In this blog post, Share Lawyers answers questions from potential clients with unexplained chronic pain. Read on to learn more about particular issues surrounding unexplained pain and disability claims.
Q: My insurance company forced me to return to work even though I am disabled. I am struggling and cannot continue working because of chronic unexplained pain. Do I have to submit a new claim?
A: The question of whether a new claim must be submitted if you cannot continue working will usually depend on the “Recurrent Disability” provision in the policy, or the clause in the policy that deals with the impact an attempt at returning to work will have on future entitlement in the event that the return attempt fails. Most policies give a specific amount of time in which you do not need to re-apply for benefits. You should carefully review the policy terms in your specific case to see how this works in your particular circumstances.
Q: I underwent an independent medical exam (IME) at the request of my insurance company. Their doctor reported that I had no symptoms of chronic pain and was fit to work. It just so happens that on that particular day, I was feeling better than usual. Now my benefits have been cut off. I am unable to work because of unexplained chronic pain that my doctor can verify. Do I have any hope of overturning this decision?
A: Entitlement to disability benefits is not frozen in time, and if you were having a better than usual day on the day of an assessment, that doesn’t mean you have no chance trying to recover further benefits. If your own doctors support your ongoing inability to work and your condition generally waxes and wanes, ie., you have some good days and some bad days, this one-time snapshot of your health does not mean your case is over. The particular circumstances of your claim need to be thoroughly discussed with a disability lawyer to assess your chances of success.
Q: I experience chronic unexplained pain that makes it impossible for me to work. I am scared because my pain doesn’t have a specific reason. Will I be denied? How do insurance companies define "total disability?"
A: The general definition of total disability during the "own occupation period" is that you are unable to do the substantial duties of your own job because of illness or injury. When the definition of disability changes to “any occupation” the insurance company wants you to believe that it means if you are not able to do any job then you are eligible for benefits. We always argue that the “any occupation” wording of most policies means that if you continue to be totally disabled and cannot do an equivalent job, at the equivalent level of experience and the equivalent pay scale, then you are eligible for continuing benefits into the future. Don’t give up, we can help you to fight to get benefits into the future, beyond the own occupation period.
Has your long-term disability claim been denied? Contact Share Lawyers and put our experience to work for you. We offer free consultations and there are no fees unless we win your case. Find out if you have a disability case.
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