In this case, the insurance company will consider you a manager, not a Chiropractor, and the definition of a manager will apply. So, if your medical symptoms would prevent you from working as a chiropractor, but don't prevent you from working as a manager (in a chiropractic office or ANY type of office), you will receive no disability benefits. Timing is very important when it comes to a disability claim, and knowing when and how to quit can make the difference between receiving benefits and receiving nothing.

How Do You Handle Your Social Life After You Go on a Partial or Total Disability Claim?

Many insurance companies use video surveillance as an important tool in their arsenal of weapons to discredit your claim. You have to make sure you are not doing something that is in conflict with your medical symptoms.

If you had to reduce your hours or completely stop chiropractic adjustments because of a rotator cuff problem, throwing a football or baseball with your 10-year-old, will certainly be in conflict with your symptoms. Skiing or being a "surfer dude" with a low back problem would also be in conflict with your symptoms. Have a lousy low back or shoulder or hand problem? Walking your 80 pound Labrador Retriever who is pulling you in all sorts of directions (in spite of a choker chain) might not be the best way to act for one with a disability claim.

This doesn't mean you cannot do any type of sports or activities. It means that you can do some activities within your limitations. Letting the insurance company know what activities you perform using the proper language will avoid the "gotcha syndrome," which can be the basis for a termination or denial of a claim.

Knowing how insurance companies do video surveillance is also important, as well as knowing what is permissible and what is not. Parking a van in your neighbor's driveway is a "no-no," as well as following 10 feet behind you in a van while you take a soft stroll with your neighbor.

If a Disability Claim is Denied or Terminated, What Are Your Options?

There are 4 options:

1. You can roll over and play dead and do nothing.
2. You can appeal the claim yourself, which would be the equivalent of filing a tax return instead of letting your C.P.A. prepare it.
3. You can hire an attorney. Some (very few) will charge you an hourly rate and ask for an "up-front" retainer fee. As the money gets used up based upon the attorney's time, you will be asked for more money. Amounts could reach $75,000 to $100,000, and that is even if the case is settled (which many are) and another $50,000 or more if you go to trial. All the expenses of which are being paid on your end. Most of the attorneys who specialize in disability claims will charge you a "contingency fee." They assume all costs initially and if the claim is settled (often for 40 cents on the dollar or less), the attorney will get paid one third or 40% of the settlement amount plus all the costs they have advanced.  If you had a two million dollar potential payout, you might end up with 20 cents on the dollar net or $400,000. Most lawsuits wind up in federal court (moved from local court). The difference being: A Federal Court Judge can pick as many people as he wants on the jury (8, 10, 12, l4) AND in a trial everyone must vote favorably for you, otherwise there is a "hung jury" (which in essence means you don't win) and your attorney will then suggest you go back to the arbitrator to see if there can be a "meeting of the minds," which means a much lower settlement. Wanting to go another round in trial might be offered with additional expenses piling up in addition to the mental anguish you will suffer.
4. Hire a consultant highly experienced in disability claims. The consultant will help you prepare an appeal for a small retainer fee and charge an hourly rate against that fee. The total cost is usually less than $10,000 even when costs exceed the amount of the initial retainer fee.

The foregoing are just some of the questions you will have to deal with if you go on a partial or total disability claim. For the following reasons, you may want to think twice before deciding to go it alone:

• There are many forms to complete — initially and on an ongoing basis. In addition, many of the questions you will be required to answer demand a very thorough understanding of the subject matter. The importance of answering the questions correctly cannot be overstated.
• Many hours of work are usually required. Submitting the initial claim form is only Round One.
• You take a simplified approach when your needs are "major league."
• Not understanding the meaning of words as they apply to a disability contract can also cause you to prejudice your rights. For example, what's the real meaning of "pre-existing condition?" Does the wording "fraudulent misstatement" change the above? Does the state in which you reside have an effect on how the insurance company interprets these clauses?
• Finally, and most important, do you know how to maintain dignity, self-respect and credibility in your relationship with your insurance company?

A disability claim consultant may be the best investment you can make in successfully and effectively submitting your disability claim.

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Arthur L. Fries is a disability claim consultant. Although no longer active in selling, for many years, he specialized in the sale of individual disability insurance to attorneys in Los Angeles. For more information or to contact him with questions, visit his Web site: www.afries.com.