten your checkbook, account number, social security number or other sensitive information. He then tries to get this information from the bank. Such conduct constitutes pretexting and violates federal law. Id.
Although private investigators claim to use only “appropriate” pretexting methods, methods which are not illegal per se, these are the same techniques which are used to facilitate identity theft and consumer fraud. Check out the FTC website for more information about pretexting and how you can protect yourself.
Disability Tracking Devices and GPS – this area of the law is still evolving. In a recent Supreme Court case, United States v. Jones, the Court held that attaching a GPS device to a vehicle constitutes a “search” under the Fourth Amendment; therefore, law enforcement officials need a warrant before installing the device. 132 S. Ct. 945, 949 (2012). Although the Court did not address the attachment of GPS devices in the private investigation context, its decision largely turned on the physical trespass involved in attaching a GPS device to another person’s vehicle. Id. The Court stated:
It is important to be clear about what occurred in this case: The Government physically occupied private property for the purpose of obtaining information. We have no doubt that such a physical intrusion would have been considered a “search” within the meaning of the Fourth Amendment when it was adopted.
Id. Therefore, this ruling may be used to argue against private investigator installations of GPS devices since such installation would also constitute a physical trespass. Private investigation companies, such as Shannon Detective Services, Inc. (SDS), are now looking how to bypass the physical trespass issue altogether through implementation of other technologies that do not require physical attachment. Here are two examples of other technologies cited from the SDS website:
- Disability stingrays (a device that can triangulate a cell phone signal to locate a user) will become popular in the future as a way to skirt around the new GPS laws for law enforcement.
- Disability ping of cell phones (by accessing a user’s cell phone GPS chip) will also fill the gap created by GPS legislation since the FCC has mandated GPS chips to be installed in all new cell phones by 2018.
Many people with disabilities find that driving enables them to keep their independence. The ability to drive means more opportunities for employment and participation in the community. Unfortunately, in order for drivers with disabilities to stay behind the wheel post-injury, vehicle modifications are often needed. Even though there is more opportunity for vehicle modifications today, the process can still be cumbersome, expensive and time-consuming.
In order to assist disabled persons with their vehicle modifications, the National Highway Traffic Safety Administration (NHTSA) has published an online brochure: Adapting Motor Vehicles For People With Disabilities. The publication guides disabled persons through the decision-making process and offers cost-saving tips along the way.
Disability insurance attorneys at Comitz | Beethe understand that getting the insurance company to fulfill its obligation and pay your disability insurance benefits is only one step toward your independence. If you are facing a disability or simply want more information regarding vehicle modifications for disabled persons, this brochure can be a helpful source of information.
The Phoenix disability insurance law firm of Comitz | Beethe is a Business Partner of the Arizona Osteopathic Medical Association and will be an exhibitor next week at the 90th Annual AOMA Convention at the Hilton in Scottsdale, Arizona. We invite all osteopath physicians attending the convention to stop by our table — Exhibitor Booth #79 near the breakfast buffet tables — to say hello and pick up informational packets about our firm and Arizona disability insurance practice.
The Centers for Disease Control and Prevention (CDC) recently created a public online database containing state-by-state, disability-specific information. Named the “Disability and Health Data System,” the CDC says that the database can help individuals “better identify health and wellness opportunities for people with disabilities by allowing users to compare over 70 different health measures, as well as data on psychological distress and disability-associated health care expenditures.” For instance, users can access an interactive map with tables showing how often arthritis causes a work limitation for adults in each state.
If you are facing a disability or simply want more information about disabling conditions, the database can be a helpful source of information.
As we have blogged many times, even seemingly straightforward terms like “total disability” or “appropriate medical treatment” in your disability insurance policy may have different meanings in the context of a disability insurance claim than they do in everyday English. In a video posted on YouTube, Jack McGarry, CEO, Unum UK, is surprisingly candid in addressing how their insurance policy language is confusing.
Insurance is so confusing, in large part because we’ve made it that way, the insurance companies. We use acronyms instead of words, we use lingo instead of language. We’ve made it easy for us to communicate with each other, but we’ve made it very, very difficult for consumers to understand what we’re saying, and we need to change that.
[Consumers] are confused by our products, they don’t understand the choices, they don’t understand the coverage, and one of the reasons they don’t understand it is because the language we use to describe it, they find it confusing, and a little scary, so we’re partnering with Plain English to help simply the language we use to describe what we do so everybody can understand it.
While Unum is apparently taking steps to clarify the language in its policies in the United Kingdom, it is of little help to American insureds who purchased policies written in language that is, in the words of Unum’s UK CEO, ”very, very difficult for consumers to understand.” The help of an experienced disability insurance attorney to interpret the language of your policy can be critical in ensuring you receive the benefits to which you are entitled.