Justia Connect Webinars How To Effectively Handle Long COVID Disability Insurance Claims

How To Effectively Handle Long COVID Disability Insurance Claims

In this webinar, we will be discussing the complexities of handling a long COVID disability insurance claim and how best to present these claims to insurance companies. Insurance companies do not appreciate the extent to which long COVID symptoms can be disabling. Using our winning strategy with these types of claims gives claimants the best chance of being paid short-term and long-term disability insurance benefits, and if necessary, preparing to litigate denials.

Topics covered include:

Insurance Law Personal Injury

Agenda:

Introduction

Introduction of Edward Dabdoub and the Dabdoub Law Firm
Overview of discussion points and main takeaways

What Is Long COVID and the Common Issues We See in Long COVID Disability Insurance Claims

Subjective symptoms are often hard to prove
Insurance companies/their medical reviewers do not understand or specialize in conditions like Long COVID
Contract limitations for fatigue conditions
Treating doctors do not know how to help in the claims process

How the Issues Above Are Made Worse When ERISA Applies

The standard of review
Closed filed review
No jury trial
No punitive damages
No discovery

How We Prove Long COVID Is a Disability

Obtain medical evidence using testing such as CPET, neuropsychological report
Create a network of doctors that specialize in Long COVID and use them for independent medical evaluations, peer reviews, and validation of testing
Obtain personal statements portraying the client before and after diagnosis
Obtain letters and questionnaires of support from treating providers that also address the independent testing and affirm

Communication With Insurance Company

Send a comprehensive letter with all supporting medical and non-medical information summarized
Follow up with polarizing questions that they can’t answer without looking unreasonable

Questions & Answers

Duration of this webinar: 60 minutes

Originally broadcast: April 16, 2024 8:00 AM PT

Webinar Highlights

This webinar is divided into section summaries, which you can scan for key points and then dive into the sections that interest you the most.

00:00 Introduction

Edward Dabdoub, the founder of Dabdoub Law Firm, specializes in disability insurance law. Edward will discuss handling long COVID disability insurance claims, focusing on insurance rather than government benefits. The presentation will cover the definition of long COVID, its symptoms, and challenges in disability insurance claims. Edward will address contract limitations in insurance policies and strategies to navigate them.

05:54 Understanding Long COVID and Insurance Challenges

Edward discusses the complexity of long COVID claims and strategies to challenge insurance companies. He explains the CDC's definition of long COVID and the subjective nature of its symptoms. Insurance companies often limit benefits based on fatigue or self-reported symptoms, complicating claims. Edward highlights the importance of understanding ERISA and its impact on disability claims. He emphasizes the need for treating physicians who understand long COVID and the challenges posed by insurance medical reviewers.

11:31 ERISA and Legal Strategies for Disability Claims

Edward explains the challenges of proving long COVID disability claims under ERISA regulations. He describes the limitations of self-reported symptoms and the difficulty in providing objective evidence. ERISA cases often rely on summary judgment with limited discovery and no jury trials. Insurance companies have an advantage due to the arbitrary and capricious standard of review. Edward outlines strategies to counteract these challenges and improve the chances of claim approval.

23:22 Building a Strong Appeal for Long COVID Claims

Edward outlines a strategy for appealing denied long COVID disability claims. He emphasizes the importance of building strong medical evidence and leveraging expert networks. The strategy involves cardiopulmonary exercise tests and neuropsychological evaluations to provide objective evidence. Edward highlights the role of independent medical evaluations and peer reviews in strengthening claims. He stresses the need for comprehensive documentation to avoid conflicting medical opinions.

36:14 Medical and Non-Medical Evidence Gathering

Edward discusses the importance of gathering both medical and non-medical evidence for appeals. He suggests using personal statements, symptom diaries, and visual evidence to support claims. Employment records can also provide insight into changes in performance due to long COVID. Edward emphasizes the need for polarizing evidence to compel insurance companies to approve appeals. He highlights the significance of expert validation and peer reviews in building a strong case.

47:48 Case Studies and Legal Precedents

Edward reviews case studies that illustrate successful legal strategies for long COVID claims. He advises against focusing on diagnosis and instead proving symptoms that cause work limitations. The Vastag case is noted for recognizing CPA testing as objective medical evidence. Edward suggests using strategic questions to challenge insurance companies during appeals. He concludes that the majority of appeals are approved, and litigation can be successful with strong evidence.

53:44 Audience Questions and Practical Advice

Edward answers audience questions, providing practical advice on handling long COVID claims. He emphasizes the importance of comprehensive evidence and consulting with expert physicians. Edward advises caution with social media to avoid undermining claims. He discusses the challenges of fluctuating symptoms and the need for thorough documentation. Edward shares insights into his specialization in disability insurance and long COVID claims.

Please note this AI-generated summary provides a general overview of the webinar but may not capture all details, nuances, or the exact words of the speaker. For complete accuracy, please refer to the original webinar recording.

Continuing Legal Education (CLE) Credits

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California CLE

Status: Approved

Credits: 1.00 General

Earn Credit Until: April 15, 2026

South Carolina CLE

Status: Approved

Credits: 1.00 General

Difficulty: All Levels

Earn Credit Until: December 31, 2025

North Carolina CLE

Status: Approved

Credits: 1.00 General

Earn Credit Until: February 28, 2026

This presentation is approved for one hour of General CLE credit in California, South Carolina (all levels), and North Carolina.

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Speaker

Edward Dabdoub Managing Partner
Dabdoub Law Firm

Edward Dabdoub is the founder of Dabdoub Law Firm – a law firm built for the sole purpose of helping people get their disability benefits from insurance companies. Eddie and the attorneys at Dabdoub Law Firm specialize in disability insurance law, as well as life insurance, representing clients across the country in ERISA disability insurance and individual disability insurance claims, appeals, and lawsuits. Read More ›