Friday, February 10, 2012

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (“CTS”) is the name given to the nerve damage from entrapment of the median nerve. CTS causes paresthesia, pain, numbness, and other symptoms in the distribution of the median nerve, which includes the fingers. According to the National Institute of Health (“NIH”), CTS is common in people who perform repetitive motions of the hand and wrist, most commonly, typing on a computer keyboard. Other causes include: sewing, driving, assembly line work, painting, writing, use of tools, sports such as racquetball or handball, and playing some musical instruments. The NIH says that CTS is a costly and disabling occupational illness.

I represent a claimant who was just approved for long term disability (“LTD”) benefits under a group disability policy issued and administered by Liberty Mutual. In the approval letter, Liberty said that LTD benefits were approved because the claimant was unable to do his own occupation, and that the claimant was required to apply for Social Security Disability (“SSD”) benefits.

Most group LTD policies require filing for SSD, and then will reduce the LTD benefit by the amount of the SSD. Moreover, the failure to apply for SSD will result in the insurance company deducting the estimated amount of the SSD from the LTD benefit. Many insurance companies refer claimants to their SSD company, which is a bad idea. Because SSD companies get their clients from the LTD carriers, they perceive the insurance company as their real client.

In some circumstances, it may be possible to get SSD benefits while conceding the functional ability to sedentary or light work, or even medium work in rarer circumstances. However, most group LTD policies require claimants to prove they cannot do any occupation after 2 years. Since the SSD company is beholden to the referring insurance company, the SSD company does not bother to argue that the claimant cannot do sedentary or light work, and while enabling the claimant to get SSD benefits, sets the claimant up to have his or her LTD benefits terminated.

No comments: