Transcript for
Joe Cunnane – Disability Claims
Dr. Lilly:
“Hello, Dr. Lilly speaking on behalf of Lilly Physical Therapy on Edmonds Way, and I’m here with Joe Cunnane. He is a local attorney here in Edmonds and he an expert for personal injuries and disabilities claims.
So, today we’ll talk about disability claims and try to answer some common questions related to long-term and short-term disability. Hopefully, we’ll help you to figure out the best way to claim short-term and long-term disability and find solutions to common problems in that process.
So, Joe–welcome, really good to have you here today.”
Mr. Cunnane:
“Thank you, Dr. Lilly. It’s good to see you again.”
Dr. Lilly:
“Thank you. So, Joe, can you please tell me a little bit about your education, training and background?”
Mr. Cunnane:
“Sure, I received my undergraduate degree from The University of Illinois, Urbana Champaign. After I received that degree I worked in Chicago at a personal injury law firm as a legal assistant for two years and I started law school at Seattle University Law School where I received my J.D.. After that, I worked for approximately two years in the Koger Dodgers office in Olympia. That’s where we draft the bills that turn into laws in Washington State legislature.
After that, I did private practice, personal injury and now long-term disability cases. And I’ve been working as a lawyer for over 20 years. I’ve handled hundreds of cases on the state level and in Federal court.”
Dr. Lilly:
“Wonderful, it’s so good to hear about your experience and great background. Joe, can you tell me what is that long-term disability?”
Mr. Cunnane:
So, a long term disability claim or policy, basically is an insurance policy where you pay money into the insurance policy and if you become disabled and you’re unable to work, then, at that time you file a claim.
So, you may be eligible to continue receiving most of your salary when you become unable to work.”
Dr. Lilly:
“Great, it sounds like an amazing safety net.”
Mr. Cunnane:
“Yeah, it’s very important and typically there are two ways that a person may have a long-term disability policy. One would be that their employer paid for it and it would be part of their terms of employment or a benefit. Two, a lot of individuals may buy their own policy, their own long-term disability policy in case they became disabled. Those could be people such as doctors, lawyers or accountants, and if they can’t do their job then they’re gonna file a claim.”
Dr. Lilly:
“So, how does somebody qualify for long-term disability. What kind of condition would actually qualify the a person for long-term disability?”
Mr. Cunnane:
“Right, you know once the person has the long-term disability policy the question is how would they get on claim. That’s where it can be quite difficult. First, you gotta look at the policy and review the policy and see what the terms are. Is this person disabled? Is this person disabled from work? How do we determine that? It’s an important and hard look, basically you’re gonna look to the medical records, the opinions of the medical doctors and any other medical professionals that the person might see. So, that’s how the claim you file will be worked and developed and typically the claim file is on the insurance company side.
A patient or claimant may not know exactly what’s in their file. It would start when they an application for a long-term disability claim.
Dr. Lilly:
“I see, that’s very interesting information. I know there are some short-term disability plans and long-term disability and–what is actually the difference between long-term and short-term disability?”
Mr. Cunnane:
“Well, typically a short term disability policy lasts up to six months of a disability, and the short-term disability would be more focused on the employer side and employer money. It may be an administered by the disability insurance company but up to six months it could be a different pot of money that the policy is being paid from.
Then, when it switches over to long-term disability, we’re talking about a disability that lasts up to and longer than a year. So, it will switch over and it will be looked at a little bit differently. And again, we’ll look back to the policy to determine what needs to be done in order to qualify.
Dr. Lilly:
“I see, that’s very interesting. So, what is difference between long-term disability and social security disability?”
Mr. Cunnane:
“So, they’re similar in a lot of ways when it comes to disability. Long-term disability deals more on the employer plan or a self-funded plan that you might have bought through your employment. And, social security disability or SSDI is more on the U.S. Government, it’s a Federal Government plan. So, although there may be similar medical conditions and medical records, the way they’re looked at and their definitions are different.
Dr. Lilly:
“I see. So, can a person file long-term disability on their own?”
Mr. Cunnane:
“Yes, they can. If they file on their own they gotta be careful that the claim file is properly developed or loaded. What’s in the claim file would determine whether the company decides whether you’re disabled; yes, or no. If there’s not enough evidence or objective findings in the claim file the company can just say “no, we don’t believe you’re disabled,” even though the person may believe they’re disabled, friends or family or co-workers may all be willing to write a letter or testify that they think they’ve changed, they’re disabled, and all the medical records may support a finding of disability.
The determination is still relied upon determination is made by the long-term disability company. So, if you file on your own you’ve got to be careful, there’s also a lot of time restriction restraints. Maybe, periods you may be disabled but you may have to wait so that your disability continues and then they will start paying the claim.
So, there can be some pitfalls for a person if they’re completely filing and trying to do it on their own.”
Dr. Lilly:
“Wow, that’s very interesting. So, can you tell us a little bit more about pitfalls and warning signs when filing long-term disability; I think this is really valuable information for our community.”
Mr. Cunnane:
“If you’re doing it on your own, and working the long-term disability, your own claim, some warning signs would be:
- If the insurance company asks you to attend a medical exam from an examiner of their choice. Typically, those doctors or medical professionals can be quite conservative in how they view disability and whether you meet the definition of disability through their eyes. So, a medical examination would be something you have to be very careful as to just go in there by yourself without having maybe a nurse or at least having a fellow family member who can be an advocate and can help you get through that tough process.
- Another warning sign would be if the insurance company asks you for an in-person interview, especially in your own home. You can be at quite a disadvantage at your dining room table and this examiner/interviewer is looking at your photos which may have been taken many years ago of you doing something physically active. And they can kind of take the advantage of your experience and ask you questions that can be used to determine that you’re not disabled. I highly recommend, if you’re gonna do an interview with this insurance company regarding your long-term disability claim, that you go with a different place other than your own home. At least a place that’s more neutral.
Dr. Lilly:
“That’s really good advice. “
Mr. Cunnane:
“And then, the other thing that comes up in these cases is surveillance. Potentially, a private investigator can be hired by this long-term disability company to either photograph or videotape you doing activities such as leaving your home, going to your mailbox or leaving your home and going to the store. So, if you file a long-term disability claim, you should be careful what you’re doing outside of the house, because they may take some photos or videos of you and later use that to say ‘hey, the person can go to their car or they can walk to the store; therefore, they should work.”
Dr. Lilly:
“Wow, that’s really interesting. It’s really amazing information–it’s surprising in some ways and Joe, we talked a little bit before we started recording and you gave me–you told me a few things about group disability insurance; filing and paperwork–can you actually share some of that information with our audience?”
Mr. Cunnane:
“That’s right, I brought in a typically disability insurance questionnaire that, one of the companies would send to a doctor to fill out the form. And, there’s some problems with the form. In particular, there’s only boxes to be checked and some doctors may be afraid to go outside of the box and check one way or the other that may be supportive of your case. If the doctor fills this out in a way that is not beneficial to your case, this form could be used to deny your claim. You’ve got to ask yourself, who wrote the form? And the insurance companies write the form. So, they’ll say questions like ‘when do you estimate the patient will be capable of full-time return to work?’ The doctor may say ‘well, maybe three to six months,’ but they may not be sure. So, if the doctor puts six months in the form, you’d better be sure that the insurance company thinks that in six months you can go back to work.
There’s also other challenges in the form that’s very specific. If you turn over to page two, there’s issues about how the physician has to certify this form and whether the symptoms are related on the patients’ self-reported symptoms or objective findings. Frankly, the doctor might not know a lot about the patient if they’ve only seen the patient a few times. And the way this letter, this form is written, it can be somewhat intimidating for a doctor to have to fill this out and have to send it back in. And if they don’t fill it out and send it back in, then the insurance company will use that lack of response against you.”
So, you’ve got to be really careful; a recommendation I have is if your doctor gets one of these forms and it’s a long term disability form physician statement, and your doctor lets you know, maybe schedule an exam, go in, and try to assist the doctor filling this form out before the doctor sends it in. And before he or she sends it in, maybe, take a photo-copy with your camera phone or ask for a copy so you have it yourself, so you know what went in.
The other thing that’s kind of interesting is that this form that the doctor’s supposed to fill out, the insurance company doesn’t pay for the doctors time, you have to pay for the time. So, you know that, so that’s kind of interesting; they want the form filled out but you as an individual, as a claimant to this insurance policy, you have to fill it out to show the evidence.”
Dr. Lilly:
“Right, but scheduling appointment with doctor being present, or intake of information or completing this form helps the client or the patient, get the best information and then cost of the time filing paperwork fee covered, right?”
Mr. Cunnane:
“Right, so if the person’s disabled under active-care, that’s one of the most important things that they don’t gap out. They should be regularly going to see their doctor, that’s the primary care doctor, or a specialist, say a rheumatologist or a neurologist and a physical therapist–hopefully all that team is working together for that patient and that claimant, and that’s helping build the claim file. We need to get in and show that maybe something’s going on, a condition is changed or you have a new condition or illness, and that’s documented in the records. That’s probably one of the most important things, and if it’s in your medical record it should be going into the claim file. That’s a big goal if you want to be successful in one of these claims.”
Dr. Lilly:
“True, consistency of care, showing up for all of your appointments and document, document, document.”
Mr. Cunnane:
“That’s right.”
Dr. Lilly:
“Wonderful, to make case strong. Joe, can you tell us when the person should hire attorney for a long-term disability claim and may need help?”
Mr. Cunnane:
“Right, it’s hard to see–different cases have different time restraints, so it’s probably pretty important to get an attorney involved at least to consult with what your rights and options are. Because, each disability plan can be a little different. If a person has filed for a short-term disability case or claim and they’re on-claim and it’s going okay, they’re getting the treatment, they’re probably kinda okay. But when it switches over from short-term disability to long-term disability is usually when a lot of the fights can occur.”
Dr. Lilly:
“Right.”
Mr. Cunnane:
“So, consulting early and getting your case kind of developed and building the file is usually better sooner rather than later. There’s an old saying that says ‘it’s never too early too hire an attorney, but it can be too late.’
So, there are potential statutes of limitations with these long-term disability cases and claims. So, discussing or calling an attorney to talk to someone who knows these files and these claims, it doesn’t cost you anything typically to consult over the phone to see whether he or she or that attorney could help you.”
Dr. Lilly:
“That’s really good advice. Yeah, it’s never too early but it can be too late.”
Mr. Cunnane:
“That goes in a lot parts of our lives, including the medical side.”
Dr. Lilly:
“That’s so true. We should never wait too long”
Mr. Cunnane:
“Right. You can sleep on your rights and then find out it’s too late, or you still have enough time to file but there’s not enough time to help the case in the right way and build a strong foundation so you do have a solid claim.”
Dr. Lilly:
“Joe, if we, if our community and our patients, clients, need help with long-term or short-term disability claim, how do they contact you?”
Mr. Cunnane:
“Well, they can contact me at my office, the phone 425.672.7100. My office is in Edmonds, so local attorney and right by the ferry dock, come down and see my office meet me, and also check me out on my website it’s http://www.cunnanelaw.com, they can go on my website and check out other videos of testimonials from other clients that I’ve helped, and give me a call because I’d be happy to talk to them.
Dr. Lilly:
“Sounds great. Well, Joe, thank you so much for your time and for this great piece of advice. And I personally recommend Joe as a great attorney both for personal injuries, you know if you get in a motor vehicle accident or you have a disability claim, you should contact Joe as soon as possible. Because again, it can be too late, and it’s never too early. ”
Mr. Cunnane:
“Well, thank you Lilly, it’s nice seeing you again. It’s always a pleasure being here in your office.”
Dr. Lilly:
“Thank you, very much.”
Contact information for:
Joe Cunnane of Cunnane Law
Phone: 425.672.7100
Address: 100 2nd Ave. S., Suite 201 | Edmonds, WA 98020
Dr. Lilly Bojic of Lilly Physical Therapy
Phone: 425.224.2476
Fax: 425.224.2612
