DISABILITY CLAIMS:

Initial Applications for Benefits

As an experienced Consultant I will provide you with all the necessary assistance you need to prepare your initial application disability forms in a manner which clearly communicates the unique circumstances of your medical impairment and why you are no longer able to perform your current material and/or occupational duties. The disability application process is extremely important to the success of your claim and represents the claim representative’s “first look” at the circumstances of your inability to work. The application process is often very difficult for those who are impaired. I’m here to help.

Good Medical Communications

Unfortunately, physicians are in the business of patient care NOT filling out frequent requests for completed forms by insurance companies. It is extremely important for physicians to report accurate medical restrictions and limitations to the insurance company who will use the information available to make decisions as to whether to pay your claim or not. Direct assistance will be given to physicians and physician staff with respect to all communications, written and verbal with any insurance company. Physicians often call DCS, Inc. for assistance as well. For more information, contact us..

Independent Medical Evaluations (IME)

I will provide you with expert consulting advice, preparation and management should you receive a request to present yourself for an Independent Medical Evaluation. Information will be given concerning what to expect, how to prepare, and how to present yourself for the evaluation on the scheduled date. Learning how to prepare for the IME and remain in control of the process is very important to a successful outcome. DCS, Inc. will provide you with our new strategies for IMEs. To find out more, please contact us.

Contract/Policy Reviews

It is extremely important for insureds to have an in-depth knowledge of their disability policy or Plan and completely understand what you and the insurance company are entitled to. Disability insurers often attempt to misrepresent policy provisions to their customers in an effort to deny claims with out-of-contract requirements.  I will do a policy audit and advise you of your obligations and duties under the policy and those of the insurance company. We want to make sure you receive what you are entitled to under the policy contract. For more information about such reviews, please contact us.

Objective vs. Subjective Symptoms and Self-Reported Claims

Disability insurers often demand you submit “objective medical evidence” in support of claim even when your policy contract does not require you to do so. In addition, for some impairments there are no objective tests known to medical science that can prove you have what you say you have. It is very important for you and your physician to know precisely what information is required by your insurance company since many claims are denied based solely on the subjective nature of the information you send them in support of claim. As an experienced specialist in managing mental and nervous claims, I will assist you in obtaining the necessary and/or required medical information to support subjective or self-reported claims. If you have such a claim, please contact us.

Any Occupation Investigations

As an experienced claims specialist managing ERISA group disability plans, I will be able to assist you in managing the 24-month change in definition in  a way that updates current medical restrictions and limitations, accurately computes “gainful”, and provides for a fair assessment of alternative occupations by obtaining Transferable Skills Analyses which are independent and medically correct. Although disability insurers write these “change of definition” provisions in group policies they really aren’t very good at managing the process fairly. I can definitely advise and help you understand what to anticipate after receiving benefits for 24 months. Please contact us for such advise.

Residual Benefits- Working Part-Time

Are you being paid accurately? Or, has your disability insurer arbitrarily decided to pay you only 50% of your scheduled benefit?  For some, it may be possible to return to work in a limited capacity over time. It is extremely important to keep track of what you are being paid and whether or not the computations are accurate. I can help you keep a close eye on the accuracy of monthly benefits you receive when you are paid residually. If require such scrunity, please contact us.

Surveillance

Surveillance is the great insurance “invasion of privacy” which catches everyone off-guard. Although it is a well-known fact that all disability insurers contract with private investigators who may be asked to observe your activities for several days, DCS, Inc. can provide you with specific methodologies to minimize the value of insurance surveillance. I have several electronic books written on surveillance available to our clients; please contact us for more information..

Specialty Impairments

Over the years I have developed an expertise in assisting clients with specific medical diagnoses such as fibromyalgia, chronic fatigue, multiple sclerosis, RSD, chronic back pain, Lyme disease, cognitive deficits, and other self-reported claims. Experience managing these impairments is extremely important when gathering medical information from physicians and determining appropriate and regular care. I’m here to help for such assistance.

SOCIAL SECURITY DISABILITY INCOME APPLICATIONS

It’s very easy to understand why individuals become overwhelmed by the thought of applying for social security disability benefits. Most individuals who file private disability claims will also need to apply for SSDI or SSI in order to meet requirements contained in group STD/LTD policies. DCS, Inc. will assist you in making application for SSDI benefits; however, our fee structure for providing this service is separate from the fee charged for managing private disability claims.

Of course, my clients will have the convenience of applying for SSDI with the same consultant who is also assisting with the management of their disability claims and there is no reason to duplicate efforts to obtain medical records.

We will, of course, also assist individuals with an appeal reconsideration should the initial application for SSDI benefits be denied. Although the Social Security Administration presumes everyone knows its language, the process continues to reinvent itself with form numbers and endless requests for information. We are here to help you during this very difficult time in your life, so please contact us.

LONG-TERM CARE CLAIMS

The need to file long-term care claims involves a wide array of medical, social, personal, supportive and specialized services required by individuals who have lost capacity for self-care due to chronic illness.

Although LTC in made up of many different services armed at helping people with chronic conditions, insurers of LTC products use many of the same “risk management” activities such as surveillance, field in-house visits etc. to determine whether claims should be paid or not. DCS, Inc. will assist those receiving LTC benefits with their reporting needs to insurance companies as well as provide valuable information about the LTC process and ongoing evaluations. please contact us for such assistance.