Wade Coye, Attorney

We’ve all been sick or injured at one point or another in our lives, and it seems to impact every aspect of daily living. Work is no exception. Disability insurance policies, purchased privately or through your employer, can cover the wages you lose during your short or long term disability. Each policy is different, but many of them have clauses specifying coverage according to the type and duration of your injury. If your injury lasts longer than the expected “short term,” then the terms of your long term policy go into effect. Be aware that disability insurance policies can be confusing, yet specific when discussing your injury, and the carrier can use it to deny your claim.

You may depend on long term disability insurance coverage if you are hurt and can’t return to your job. You will lose wages and have to pay for medical bills, all while continuing to support yourself and your family. You need to know that insurance companies use legal loopholes and provisions in the policies to resist paying adequate benefits or any benefits at all. They make it seem like they’re trying to help you if you become injured or sick, but keep in mind that they are still a business and want to make a profit. It seems that the insurance company is least cooperative in the most desperate times for their customers.

If you want to file a claim with your long term disability insurance company, the policy will usually require you to file for Social Security disability benefits. You would think that different decisions mean different consequences, but the insurance company can use approval or denial of Social Security disability benefits to reduce or deny your claim.

Getting approved for Social Security disability benefits isn’t easy, so you’ll probably feel relieved if you get a notice of award in the mail. But if you’re approved, the disability insurance company will reduce your benefits or make you reimburse them for the amount you receive from Social Security. The same goes for any of your dependents who receive benefits checks because of your disability. The insurance company seems to take any chance they can to reduce your benefits, even if those other benefit checks are going to your children or spouse.

Depending on the terms of your policy, a denial letter from Social Security may turn out as a convenient way for the insurance company to deny your claim. They might say that being denied for Social Security justifies being denied long term disability benefits because the requirements for both programs are the same. If your claim is denied, there is also little you can do in the appeals process.

Some insurance carriers hire representatives to help their customers apply for benefits from the Social Security Administration. You should know that these individuals might be working in different states, never meet you, and never truly understand the nature or impact of your disability. Before you agree to accept their help, think about whose interest they have at heart. A representative will work to defend the interests of the company that signs their paycheck. They analyze your policy, looking for loopholes to avoid paying benefits rather than opportunities for you to get the most out of your claim. If you need Social Security disability benefits, hire a lawyer that wants to help you, not the insurance company.

Most disability insurance policies that are offered as a benefit to employment are subject to federal regulation under the Employment Retirement Income Security Act, or ERISA. Before ERISA, a claimant could have their appeal heard in state court by a jury of their peers. Now, a judge reviews the case in his or her office, only to decide whether or not the insurance company’s decision was according to the terms of the policy. They use no moral judgement to make their decision about your benefits; they only take into account the confusing language that exists in the fine print, which you probably didn’t read or understand when signing up for the policy.

The requirements and procedure for filing for long term disability insurance benefits is not designed to help you. In fact, the insurance companies sometimes use confusing language to make it next to impossible for you to see benefits that match the amount you’ve invested in the policy. It is a difficult and frustrating situation to find yourself in an insurance dispute while you’re trying to recover from a disability and get back to work. You’re not alone if you don’t get benefits you paid for: you can appeal the decision.

If you are having trouble getting benefits under a disability insurance policy, your best bet is to call a lawyer. An attorney can help you understand your rights, your policy, the disability insurance claims process, and how to resolve the situation while minimizing your stress. I want to help you get the most out of your insurance policy. It is difficult to learn that your claim has been denied or diminished. Don’t settle for limited, slow, or denied disability benefits. Call our offices today to discuss your claim in a free consultation with an experienced disability advocate.

Wade Coye

The “Great Recession” that started three years ago has affected (and continues to affect) everyone. The irresponsible activities of Wall Street didn’t remain within one company’s walls, or even within the borders of this country. The whole world has had to deal with the consequences of corporations acting in their own best interest. Ordinary people without millions of dollars to risk on speculative investing now want answers for why their mortgages are unaffordable, why their retirement savings are gone, why their jobs are no longer available, and why a wealth of other things have gone wrong.

Part of the massive financial problems on Wall Street were brought on because of government policies from nearly 20 years ago. In 1992, Congress eased their ability to regulate Fannie Mae and Freddie Mac. The Bush administration tried to limit the mortgage companies’ spending limits by implementing stern suggestions as opposed to laws. When the Clinton administration came into office a few years later, there were no laws for them to enforce in regards to these federal loan companies. This misstep was just one of the ways that corporations were able to overstep their bounds without the government being able to exercise their oversight responsibilities.

Government regulation in a capitalist system needs to strike a balance. Too much regulation functions as a prescription for business and the economy. If there are too many standards in creating or conducting small businesses, then many business owners will function at these minimums because there is little incentive or permission to work above them. But too few government regulations can hurt the public interest, such as the food safety violations that Americans experienced in the early 1900’s. No economic system is perfect; another system of holding businesses accountable needs to exist.

If someone acts without considering the consequences that other people will have to face, then that is negligence. Innocent people have lost their livelihoods as a result of big corporations making risky investments. When one thinks about this situation occurring between two people, the answer may seem obvious: file a lawsuit. One person can sue another if there is enough evidence to show that the defendant’s negligent actions harmed the plaintiff. There is no doubt that a small group of speculative investors caused millions of people to lose their savings, jobs, or homes.

Citizens can file lawsuits against the American government or large corporations if there is justification, or in this case, a degree of negligence. Economic harm can cause as much damage as physical harm, and in a legal system based on justice, those responsible should be held liable. High-profile cases can take years and millions of dollars to resolve, so not many working citizens can successfully bring suit against a large corporation. Barbara Ann Radnofsky, a candidate for attorney general in Texas, is leading the charge to file a “sweeping lawsuit against Wall Street firms.” She feels that Texas citizens can win a settlement from executives responsible for the economic collapse just like Americans did against tobacco companies in the 1990’s. There’s no telling if the suit will be filed or even successful, but her convictions are in the right place.

Lawsuits won’t solve the problems caused by Wall Street, but they serve two valuable purposes. The opportunity to sue gives each consumer an outlet to recover damages incurred by the recession. It also shows these companies that they can’t act recklessly with money that is not their own. A lawsuit shows a company that no matter how large they are, they cannot act with impunity. Regulation (as it stands now) lets corporations keep most of their profits, but share liability for losses with the public. Legal action sends the message that these actions have consequences, and that someone besides the average American should be the one to deal with them.

There is controversy over the number of lawsuits filed in America, and discussion of tort reform is a result. Setting a cap on the amount of money one can collect in a lawsuit settlement is controversial because it doesn’t take into account the circumstances of a matter. The BP oil spill in the gulf is a perfect example. The Oil Pollution Act of 1990 sets a cap of $75 million in damages per oil spill plus removal costs. This means that if BP can’t fix their mess in the Gulf of Mexico in one, five, or maybe even 10 years, then they only have to pay citizens for it up to $75,000,000, even if the economic impact is well over that number.

Now, if you’re the head of a multi-billion dollar oil company and are only threatened with the possibility of having to pay 75 million dollars in damages, would that stop you from drilling? Maybe even violating a few environmental safety guidelines in the process? It probably won’t, especially if you have a team of lawyers to limit your liability and award consumers low damages in a settlement.

Lawsuits and uncapped damages show corporations that they can’t play by their own rules. Individuals can hold them responsible when government can’t or refuses to. The events of the past year show that corporate governance and governmental regulations are no substitute for citizens in a free society having the right to file a lawsuit against someone who has caused or contributed to great economic harm.

It is so easy to communicate in today’s world. People can speak to each other whether they are on the next street or on the next continent through phone calls, emails, instant messaging, video chatting, etc. These technologies allow people to stay connected and feel like they are having a face-to-face, personal conversation.

Legal professionals around the world are beginning to adopt videoconferencing as an alternative to traditional meetings. Depositions, mediations, and other litigation matters can be conducted through video conferences. There are a lot of benefits to conducting a conversation online rather than in person or by phone, but there are a lot of downsides as well. Either way, this new means of communication is having a big effect on how certain cases are being resolved and its significance needs to be considered.

Video Conferences in General

At the Coye Law Firm, we participate in videoconferencing mainly for Social Security disability and workers’ compensation cases. Many clients pursuing these types of claim are injured or disabled and unable to leave their homes. Video conferences provide a face-to-face interaction between the client and legal professionals without the need for strenuous transportation. Video conferences can be set up at any time and virtually anywhere, so meeting times are more flexible. Because those involved in the chat may never need to leave their homes or offices, videoconferencing also saves time and money.

Case by Case Conferences

Florida is a big state and has many courts to reflect it’s size. If a client appeals a workers’ compensation claim, their case isn’t handled by a local court, but by the First District Court of Appeals, which is located in Tallahassee. Workers’ comp clients in the Keys would have to travel 10 hours to appear at a live hearing in Tallahassee. The workers’ compensation system has adopted video conferencing as a courtesy to clients who prefer not to travel to the state capital. Clients and attorneys can choose to appear at a live hearing if they want to, but our firm has yet to see anyone take this option. These cases can require many short meetings, so clients and attorneys both recognize the benefit of appearing virtually rather than in person.

Social Security disability hearings are designed to show the claimant’s impairment or pain to a judge. Claimants are also expected to testify on their vocational, educational, and workplace history as it relates to their disability. After their disability is assessed, the judge then grants them monetary benefits to make up for their limited ability to work. Video conferences let clients with limited mobility appear at their hearings, but a judge may not be able to assess their character or veracity as well. Because this essential element of the SSD process is impeded by a video conference, the client and/or their lawyer may request a live hearing instead. The Coye Law Firm is making efforts to test video technology and conduct conferences in SSD claims from regional offices. Instead of having to travel across the state or country, judges can meet online with our attorneys and clients at a regional SSD office.

Drawbacks to Video Conferences

Cost is an important consideration in any part of the legal process. It costs money to hire court reporters, rent conference rooms, purchase equipment, and ensure that all of the necessary professionals are able to participate. If the benefits outweigh the costs, then an attorney may schedule a video conference during a case’s resolution if it isn’t already required. As more offices and systems switch to paperless or efficient communication methods, video conferences are becoming a more prevalent means of resolving a legal claim.

Is cost the only thing that keeps legal professionals from embracing this new technology? Not quite. Credibility is an essential part of any case. Visual cues and body language are instrumental in communicating effectively, while appearance and facial reactions can help to bolster a client’s credibility. Unlike telephone calls, video conferences let legal professionals see the client’s reactions. However, the technology hasn’t accounted for normal conversation cues such as eye contact. Many people become nervous when they are on camera or being recorded, so communication can be stifled this way also. Soft-spoken clients may have trouble voicing their concerns through video. If additional evidence needs to be submitted, it can take extra time to fax documents or send files, although all evidence should be submitted before a hearing. These difficulties have been noted in practice rather than anticipated before a video conference.

Daily Applications of Video Conferencing

Despite all of the benefits and drawbacks, the Coye Law Firm has integrated video conferencing into our daily routine. One of our attorneys, Dan Smith, communicates on a regular basis with a client who lives in Japan via Skype. Our firm set up a deposition for this client using the same program, which saved him an expensive and exhausting trip. You can contact our office via Skype by calling username CoyeLawFirm. Our regional offices benefit from video conferencing programs such as iChat and Jabber because our attorneys can share documents instantly and meet clients when they otherwise wouldn’t be able to.

Client reactions are emerging slower than the technology; some believe that their day in court is less personal or ineffective if they only appear in front of a judge on a television screen. Obviously it will take time for everyone to adjust to the changing means of communication during a case. Since the beginning, our firm has taken advantage of how the latest technology increases communication efficiency. As the legal system adapts, so does our practice. The attorneys of the Coye Law Firm want to help clients resolve and understand their specific case. Visit our website to learn about our firm’s experience, qualifications, and ways we can help you.

As construction comes to a close, we would like to share with you some milestones in the building’s construction. Follow our updates on Twitter (@theCoyeLawFirm) and view many more photos on our Facebook page.

Last week crews installed the air conditioning system to cool the three floors of open office space.

Wade Coye

It is a rare case that involves only one area of the law. If laws and the legal system were straightforward and easy to navigate, there would be significantly less demand for legal assistance, i.e. attorneys. People call lawyers to understand their options, work on their problems, and ultimately recover from them. Some attorneys serve clients by being well-versed in many practice areas and others do this by specializing in a limited range of cases. There are advantages to focusing on a few practice areas, but some attorneys lack the knowledge or initiative that complex issues require. For example, car accidents in other states are inherently complicated because each state has different laws governing the sources and process of claiming benefits. If you live in a different state from where the accident occurred, it is intimidating to say the least.

Every day, Americans travel from state to state by car with their families or friends. This form of travel can give people great freedoms in their vacations or visits, but it can also carry some risk. If you have ever been involved in a car accident in another state, you know it can be difficult to sort out even without serious injuries. Each state has different laws governing insurance and liability. The insurance and personal injury lawyers of the Coye Law Firm want to help you recover quickly from these overwhelming circumstances.

Unfortunately, some attorneys may say “you need to find an attorney in that state” or “I’m not experienced in insurance claims” when you call their offices. This sort of “tunnel vision” comes about when legal professionals only take on cases in a small number of practice areas. The attorneys at the Coye Law Firm know that this strategy doesn’t do the most to help clients. We want to help people solve the many problems that they need help with. Out of state car accidents, as mentioned above, are a prime example of the coordination, investigation, and communication that attorneys need to resolve a client’s complex problem.

Out of State Drivers in Florida

The first thing that tourists or other visitors from out of state need to know is that Florida is a no-fault state. This means that, regardless of who is at fault in an accident, a person’s injuries are paid for by their own insurance policy under most circumstances and up to the limits of their Personal Injury Protection. The system is designed to prevent law suits and pay benefits quicker, but it can also be confusing and limiting for people who don’t know what areas of liability exist in their accident. For example, you can use health insurance or workers’ compensation benefits in some circumstances to help cover extra medical bills or lost wages if necessary. These other forms of insurance can be repaid by any recovery you receive from the at-fault driver in court. As you can see, skillful coordination is needed in these accidents.

So what does this process mean for you and your accident? If you are an out of state driver and get into an accident in Florida, your own insurance may pay for your injuries if you are from a no-fault state and have a no-fault policy. Accident victims from non no-fault states may recover their full payment from the at-fault driver in some circumstances. Your ability to sue for more money may be limited in a no-fault state. In Florida, your injuries and other damages must surpass a certain threshold in an aspect of your policy in order to bring the case to court. Visitors from other no-fault states may have some familiarity with the system and can have a significant amount of coverage to protect themselves. People from non no-fault states, however, can feel overwhelmed and confused when seeking compensation for their injuries. A lawyer can help you understand insurance policies, laws, and areas of liability. A personal injury attorney from the Coye Law Firm can get you the benefits and peace of mind you need in the aftermath of an out of state car accident.

Florida Drivers in Other States

The Florida no-fault law requires that resident drivers have a minimum of $10,000 for Personal Injury Protection (PIP) and Property Damage liability. Just like the name implies, “no-fault” insurance pays for the policy holder’s injuries regardless of who caused the accident. Of course, your insurance policy may limit or deny claims that occur in other states based on the contract. For example, you might be required to be in the car listed on your policy. But if you are covered and in a car accident and break your arm, your own insurance pays for the hospital bills up to the amount you have insured. If your injuries go over the amount you have insured under the car insurance policy, then your health insurance can pick up the rest of the bill. You can choose to pursue benefits from the at-fault driver, but there is no guarantee that you can recover benefits this way. Property Damage Liability coverage pays for any damage you may cause in an accident up to the amount that you have insured. Both of these coverages also protect family members, as well as some unrelated passengers if they do not own a vehicle or have their own PIP coverage.

What happens if you get into an accident in another state? The short answer: it depends. Some other states (including Massachusetts, New York, Michigan, and Utah) have no-fault laws as well. Although the no-fault system is designed to limit the amount of law suits, the injured driver’s ability to sue for damages varies based on the way the state’s law is written. For example, drivers in Massachusetts can file a suit if their injuries surpass a certain quality, i.e. their injuries are classified as “disabling” or “severe.” In New York or Florida, a person can file suit if the damages exceed their covered amount in a certain area, such as coverage for medical bills. If the victim is disabled and can prove that they need costly long-term care, they can pursue damages as well. Additionally, no-fault benefits often only cover your injuries if you are in the vehicle listed on your policy.

Compounded Laws: Interstate Accidents

What happens when a driver from New Jersey gets into a car accident with a driver from Florida while they are both traveling on I-95 in South Carolina? Road trips can be a great way to see the country, but each state has its own set of laws that govern who is at fault, who pays for damages, and how the legal system protects those involved in an accident. It is important to know that wherever your accident occurs, that is where the case or claim will be filed, and the laws of the state dictate the process of delivering benefits. This area in which the accident occurs is referred to as the “jurisdiction.” So, in this example, the case will be filed in South Carolina and the recoverable benefits are governed by their laws. The cases can be moved in rare circumstances, but victims should be prepared to communicate with attorneys in many areas of the country in these situations. Again, the benefits you are entitled to and the process of getting them is governed by the state in which the accident occurred. The Coye Law Firm can communicate with other attorneys and multiple insurance carriers in order to speed up your recovery.

The Coye Law Firm helps injured victims in many ways. Our lawyers are experienced in many practice areas, thorough in their research, and able to practice in many parts of the country. Additionally, our firm maintains professional relationships with other firms around the United States. These connections help Florida residents or visitors work from their home states and recover the benefits they are seeking. If you have been in a car accident in Florida or anywhere else in the country, contact the Coye Law Firm to recover quickly, both physically and financially.

The information contained in this post is not intended to be or replace legal advice. Consult an attorney at the Coye Law Firm to receive legal advice tailored to your situation.

Wade Coye, Attorney

The fight to provide more health care coverage for Americans has sparked debate in all parts of the country. The issue is complex and goes beyond tax payer costs or quality of care. Nationalized health care raises many legal issues as well.

How Can a Benefit Be a Burden?

It can be an exciting thing to get a new job, especially in our country’s current economy. When a person finds out that their new job provides health insurance benefits under an employer-sponsored plan, they think that concerns over health care costs have been lifted from their shoulders. But what happens if the plan precludes coverage for certain areas or the language is confusing? While it may save employees money in some circumstances, employer-sponsored health care plans can create expensive, federal-level legal disputes that can end up costing you more money than you’re saving.

Employers are not obligated to offer group health insurance plans. If they do, the plans are regulated under federal law, specifically the Employee Retirement Income Security Act or ERISA. ERISA excludes employees of state or local government entities, religious groups, and some unions. Some states have laws governing employer health care as well.

Self-funded vs. Insured Health Care

The health care plans offered by employers may be self-funded or insured. If employers do not purchase insurance for their employees, but instead pay for health care costs themselves, then the plan offered to employees is said to be “self-funded.” This is a risky practice, particularly when the employer faces financial trouble. Insured health care plans are offered when employers buy an insurance policy for their group of employees. Which one do you think is more likely to create disputes? If an employee has a problem with the benefits they are receiving–or they are receiving none at all–they have certain options when it comes to fighting the decisions.

If your coverage, even routine care such as prescriptions or preventative doctors exams, is disputed and your plan is insured, your right to appeal the decision to the insurance company’s review board is governed by ERISA. ERISA dictates the process of internal appeals in self-funded plans as well, but that is where the government’s assistance ends. If your appeal is denied, you have the option to file a lawsuit in federal district court. Our firm sees these cases often and we know the heart-wrenching circumstances that come with the frustration of benefit denial. This is when you need a lawyer. This is when your small insurance dispute can become a state or federal case. Call the Coye Law Firm to speak with a compassionate, experienced attorney who can address your specific questions regarding employer-sponsored health insurance benefits.

If your claim reaches court, a judge often just reviews the terms of your employer-sponsored health care plan and decides whether or not the decision to deny benefits fits into the rules outlined. They cannot take over a decision on your health care benefits, but instead only decide on whether or not the decision matches the terms of your plan. Even if he or she rules in your favor, there is no obligation for the employer or insurance carrier to pay your attorney’s fees. You may end up paying more to win your case than the cost of the original benefits that you need to collect.

A Federal Case out of Health Care

The discussion about nationalized health care is different for many people. Consumers tend to focus on the costs and delivery of health care, while legal professionals are considering what the new system would mean for the appeals process and number of law suits. Consumers will have to spend more money to defend their right to insurance coverage and attorneys will have to fight to get their fees covered. Courts rule in favor of employers often, which can prevent employees from receiving care they need. If health care is nationalized, then more disputes will be turned into “federal cases,” creating a financial and time-consuming headache for many employees who are being denied health care coverage.

The Bottom Line…

Any insurance plan needs to be thoroughly reviewed before you know you’ll need to use it. If an employee suffers a broken leg on vacation, and finds out too late that their health insurance plan will do nothing to protect them because of some small clause or loop-hole, he or she does not want to find this out while lying in a very expensive hospital bed. No one wants to get tangled up in legal disputes, especially when they’re recovering from an injury or illness. If you’re in the middle of a battle with your health insurer, call our firm today.

Wade Coye, Attorney

The ugly secret about Florida car and truck insurance is the minimal amounts required by law. Did you know, for instance, that you are required to insure yourself from injuries that you sustain irrespective of whether you or another person are at fault? The Florida no fault law requires each person who owns a car to carry $10,000 in personal injury protection insurance coverage. No doubt this coverage helps with minimal lost wages and medical bills, but does nothing in a more serious case. Particularly since the hospital bills alone can eat up the entire amount of available personal injury protection coverage. Even more incredible is that you are required to carry damage insurance to help pay for any property damage that you may cause when driving your car. It would seem a bit odd that you have to carry insurance to pay for another persons car damage but nothing for damage to anothers person, but that is the sorry state of Florida law.

A substantial number of people who move here from other states are shocked when they discover that the minimum required insurance does not mean you have to carry bodily injury coverage much less uninsured motorist coverage. This often times leads to difficult circumstances when we try to help someone who needs to make a claim for injuries they have sustained due to the negligence of another driver. Typically the problem is too many medical bills and not enough insurance, in no small part because there was not any bodily injury and or uninsured motorist coverage. This is why it is very important that you use whatever available health insurance, medicare, medicaid and or champus benefits to pay for medical bills even if someone caused or contributed to an accident or injury that you have sustained. If you use these resources, at the very least you will have paid most of your bills. In some cases it is important to reserve personal injury protection benefits to allow you to receive some wage loss benefits prior to benefit exhaustion. A common mistake made at hospital rooms and doctors offices is to insist that the defendant driver of another vehicle will pay all the bills. It is better to consult with a lawyer who can direct you on the options to get your bills paid while you work through the difficult circumstances of an accident or injury.

After nearly a decade of minimal regulatory oversight and most favored industry status, the Florida insurance companies are quickly learning that Governor Crist & Company will not tolerate bad behavior. The recent conflict in Tallahassee between the Allstate Insurance Company and Florida Insurance Commissioner Kevin McCarty has all the trappings of a classic showdown in the old West between the new Sheriff who promises to clean up Dodge and the entrenched railroad and cattle barons who want business as usual.

The insurance industry could do no wrong during the entire Jeb Bush tenure, which may have led Allstate to believe that it no longer needed to comply with the rule of law. This all changed with the move to require insurance executives to testify under oath and to produce key documents pertaining to its anti-consumer, predatory corporate practices. Who knows where this will lead. Likely increased governmental regulation and a return of consumers having an open door to governmental leaders. But will it lower rates? Likely not.

One thing is clear, there’s a new Sheriff in town and he has willing deputies who are committed to cleaning up Tallahasee. The time has come for a balance between the rights of industry and the rights of consumers in insurance rates.

Wade Coye, Attorney

Any discussion of universal healthcare necessarily requires inquiry into the types of insurance that already provide some level of care for a person’s health. For instance, many people access healthcare through health insurance that is paid for by tax dollars already: federal, state, and local employees, medicaid, medicare, federal workers compensation, and military benefits such as veterans benefits. In the private sector people receive health care from individual and employer sponsored group health benefits, workers compensation policies, auto no-fault policies and other accidental and health policies. Some of these policies pay based upon specific conditions and some pay for health care no matter the situation.

All of the above pay for much of the care that is obtained in this country and is necessarily something which bears significant consideration in a discussion of so-called universal healthcare.  Each of the above has overlapping and duplicate coverages for some, and for others is the sole financial resource to obtain healthcare.  The funding for the different types of coverages are paid for by a combination of state and federal regulatory frameworks, compensation plans, and tort liability. No discussion in the national media has completely reviewed these issues or the likely effect that universal healthcare will have on the existing means of obtaining medical treatment.