Hi, I’m Nick Ortiz. I’m a board certified, Disability Insurance Attorney in Florida.
Today I’m here to talk to you about Mutual of Omaha and long term disability claims.
You’re probably here today because Mutual of Omaha has either unreasonably delayed in making a decision on your long term disability claim, or they’ve wrongfully denied or terminated your benefits.
One of the primary reasons why Mutual of Omaha denies claims is that they had your file reviewed by one of their doctors. And what that means is, either their doctor reviewed the medical evidence in your case and issued a report, or they may have sent you for an examination by that doctor. That doctor will then issue a report of findings as to what your limitations are as a result of your medical condition. As you can imagine, often times their doctors don’t find a whole lot wrong with claimants and therefore, the insurance company will use that doctor report against you and deny your claim.
Another reason why Mutual of Omaha may have denied your claim is because of the findings of a vocational expert hired by the insurance company. A vocational expert’s a job expert who is retained to make a decision as to whether you could do work activity given the medical evidence in your file. So what that means is the insurance company will have them look at your medical records, any opinion evidence as to limitations identified by doctors, and your work history, and then the job expert’s gonna conclude as to whether there are jobs out there that you could do given all of those factors. And as you can imagine, often times these vocational experts say that there are jobs out there for someone like you in your condition.
A third reason why Mutual of Omaha may have denied your claim is because of a change in the definition of the term disability. Under most group plans, you are deemed disabled so long as you cannot perform the material duties of your job for the first two years. We call that the own occupation or own occ for short, standard. But after two years, it broadens and they look to see whether you could do any occupation or any occ. And if they feel like there are other jobs that you could do, even if you couldn’t do your own job, then you would no longer qualify for benefits and your benefits are terminated at that time.
A fourth reason why Mutual of Omaha may have denied your claim is because they say that there is insufficient medical evidence to support your case. What that means is they may have looked at all the evidence and they just feel that the evidence is not so significant as to keep you from working. So for example, if you have a back pain problem and you had an MRI done and the MRI shows mild to moderate symptoms, then they may say that, “We just don’t think “that that is severe enough “to keep you from doing your work.” But here’s a tip, sometimes there’s insufficient medical evidence because they don’t have all of your medical records. And at the end of the day, it’s really your responsibility to make sure that they have everything and we can help you make sure that the insurance company has all the evidence it needs to make the right decision.
A fifth reason why Mutual of Omaha denies claims is because they may have conducted surveillance in your case. And that surveillance may be in one of two ways, number one it may be video surveillance. And in that situation, the insurance company may have hired a private investigator to follow you around and record your activity. If you’re recorded on camera engaging in certain activities, then the insurance company may say that that activity level is inconsistent with the disability, and therefore you’re not eligible for benefits.
But in today’s day and age, there’s another form of surveillance, and that is the insurance company will be tracking you on social media. If you have a Facebook page, Twitter, Snapchat, pretty much any other form of social media, you can rest assured that the insurance company is checking out your profile. And if you don’t have your privacy settings set correctly, they may find pictures, videos and posts that they can use against you in your case.
Now another reason why your might be here is because Mutual of Omaha is just taking way too long to issue a decision in your case. There are certain statutory timelines within which the insurance company must make a decision, and the insurance company may be beyond those time limits.
And if you want to discuss your legal rights in such a situation, then I encourage you to call us right away at 850-898-9904. If you’re not ready to talk to someone right away, then I do encourage you to download a free, digital copy of a book that I wrote called The Top 10 Mistakes That Will Destroy Your Long Term Disability Claim. If you visit www.freeltdbook.com you can download a copy right away. We look forward to hearing from you.