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Managers are typically highly skilled leaders within an organization. They provide direction and oversight and work with other senior leaders to achieve the organization’s goals. Successful managers have a proven track record of strategic planning and execution.
In this article, we will explore the following:
- Why it’s so difficult to file a long-term disability claim as an executive manager, and
- How to craft a winning claim.
Why It Is Difficult to File LTD for a Manager
Managers have many duties and responsibilities. Here is a short list of just some of the duties and responsibilities of a manager:
- Participate in the hiring and training of new team members
- Coordinate with various teams and stakeholders as needed
- Lead status meetings
- Oversee all team activities to ensure projects are completed on time and within budget
- Manage budget and production schedule
- Accountable for the overall successful operation of the team
- Manage a diverse, multi-disciplinary team of professionals
- Set clear goals and objectives for the team
- Report directly to senior management
- Delegate responsibility to subordinates and provide guidance and direction
- Serve as a liaison between other members of the leadership team and subordinates
- Evaluate subordinates and provide constructive feedback
- Manage employee concerns in conjunction with HR
- Contribute to maximizing efficiency and productivity
- Maintain a keen awareness of market and industry trends
Depending on the company, sample manager requirements and qualifications may include:
- Bachelor’s, MBA, or Master’s degree in business management or a related field
- Significant industry experience
- Leadership or management experience
- Exceptional communication skills, both written and oral
- Strong team building skills and ability to motivate others
- Team player mindset and willingness to collaborate
- Willingness to take responsibility and act independently when necessary
Similar job titles include:
- Operations Manager
- Regional Manager
- Area Manager
- Senior Manager
In short, here is a list of the top 10 skills a manager may need in his or her job:
- Complex problem solving
- Critical thinking
- Creativity
- Managing people
- Coordination with others
- Emotional intelligence
- Judgment and decision-making
- Service orientation
- Negotiation skills
- Cognitive flexibility
Managers are well compensated for the high level of skill required to do their jobs. If a manager becomes disabled and applies for long-term disability, he or she will struggle to get approved. Why is that? Because the insurance company looks at the case from a financial standpoint. The insurance company looks at how much money it will cost the company to provide a manager with benefits throughout the duration of the illness or injury. The longer it could potentially take for the manager to return to work, the more scrutiny the manager will face in the claims process.
Tips for a Successful Claim
Tip #1 Gather Strong Medical Evidence
Medical records are the foundation of any long-term disability claim. Gather all medical evidence from your doctors treating your disability. Make sure your doctors note your pain levels and cognitive difficulties in your medical records. This is not always common practice, but you will need detailed documentation for your claim.
For example, let’s say a claimant has a significant back injury (such as a herniated disc), and can’t sit, stand, or even walk for very long. The most comfortable position is for the claimant to lie down for 50% of the day to relieve the pain. Not many jobs will accommodate the need to lie down for half of the day. Therefore, the claimant must obtain “objective medical evidence” to support the subjective complaints of pain. Objective evidence can include MRIs, X-rays, etc.
Tip #2 Anticipate Surveillance
A large monetary claim – such as a claim for a manager – will likely require video surveillance, which is legal. During the surveillance period, a private investigator will stake out the claimant’s home, talk to nearby neighbors about the claimant’s daily activities, and then try to use this information against the claimant in the administrative decision (or in court). For this reason, it is important not to rush back into exercise routines or anything else that is very strenuous for the body during the claim period.
Tip #3 Stay Off Social Media
There is a good chance that social media accounts are being monitored. As a busy manager executive, you probably do not have much time to spend on social media. However, when you are at home with nothing to do but rest, you may be tempted to create an account on a social media platform such as Facebook, Linked In, Twitter, Instagram, or Snapchat. We recommend that you stay off social media completely during the claim period. The insurance investigator will try to use posts on social media accounts to deny your claim.
Tip #4 Don’t Try to Return to Work Too Soon
The amount of time spent recovering from a disability can be boring and feel unproductive to a manager. Going from a very active schedule to weeks (and perhaps months or even years) of rest can feel like a prison sentence. Managers must resist the urge to return to work too soon. If a manager pushes himself or herself back to work before his or her body is physically and mentally ready, the manager runs the risk of making a mistake that could cause more harm.
Tip #5 Don’t Forget Cognitive Issues
An individual suffers from “cognitive impairment” when his or her ability to think and process information is impaired (for any reason). Examples include when the individual struggles with basic cognitive functions, such as memory processing, perception, problem solving, and language. Symptoms of cognitive impairment can vary greatly from person to person, but common symptoms include short or long-term memory loss; difficulty with planning, organizing, and problem solving; confusion; an inability to cope with stress; problems with time management; and difficulty managing, influencing, and communicating with others. Cognitive impairment can even have physical manifestations, such as poor motor coordination.
Cognitive impairment can result from several serious and disabling medical conditions, such as delirium, dementia, amnesia, Alzheimer’s disease, Parkinson’s disease, or Huntington’s disease. Cognitive impairment can also occur as a result of other medical problems/diagnoses, including a stroke, heart disease, brain injury, major depression, an anxiety disorder, insomnia, high blood pressure, chronic migraines, lupus, Raynaud’s phenomenon, and fibromyalgia. This is not an exhaustive list of causes. There may be other diagnoses that cause cognitive problems.
While the language of each short- and long-term disability policy is different, you’re generally entitled to disability insurance benefits if you can’t perform the material and substantial duties of your own job or any gainful employment for which you’re qualified by education, training, and experience.
It seems obvious that a manager with a cognitive impairment, regardless of the cause, would have difficulty performing the material and substantial duties of the job. However, insurance companies do not always pay benefits, even when their liability seems obvious. All too often, the attorneys at the Ortiz Law Firm have seen insurance companies/ERISA administrators claim that an insured has the “functional capacity” to return to work even when they have a cognitive impairment.
An insurance company may require the claimant to undergo an “independent” neuropsychological evaluation. Keep in mind that a medical professional hand-picked by the insurance company will conduct this examination. The insurance company pays the bill. As you can well imagine, the paid neurophysiologist often produces a biased report concluding that the claimant has the residual capacity to return to work, regardless of the limiting cognitive impairments from which they suffer.
The Ortiz Law Firm has extensive experience assisting claimants in this situation and has successfully convinced insurance companies to reverse their denial decisions, even when the results of an unfavorable neuropsychological examination initially supported that decision. We also have testimonials from many of our satisfied clients.
Get Help with Your Long-Term Disability Claim
Managers will find it challenging to get a long-term disability claim approved. The insurance company will look for virtually any reason to deny the claim. By providing strong medical evidence, keeping a low profile, and not rushing back to work too soon, a manager can build a solid case for disability. Using an experienced disability attorney will help you protect yourself from insurance investigators.
The Ortiz Law Firm is based in Florida, but represents long-term disability claimants nationwide. If your LTD claim has been wrongfully denied or terminated, you can get a free case evaluation by calling (888) 321-8131. We can help you evaluate your claim to determine if you can access long-term disability benefits and how to move forward with the process, and there is no obligation.
