text:
Imperial Triumphant List Their Top 5 Luxurious NYC Structures
February 25, 2019 Chris Dick
Lists 432 Park Avenue Condominiums, Avant-garde Black Metal, black metal, Chrysler Building, Ed Koch Queensboro Bridge, General Electric Building, Gilead Media, Imperial Triumphant, New York City.
Kenny Grohowski, Steve Blanco and Zachary Ezrin are New York City. From their brimming musical confidence to their band's — Imperial Triumphant — out/inward projection, there's no doubt the trio are the product of the Empire City. While most think of New York City for its tourist traps, its famous Metropolitan New York English accent and how it's remained the focal point for American capitalism since 1817 (OK, that's arguable), there's something else afoot in the Big Apple. Buildings are symbolic of many things, but chiefly among them are power, opulence and masculinity.
These things directly informed Imperial Triumphant's new album, Vile Luxury. Whether it was the Art Deco madness of the General Electric Building, the transcendence of the Queensboro Bridge or the ego of Walter P. Chrysler — the Chrysler Building is a personification of industrialist prestige and power — the New York City-based trio have channeled the spirit of these symbols into their avant-garde black metal. So, Decibel, being the clever gents we are, decided to prompt Kenny, Steve and Zachary into thinking heavily about the ornate steel and concrete phalli that occupy New York City's skyline.
Read on. Imperial Triumphant are about to turn New York City iconic structures — the vilest of luxuries — on their proverbial heads.
5. 432 Park Avenue Condominiums.
A huge failure of decadence. You can see from anywhere outside the city. It's the tallest residential building in New York. It's built so that every 10 floors is open for wind to go through it. Half of it is, we're sure, owned by Russians, Chinese, Saudis. Actually, they just own it. They only "live" there like two days of the year. The top floor is always dark, vacant. You never see lights on there. Truly, a building built for people to invest in. Nobody lives in that shit. It's sole purpose is property ownership in New York City, like some rich Russian guy, who can brag about it to his cronies or whatever. That building is cool looking — it's so fucking tall — but where all other buildings in the city are illuminated, 432 Park is this huge dark pillar on the skyline. It's a Jenga piece that's pure evil.
4. Chrysler Building.
Built in 1929 by William Van Alen, it is the single most powerful structure/symbol in New York City, as far as decadence and opulence goes. The entire top is made entirely of one piece stainless steel. There used to be a bar in there, where the owner of Chrysler could hang out with his friends and do crazy/sleazy shit. It's so fucking dark, actually. The secrets that are buried within that structure are unreal. There's an ominous presence to it. The gargoyles can be seen from so far away. On top of all that, just like New York, where there's extremes of good and bad, it's also a beautiful building.
3. Grand Central Station.
Mercury is right out front, looking down on everyone. A lot of people don't know his but Mercury is the god of financial gain. There's no accident that he's there front and center, atop Grand Central Station. Mercury is where the word 'mercantilism' comes from. The clock is right there, too. So, here's Mercury, keeping time, time is money, looking down on everyone. Structurally, it's beautiful. Inside, no matter how many people are in there, it's still quiet. The public space is gigantic. You never feel closed in at Grand Central. Also, Grand Central happens to be right next to the Chrysler building. And it's not too far from General Electric. I'd imagine, thinking about it now, that these three buildings would form a triangle. There's a lot of crazy triangles in New York, the World Trade Center, which goes straight up the Citibank Building, the one with the sloped roof. Then, front there it's directly across from City Tower. That's one of the more well-known isosceles triangles in New York.
2. Ed Koch Queensboro Bridge (aka Queensboro or 59th Street Bridge).
I love the Queensboro Bridge. It looks like a monster, an evil monster. It goes from Queens across the East River, and then descends into Midtown. You really don't see that in any other city. The bridge is so massive. If you look carefully you can see a lot symbols strategically places along the bridge. Meaningful shit, really. There's keystones. Who knows where it's coming from? Sumeria, maybe? That's definitely structure I can think of that fits the parameters here. It's not a skyscraper or building, but it's fucking cool all the way through.
1. General Electric Building.
General Electric Building. 570 Lexington. So phenomenal. General Electric owns it. It's a very dark building. The top of it is terrifying. It was built as a homage to power and electricity. The top is just crazy. It's so decadent, but you can't really even see it from the ground. It's built like a homage to the gods. So epic! But if you look around the bottom you'll see lightning bolts, fists, symbols of aggression, symbols of masculinity. There's also pieces of Egyptian art in there too. It's very esoteric. The powers of ancient cultures and putting them on a gigantic building for all to see. We're obsessed with this building.
** Imperial Triumphant's new album, Vile Luxury, is out now on Gilead Media. Click HERE for digipak CD or 2XLP. Order now or find yourself not imbibing in the vilest luxury from the darkest towers of New York City.
For continued reading, check out Imperial Triumphant's Top 5 Jazz Albums. Click HERE.
Because we're only two weeks into 2020 and there is still music to discover. And because you can't get enough goddamn lists, here are 60 more from 2019 to chew on.
Scott Taysom's (Cloak) Top 5 Horror Movie Soundtracks
Cloak guitarist/vocalist Scott Taysom gets creepy with his Top 5 Horror Movie Soundtracks at Decibel. Relive the horrific repetition and moody atmospheres of winter's cruel throes with us!
I always like to refer to Type O Negative as "Flock of Assholes." But we have somewhat better haircuts.
- Peter Steele, Type O Negative (Issue #69)


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EUROMETAL // Klöckner eyes net zero emissions by 2040
Klöckner & Co plans to reduce directly controllable emissions to net zero by 2040, Kallanish learns from the German-based steel distribution group. Emissions that it can only control indirectly – primarily from bought-in steel products – are to be cut to net zero by 2050.
The company signed up in 2020 to the Science Based Targets initiative (SBTi) "Business Ambition for 1.5°". The SBTi has now validated the near-term carbon reduction targets adopted by Klöckner as science-based targets.
With those targets, Klöckner says it will achieve by 2030 a 50% reduction in its scope 1 and 2 emissions, meaning emissions associated with the business itself, such as from company-owned vehicles and purchased energy. In Scope 3, the company will likewise reduce directly controllable emissions, such as from business travel, by 50% by 2030. Non-directly-controllable emissions, for example from bought-in products and services, will be cut by 30% by 2030. These near-term targets are in line with the Paris Climate Agreement, the firm says.
In Scope 1 and 2 alone, the company expects to save some 90,000 tonnes/year of carbon from its own emissions. The package of measures to this end has been titled "kloeckner takes action 2040". Activities include further centralisation of energy procurement and a progressive switch to renewable energy sources. The group has also begun converting its car and truck fleet to innovative means of propulsion, including electric mobility and hydrogen.
In October, Klöckner was the first steel distributor to enter into partnership with the Swedish start-up H2 Green Steel (H2GS) to secure access to virtually carbon-emission-free steel (see Kallanish 7 October).

redpajama_set_name: RedPajamaCommonCrawl


Peter Lynn has been an avid kite flyer all his adult life and founded Peter Lynn Kites in New Zealand in 1973. Peter Lynn is a pioneer in the kite buggy and power kiting fields, developing the first commercial kite buggy in the late 1980s. Today their products cover the entire range of kiting from small diamond kites to the world's largest show kites as well as land based traction kites and kite surfing gear.


Michelle Nicolle and band were appearing at the Lido Jazz Room. It's a little room located in the Lido Cinema complex with no windows and cinema staff providing drinks to your table for 50-or-so listeners after paying entrance at a box office. Strange, but comfy and intimate. Intimate enough for chats with other listeners and perfectly intimate for Michelle who sings so close, with such detail. We could hear every nuance here and it's all a gem. And she's daring. The first set was comfortable and hugely developed standards but then there were first takes and sight reads in the second, and not too predictable, but a cover of Mark Murphy with dropped beats and a take on Isfahan that melded into Caravan with an F that was refused in London. Thus her call to Frank that "I never like to tell people what to play, but can you play that" in their ongoing repartee of the evening. This night Frank DiSario was playing and he was big and boldly toned and delightfully expressive, not least in solos, including some wondrous swaps with a cheekily accelerating Geoff Hughes. No bass could keep up with his guitar speed and Frank answered by slowing and it worked. Ronny was in his corner with his occasional fours, too, but mostly unobtrusive, quietly delightful and subtle accompaniment. They could all twist the feels, too, sometimes to swing also elsewhere, extended twos against swing or latin or whatever. In this space and with this PA we heard it all, Geoff's woody, uneffected tone and generous clarity from both Frank and Ronny and Michelle's gloriously even deliriously detailed treatment of lyrics and inventive, intelligent scats. How satisfying was this. We heard it all to the n-th degree of subtlety in this space and I for one just melted with the beauty and skills of it all. A treat of the highest order: an intimate space and a master or a few who knew how to use it. Absolutely fabulous.
Michelle Nicolle (vocals) led a quartet with Geoff Hughes (guitar), Frank DiSario (bass) and Ronny Ferella (drums) at the Lido Jazz Room in Glenferrie Road, Hawthorn.


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Q: all combinations of differences of two lists I have two lists, one being the canonical good list, and the other being the current bad list. I want to try all combinations of deviations of the bad list from the good list. For example:
good = (0,1,2,3)
bad =  (0,10,20,3)

after applying operator op(good, bad), I should get back
ret = ((0,1,2,3), (0,10,2,3), (0,10,20,3), (0,1,20,3))

in any order for the sub list.
The lists I am working with are the output of stty -g, which are 36 elements, and the lists differ by 16 elements.

A: Zip the good and bad lists, map each resulting tuple to a set and feed that to itertools.product():
from itertools import product

for combo in product(*map(set, zip(good, bad))):
    print(combo)

Demo:
>>> good = (0,1,2,3)
>>> bad =  (0,10,20,3)
>>> from itertools import product
>>> for combo in product(*map(set, zip(good, bad))):
...     print(combo)
...
(0, 1, 2, 3)
(0, 1, 20, 3)
(0, 10, 2, 3)
(0, 10, 20, 3)

This will take any size of inputs; not just good and bad, but you can add in ugly as well:
>>> ugly =  (1,2,4,3)
>>> for combo in product(*map(set, zip(good, bad, ugly))):
...     print(combo)
...
(0, 1, 4, 3)
(0, 1, 2, 3)
(0, 1, 20, 3)
(0, 10, 4, 3)
(0, 10, 2, 3)
(0, 10, 20, 3)
(0, 2, 4, 3)
(0, 2, 2, 3)
(0, 2, 20, 3)
(1, 1, 4, 3)
(1, 1, 2, 3)
(1, 1, 20, 3)
(1, 10, 4, 3)
(1, 10, 2, 3)
(1, 10, 20, 3)
(1, 2, 4, 3)
(1, 2, 2, 3)
(1, 2, 20, 3)

Generalized to a function:
def op(*sequences):
    return product(*map(set, zip(*sequences)))

for combo in op(good, bad):
    print(combo)

for combo in op(good, bad, ugly):
    print(combo)

Because a set is used to produce unique values from each combined set of inputs, the output order is not the same as the order of the inputs. If order is important, you can replace set with a dupe-removing order-preserving function instead:
def unique_with_order(seq):
    seen = set()
    seen_add = seen.add
    return [x for x in seq if x not in seen and not seen_add(x)]

def ordered_op(*sequences):
    return product(*map(unique_with_order, zip(*sequences)))

which produces output ordered according to the order of the inputs:
>>> for combo in ordered_op(good, bad):
...     print(combo)
...
(0, 1, 2, 3)
(0, 1, 20, 3)
(0, 10, 2, 3)
(0, 10, 20, 3)
>>> for combo in ordered_op(bad, good):
...     print(combo)
...
(0, 10, 20, 3)
(0, 10, 2, 3)
(0, 1, 20, 3)
(0, 1, 2, 3)

A: What you want is the Cartesian product of the good-or-bad value at each index, except that when good and bad have the same value, you only want one of them, not two copies of it.
So, let's zip the two lists, and reduce each component where good==bad to a single value:
>>> gb = (([g,b] if g!=b else [g] for (g, b) in zip(good, bad))

Then the Cartesian product:
>>> ret = itertools.product(*gb)

And since you want it as a tuple:
>>> ret = tuple(ret)
>>> print ret
((0, 1, 2, 3), (0, 1, 20, 3), (0, 10, 2, 3), (0, 10, 20, 3))

redpajama_set_name: RedPajamaStackExchange


Sooner Rotarians were treated to talks by directors of two of Norman's most successful social service agencies at Tuesdays meeting. The Mary Abbott House and Center for Children and Families are vying for $100,000, proceeds of the 2014-15 Le Tour de Vin events sponsored by the four Norman Rotary clubs.
Clint Williams director of Mary Abbott House, spoke about the project to build out the upper level of their newest facility which will expand the ability to serve children who have experienced sexual abuse. The nationally accredited program provides forensic interviews and medical assessment of children, working closely with the Norman Police Department.
Kate Fitzgerald spoke on behalf of CCFI on the needs of that agency to make improvements to the former Emmanual Baptist Chuch to fit the needs of CCFI. The agency provides therapeutic education and recreational services for 2,000 children and their parents each year. She indicated that the Rotary money would be used to develop an indoor therapeutic playground.
Norman agencies were invited to submit proposals for capital projects for funding from Le Tour de Vin. Sooner Rotarians will add their vote with the other Norman Rotarians to select the designated recipient.


text:
How to fuel a rewarding culture
'Money matters, but sometimes we find financial incentives to be insulting or grubby'
Here's an age-old management conundrum: who should be rewarded for high performance, and how? As Diane Coyle, the economist and former adviser to the UK Treasury, recently observed in this newspaper, the answer to the question is usually self-serving. Simple and easily monitored jobs, such as flipping burgers, are natural candidates for performance incentives. Yet somehow it's the inhabitants of the C-suite who tend to pick up bonuses, despite the fact that their complex, hard-to-measure jobs are poorly suited to the crude nature of performance-related pay.
But let's assume that managers really want to answer the question. The answer is deliciously complex. Money matters, but sometimes we find financial incentives to be insulting or grubby. And we can respond keenly to non-financial rewards such as praise, status or the satisfaction in a job well done.
So managers might try running experiments to see what works in a particular situation. There is a long tradition of this, going back to Harvard professor Elton Mayo's productivity trials at Western Electric's Hawthorne works in the 1920s and early 1930s.
The Hawthorne experiments themselves, alas, were flawed and have been mythologised. But more modern experiments are revealing some intriguing results. I reported a few years ago on the curious alliance between "Farmer Smith", owner of a large British fruit farm, and three economists, Oriana Bandiera, Iwan Barankay and Imran Rasul. Bandiera and her colleagues designed and tested different incentive schemes on Farmer Smith's farms. (The deal: he got higher productivity; they got the data.)
The fruit farm experiments show that financial incentives do matter, at least for casual immigrant labour on fruit farms. First, a piece-rate scheme boosted productivity by 50 per cent; then, performance pay for the front-line managers ensured that work was no longer assigned as a favour to friends, and productivity increased another 20 per cent; then, a tournament encouraged workers to sort themselves into productive teams, and productivity increased by a further 20 per cent.
In another study by Bandiera (with Nava Ashraf and Kelsey Jack), hair stylists in Zambia's capital Lusaka were recruited to sell condoms and give advice on HIV prevention. It turned out that celebrating the top performers at a public ceremony proved a far better approach than providing financial incentives to sell more condoms.
But sometimes neither a public ceremony nor a financial incentive is appropriate. Consider the case of long-haul airline captains. Unlike part-time condom agents or fruit pickers, these senior pilots have high-status, six-figure salaries and powerful unions to defend their pay and conditions. Nevertheless, a recent experiment conducted by Greer Gosnell, John List and Robert Metcalfe examines what can be done to influence the behaviour of these star players.
Gosnell, List and Metcalfe teamed up with a commercial airline that wanted to encourage captains to save fuel. Broadly, there are three ways to do this: before take-off, by carefully calculating fuel requirements; after landing, by switching off some engines while taxiing; and during the flight, by carefully adjusting the flap settings and negotiating the most efficient altitude, speed and course with air traffic control. The airline's own data suggested that captains could potentially save 3 to 6 per cent on fuel — a substantial financial and environmental gain. But how to incentivise them?
Gosnell, List and Metcalfe designed an experiment that did not rely on paying bonuses. Instead, the captains were told that their company was running an experiment with the aim of saving fuel, and that the researchers would maintain anonymity for all the captains. There would be no financial incentives and no league tables.
Instead, the captains were split randomly into four groups. The "information" group received monthly feedback reports detailing how often they had saved fuel before, during and after each flight. The "target" group received the same reports but were also set targets to improve their performance. (The reward for hitting the target was a hearty "well done!") The "incentives" group were told that for each target they hit, £10 would be donated to the charity of their choice — a total donation of £240 was possible if all three targets were hit across the eight months of the study. A control group was simply told that a study into fuel efficiency was taking place.
The most obvious outcome was that there was a large and lasting "observer effect". Merely telling captains that the experiment was happening prodded them into being more careful and saving a lot of fuel. It is always possible that the sudden switch to fuel-saving behaviour had a cause that was nothing to do with the experiment but there are no apparent alternative explanations.
The second outcome was that all three treatments saved fuel compared with the control group but setting targets (with or without the charitable donation) had a particularly notable effect. And the third outcome was that captains who hit their targets were substantially more satisfied with their jobs.
"I just couldn't believe the impact we had on job satisfaction," says Metcalfe. Far from annoying the captains, the fact that the company was taking an interest in fuel saving, and acknowledging success, seemed to delight them.
No performance scheme will fit every occasion but the fuel-saving study does suggest an approach worth trying more broadly. If you want people to do a good job, tell them what success looks like to you — and that you've noticed when they've achieved it.
21st of June, 2016 • Undercover Economist	• Comments off


text:
Zimbabwe bride weds in hospital after losing arm in croc attack
Harare (AFP) –
A Zimbabwean woman lost her arm after a crocodile attack whilst holidaying with her fiancé wedded days later in a hospital chapel, state media reported Tuesday.
Zanele Ndlovu-Fox exchanged vows with her husband Jamie Fox in a hospital chapel before 60 guests in Bulawayo, Zimbabwe?s second largest city.
A picture in The Herald showed Ndlovu-Fox decked out in her white wedding gown with her remaining upper right limb covered in white bandage.
The lovers were canoeing along the Zambezi river, near the Victoria Falls, when they were attacked by a crocodile few days earlier.
"The crocodile just jumped out of the water and bit a chunk of my arm together with the side of the boat,? Ndlovu-Fox told the newspaper.
"The canoe started deflating and it all happened so fast. The crocodile bit me again and pulled me into the water. My husband was thrown out on the opposite side, so the boat was between us."
She said her husband and their tour guides wrestled the crocodile which later released her before she was airlifted to a hospital by a helicopter where the crushed part of the arm was amputated.
Hospitalised, she walked up the aisle to wed Fox at the infirmary.
"I spent a lot of time preparing for my wedding day, running around for venue, decor and so forth. I didn?t know that fate would have me wed in a hospital chapel, with one limb missing," she said.
Despite all this, "my wedding was the best," Ndlovu-Fox said.
Her husband told the same newspaper that the crocodile attack strengthened their union.
"This incident actually made me feel the deep meaning in our vows. For the better or worse, in sickness and in health, that?s just how our love is going to be," said Fox.
The couple is reportedly preparing to relocate to Britain soon.


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CLE Overview
Long-Term Disability Claims - Navigating the Complexities
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Long-term disability claims are complex mixtures of insurance policy interpretation, medical, vocational, and financial issues, often injected with a dose of federal statutory and regulatory interpretation under ERISA. The process can be amplified in pressure by the difficult circumstances of a client who is sick or injured and simultaneously losing their job or occupation. The purpose of this program is to assist lawyers and those otherwise interested in identifying basic issues involved in preparing and filing a long-term disability claim and managing the claims process with the insurance company.
Founder, CEO, Managing Partner
Schwartz, Conroy & Hack, PC
Evan Schwartz: Hello everyone. My name is Evan Schwartz and I am the founder of the law firm, Schwartz, Conroy & Hack. We are a law firm that represents business and individual insurance policy holders in claims and lawsuits against their insurance companies. We make the insurance companies keep the promises made to their insureds. I'm here today to talk to you about long term disability claims, navigating the complexities. My firm for over 25 years has been representing the disabled professionals and others in claims and lawsuits against insurance companies involving long term disability insurance policies. I wanted to give you some information concerning how to deal with these claims. We're going to start and go right into things with understanding what kind of long term disability insurance coverage you're dealing with.
If you're a lawyer and a client comes in and they're going to talk to you about either making a claim or having a problem in a claim or what they need to do in order to manage their existing claim or denial, we're going to get into some of the basics and then we're going to move through some things you need to think about an issue spot, to navigate your way through the complexities of long term disability insurance and the claims that get filed under them. Let's talk first about everything, of course starting with a policy. When you are in the long term disability world, if you're dealing with an individual, it's going to start with the policy or the policies. There are lots of different types of policies in the long term disability world. And you want to make sure what your client has in order to figure out what all the issues are and how you are best going to be able to unlock the door to the client's money, or if you're on the defense side, how to deal with those claims and if appropriate to shut down and lock that door to the client's money.
In any event, let's start with the basic individual disability income insurance policy. The policy that somebody goes to a broker and buys. Typically over the years, that is professionals, healthcare professionals and other white collar professionals are the ones primarily who get marketed these policies. We will occasionally get individuals who are non-professionals with these policies as well. Typically those are CEOs or business owners, more so than anybody else. But most often in my experience, we are representing the healthcare profession, lawyers, accountants, and business owners when it comes to these. The first one is individual disability income insurance. The question is, do they buy one policy? Do they have more than one policy? A lot of these policies include a rider which allows the insured to increase the benefit over the years without additional medical underwriting, only with proof that they're earning enough money to qualify for the increase.
If they have additional policies that were subject to what we call, a future increase option in the policy, they might have additional policies, but those policies should contain the exact same language as the initial policy from which the future increase options flowed. Sometimes people have multiple policies that they purchase separately at separate times, either from the same company or different companies. You want to make sure that you have the full panoply of those individual policies, so that you know whether or not there are going to be nuances in language or other issues that you need to consider. Another form of disability insurance for business owners. Now we're going to talk about two different types. One is disability buyout insurance, or DBO, which is a form of what was traditionally called key man or key person insurance in the life insurance world. But it's the same thing.
It provides money to buy out a disabled owner, partner, shareholder of a business. If someone's a sole practitioner, they're not going to have any usable disability buyout insurance, but if there's more than one partner and they have those policies, those policies are going to be something you're going to want to know about if they're a business owner. If they're an employee at a company, it's most likely not going to be relevant at all. But that's a form of insurance that typically provides that if you remain disabled for a period of at least a year or in, or about a year, then the policy may make monthly payments or a lump sum payment to whoever's identified as the owner and beneficiary of the policy, typically the business, which gets reimbursed for buying out the shareholder or the owner of the partner. And then you also have something called BOE or business overhead expense insurance, which covers ongoing monthly business operating when someone is disabled.
And again, they need to have a business with ongoing operating expenses in order to take advantage of these policies. Those are the sort of three individual type, personally purchased or business purchase policies that you want to explore and ask whether your client has to review for purposes of evaluating what type of claim they have and how best they're going to successfully unlock the door to their benefits. On this topic, we also are going to get into group insurance, which many people either have exclusively, or they have it in addition to their individual insurance policies. But before we get into that, I want to also mention that many life insurance policies contain a waiver of premium benefit if your client is disabled. And so when you're evaluating their situation from a long term disability perspective, it always is a good practice to ask the client if they have any life insurance coverage and to review and make sure that you've reviewed to see whether the life insurance has a waiver of premium benefit for disability and what the language of that waiver of premium benefit is as part of the full scope of your review.
That's before we move into group policies. In addition to all of that, you have your group disability insurance coverage, which someone may have if they are an employee of a private company or some other, even if they're employee of a public company, it doesn't matter if they're employed and if it's part of an organization, there's a chance that there may be group disability insurance coverage. Those policies, which we'll get into later, if they're a private employer of some kind, are most likely going to be governed by a federal statute called ERISA or the Employee Retirement Income Security Act of 1974. These benefits can be very, very similar to an individual long term disability policy, but for a lot of different reasons they're typically less protective of the insured and the language in them usually isn't good as an individual disability insurance policy, which the insured purchase on its own.
They're also part of an employer or a larger group, so they're typically annually renewed by the employer and they can be canceled, changed or modified by the employer without any controller input from the insured client or the beneficiary client. Whereas most individual insurance policies that we just talked about, business overhead expense or BOE, DBO, or disability buyout, or just a typical individual insurance policy are non cancelable as long as the premiums are paid on a timely basis to the insurance company. Those policies are what they call non-can in the business, non cancelable, no matter what else happens, as long as you pay your premiums the policy stays in force. Whereas these group policies can change year in and year out. They're a little bit of a riskier proposition from that perspective. But having said that, they could be great policies. They typically insure 60% of somebody's income.
And if somebody's making a lot of money, they could be a huge benefit. They're capped for maximum benefits, but they can be capped at 5,000 or 10,000 or 20,000 or more. And if someone's making a big salary like a surgeon, their group policy could give them 20, 25, $30,000 a month. And so they're not to be discounted just because the language may not as be as favorable or because they're non cancelable, because they are cancelable, I mean. That's the panoply of all types of policies that you want to be looking for if a client is coming in and talking to you about their long term disability claim. And even if they haven't mentioned any of those other policies to you, you still want to ask and explore whether they have any of them.
The last thing I'll say about this, if you're talking to a client that is a high, usually a high level employee or an owner, if they're an owner of a business, some type of a shareholder or a partner or a member, they may have disability buyout provisions in a shareholder or operating agreement or owner agreement that provide for reimbursement to them if they become disabled and are unable to perform their duties in the business. In addition, they may have some form of employment agreement that talks about disability. When you are talking to one of these clients or when you're evaluating their situation, to me I'm always running through all of those things. Do you have business overhead expense policy, if appropriate? Do you know whether or not you have a disability buyout insurance policy, if appropriate? Do you have an employment agreement? Do you have some ownership agreement, shareholder agreement, partnership agreement, membership operating agreement?
Because all of those things are going to contain language about trigger of coverage and entitlement to benefits that you're going to need to know and potentially harmonize with all the other policies when you're evaluating one of these client situations. Okay. That's the basics of, hey, what kind of insurance and coverage is there and what is it for? The next thing is, what do these policies basically insure? The classic individual benefits policy or the good group disability insurance policy is going to insure somebody's occupation and it's going to pay them benefits if they're unable to perform the material, substantial duties of their occupation. That quality language in its best form is going to say, you can't perform the material, substantial duties of your own occupation or the important duties of your own occupation, even if you're working in some other occupation.
What's the classic example? Well, you're a dentist and you spend your days standing, evaluating and working in patient's mouths all day long. You become disabled and you can't do that anymore because you have a wrist injury, a neck injury, something of that nature, but now you want to own dental labs. The good classic own up occupation definition if you meet it, will entitle you to benefits and you could go out and own dental labs and make more money than you were making as a dentist and still get paid benefits under this policy. Okay? Now, that's the best and classic own occupation language. I'm not telling you that every policy you're going to encounter is going to have that language, but that's the concept of own occupation disability insurance, and understanding that it insures your own occupation and not just any occupation and understanding what the occupation of that person is, is a really important component of evaluating these claims and successfully managing these claims and litigating these claims.
Do you have what they call an own occupation or own-occ benefit and is the client entitled to that own-occ benefit? And of course, that may present to you along a very different spectrum, depending on when the client comes to see you. Are they coming to see you when they're first filing the claim? Are they coming to see you whether in the middle of having problems, the benefits have been denied, the insurance company's giving them a hard time, the claim forms have already been submitted, the clients already made representations? Are you looking at a potential lawsuit and trying to look back on what was done thus far? But the classic own occupation definition is that. Okay? There are other definitions for total disability that may not be that. They may say you're not working at your own occupation and not gainfully employed in another occupation.
Now, I will tell you, gainfully employed typically means that you're not otherwise working for wage or profit doing anything else. Okay? But if you're actively working and making active income, that's going to be considered gainful employment, whether full or part-time. And the insurance company's going to say you are not totally disabled within the definition of total disability in the policy if you're working for money doing something else. A caveat to this is, that making investment income or passive income and the distinction of passive versus active income is something that will be reported on an income tax return. In addition to being evaluated from a long term disability definitional perspective, but by bottom line is, if you're making money in the stock market, because your broker bought and sold you some stocks or you have investments of that nature, that's typically going to be passive income and not considered income for purposes of whether or not you're entitled to an own occupation long term disability benefit, or whether you're totally disabled versus partially residually disabled, which we'll get to later.
But so not working in your own occupation and not otherwise gainfully employed is going to be some of the definitions you're going to see. And then you're going to have definitions that are not the true classic own-occ definition as well, where it says, not working in any occupation and that some definitions will say that total disability means inability to work in any occupation that you are reasonably suited to work in, in the national economy, or that you're reasonably suited to work in based on your education, training, and experience, which is what I would call an any occupation definition versus an own occupation definition. It's important for you to know, what does that definition say? And the other important thing is to make sure you understand what the occupation means in the policy. The words your occupation are often defined, or the word occupation may be defined in the policy. You need to see what that definition says.
In the classic own-occ definition, your occupation is typically defined as the occupation you were engaged in at the time you became disabled. A lot of clients will come onto me and say, hey, I bought this policy to insure me as an orthopedic surgeon. I'm going to say, no, you bought this policy to insure you in the event you couldn't perform your occupation, but your occupation is the occupation you were engaged in at the time you became disabled. If you had morphed from orthopedic surgery to non surgical orthopedics, and you've been doing that for two years, and now you want to make a plan, the insurance company's going to look at your occupation as to what you were doing when you became disabled. And for the last two years you haven't been doing surgery. It doesn't matter what you were when you were insured anymore, it matters what you're doing when you file the disability claim and say you're disabled.
And so what is the definition of your occupation is going to be very, very important when you are dealing with evaluating one of these claims, representing a client in one of these claims and working on making sure the client gets their benefits. Now, the classic problem that I've seen over the years, is that people change their occupation because of their disability and continue to work because they don't want to give up working, so that if you are a surgeon or a dentist or engaging in some high level profession like that, they change. They stop doing the harder surgeries. They stop doing the harder procedures. They stop taking call. They morph into nonsurgical procedures, and then they say, hey, I'm disabled for being a surgeon. I'm disabled for being some type of dentist that performs, like an endodontist versus a regular dentist, but they went to regular dentistry or they stopped doing the harder procedures because they couldn't work in the mouth for that many hours.
Well, now you have a problem because you never made a claim back when you changed your occupational duties. And now I wind up looking at, and my firm winds up looking at, wait a minute, can we say that this person was disabled three years ago and just was late in filling a claim and what are the consequences of that? And can we prove that they were disabled three years ago from being a full-time surgeon and that when their income level was that much higher and their duties and activities were that much higher? Can we backdate a claim? What is the consequences of trying to backdate that claim to the insurance company? I will tell you that this fits into a concept in the insurance world called trigger of coverage, right? When was coverage triggered under the policy? Well, as I like to explain, as an example, trigger of coverage applies to almost all insurance. But to use a simple example, if your house burned down on January 1st, no matter what happened with regard to your homeowner's policy, the trigger of coverage was the date that your house burned down, because that's when the event or the loss occurred. Right?
Now when you take that into disability world, your trigger of coverage was the date that you had an injury or a sickness that either prevented or limited you from performing the duties of your occupation. And when that was, has nothing to do with when you notified the company, when you gave them proof you were disabled or anything else. All that matters is that you can prove that you had a sickness or injury which limited or prevented you from performing your occupational duties. And if you're a partial, residual, it may be that you also had to drop an income as a result. But if you had those things, you triggered coverage even if you didn't know it and you didn't tell anyone about it. And so we get a lot of clients coming in, lawyers, accountants, doctors, dentists, other healthcare professionals that have that conundrum where they change their occupational duties, but never made a claim and now we're trying to figure out if we can backdate it.
That is a good time for me to morph into the other disability definition, which is residual or partial disability. Number one, what is it? Well, as I just explained in my prior explanation about trigger of coverage, it usually occurs when you have an injury or sickness which doesn't prevent you from completely doing your occupation, but you just can't do it for as many hours as you did before. Or you can do some of the duties, but not all of the duties. You can perform the minor surgeries, but not the major surgeries. You can still do some harder procedures, but it takes you three times long to do them. Those are the types of things where you're now limited from performing the duties of your occupation. And once again, as I tell you, you've always got to go to the policy.
Number one, does the policy give the insured partial or residual disability income insurance coverage, and under what terms? Now, to qualify for benefits under a partial or residual disability definition, most policies as part of the definition, require that in addition to having a reduction in duties or hours due to a sickness or injury, you also have to have a sufficient drop in income to give you a potential proportionate amount of the disability benefit that you are insured for under the policy. And some make it part of the definition. Some also don't make it part of the actual definition of disability, but they'll say you still need a reduction in income to qualify for benefits. That is a whole nother analysis that needs to be performed when you are trying to figure out, well, this person says they're residually disabled. Okay. Assuming the policy has a definition that provides for it. Now we have to analyze it.
Okay. When were they limited due to sickness or injury? At that time did they see a doctor? Did they get a diagnosis? Is there going to be medical support during that timetable? Okay. Is there medical support? Now can we prove a reduction in their duties and gathering and marshaling up that evidence? And then the third part, can we prove that during that timetable they also had a drop in income, sufficient to entitle them to benefits under the policy? Most policies require that you have a minimum of a 20% drop in your prior income before you're potentially entitled to a benefit. Some policies say you need maybe a 25% drop or a 20% drop or a 15% drop. It just depends on how the policy reads. But most of them say, if you have at least a 20% drop in your income, you're going to be qualified for benefits.
You start analyzing those things and that's when you get into another interesting issue when you're looking at these claims is, what was the date that the client actually became disabled under the policy? When did all those three things, reduction in duties, medical support, and drop in income, all come together? Such that I can determine whether or not and when this client met the definition of partial or residual disability. Okay? Those are the components, an injury or a sickness that caused a reduction of the ability to perform the occupational duties and a competent drop in income. That's the basics of, okay, what do these policies do and what is their purpose? These policies have other features, all of them do, but understanding the basics of how they work is the first step to evaluating these policies, making sure you have the complete coverage and all the different types of coverages that may exist for the client. Okay? And then determining what they are claiming and what the policy support.
Okay. Let's move on. You've got that. You also have to understand when you're looking at these policies and typically you're going to the declarations page, how much monthly benefits somebody's entitled to, and if they're residual and you're going to have to try to calculate and estimate what the partial benefit amount is that they're entitled to, which is a whole nother analysis. We've got an example here in the materials. And then the next question is, what's the maximum benefit amount and what's the maximum benefit period and the waiting period under the policy or the deductible period? Most policies have a waiting period anywhere from 30 days to six months before someone can be eligible to receive a benefit out the policy. The old individual policies will have the shorter ones. The group policies typically have the longer ones. You just have to look at the policies and see how long the waiting period is. The waiting period like a deductible is a period where the insured needs to still be disabled, but is not entitled to receive any money.
The most typical waiting period in an individual policy you're going to see is 90 days. That is because 90 days is a date that the insurance companies have determined is a good length of waiting period to get rid of basic surgery claims, basic illness claims and pregnancy and delivery. They get around a lot of having to pay on those short term claims when they use at least a 90 day waiting period. Okay. And then does the policy pay to age 65? Does it pay to social security retirement age? Does it pay for life? There are a lot of policies that have lifetime benefits, but there are all older policies and the older policies will have a full lifetime benefit typically before somebody reaches age 65. Or the lifetime benefit may be less generous for someone that's disabled due to a sickness versus an injury, where that person may need to be totally disabled earlier than age 65, in order to get the lifetime benefit for sickness. Some policies have a descending benefit where at a certain age the lifetime benefit starts going down.
If you were disabled before the age of 60, you might get the full benefit. Before the age of 61, you might get 90% of the benefit or 80% of the benefit. Before 62, 60% of the benefit. It keeps dropping as you get older. Again, you've got to look the policies and see what is the trigger of coverage for a lifetime benefit or a later maximum benefit period, if it's available. Okay. Going to shift gears completely now and talk a little bit more about ERISA and understanding just for purposes of issue spotting, when ERISA may apply to a policy and what that means. As I had previously said, ERISA stands for the Employee Retirement Income Security Act of 1974. It was designed to protect employee trust fund monies after two large companies took the pensions and deferred compensation money from their employees and went bankrupt. Congress quickly jumped in and made this law.
It was determined that it applied to all types of employee benefits, including those fully funded by insurance. But the most important thing to know when you're looking at as to whether ERISA is going to apply, is that it applies to private employers only. It does not apply to government employment and government would include federal city state, and municipality. It does not apply to church plans. It typically doesn't apply to school districts. And so if it's a private employer, more likely than not you're going to have ERISA applying to your plan. I guess the only thing I'll say there are also association plans like the American Dental Society or the American Medical Association. Those plans typically are not governed by ERISA, because those groups are not employers and they're not private employers. They're just association plans. But you have to be careful when you're looking at these things to make sure you know whether it's going to be governed by ERISA. The insurance companies want these policies to be governed by ERISA and I'll tell you why.
Number one, if a policy is not governed by ERISA and they deny or terminate a claim, the insurance company, you have a mandatory appeal. You must appeal. If you don't appeal as an insured or a planned beneficiary, you have been deemed not to have exhausted your administrative remedies and will be thrown out of court and you may lose the case entirely. That's number one. Number two, no jury trials. Number three, many plans have something called discretionary authority where the decision by the plan administrator or the claims administrator, I.e the insurance company, is to be afforded discretion by court and not to be overturned unless it's determined to be an abusive discretion. In the tie goes to the runner concept, tie goes to the insurance company in court, not to the insured or plan beneficiary. In addition, discovery will be extraordinary limited when bring that case. In addition, it's a federal statute, so you're going to be in federal court for these cases.
There are a lot of negatives if you are a planned beneficiary/insured or disabled individual seeking to challenge a determination by an insurance company on a case that's governed by ERISA. There are ways to get around it. There are also certain potential benefits of ERISA, the most significant being you can get cost and attorney's fees if you win the case and you can press for them if the insurance can company voluntarily changes its mind in litigation. They can't stop you from making a fee application. It's a load star application, it's hours for dollars. Lawyers need to assiduously track their time because the court's going to review it and they need to make an application to the court. It's not an automatic.
Some lawyers like it if they're on the plaintiff side, because they think it's a truncated procedure and they don't have to deal with a trial. But my view of the world personally is, there's nothing better than suing an insurance company than knowing that they have to face down a jury trial of a bunch of people who do don't like them to begin with. In any event, those are some of the things that you need to think about and know about if you're going to be dealing with an ERISA claim. I will tell you that, if you have a case with a policy that's governed by ERISA and one that's not, it can be very interesting determining are you going to bring both in the same court? Can you bring both in the same court? Do you want to do all the discovery together?
There's just a lot of interesting issues that come up with multiple policies and some that are governed by ERISA and some that are not, which is a little bit beyond, it's a little bit beyond what I want to get into today. I wanted to give you some basics about ERISA and understand what you might be facing in issue spotting when ERISA is involved in one of these claims. Okay. Let's move to the claims process itself. Let's say you've got a client, they come in, you get their medical records and their policies and you understand their occupational duties and you determine that you're going to take on their case, you're going to represent them and you're going to move forward. Well, what happens? With clients that come to us in that stage, the first thing is, well, assuming your doctor's going to support your claim, you have to pick a date to stop working, because you can't be more working and saying, you're totally disabled. You have to stop.
Big leap for clients, but they do it. Because as I like to say a lot of times, the medical condition drives the issue. If you can't do it because you're unable due to your sickness or injury, well then you're unable and eventually you're just going to get taken out. The first thing you do that you think about that is giving notice of claim to the insurance company. Now, notice of claim in these particular scenarios is really, really simple. In our case, we usually just send a letter to the insurance company that says, we've been retained to represent John Q Public. Please don't communicate with our client or his treating physicians without our participation and consent and direct all future correspondence communications to our office.
On behalf of John Q Public, we're submitting notice of claim. Please send us the claim forms. Have a nice day. Evan. Right? Basically you just need to identify the insured enough for them to understand who it is and tell them you're making a claim. These policies have provisions for notice of claim, just telling someone you're making a claim. We counsel clients all the time that when we give notice of claim, we don't tell them what type of claim it's going to be. We don't tell them what's wrong with the client. None of it. It's not required. We'll worry about that when we're putting together the claim forms or the proof of disability that we need to file. But in the meantime, all you need to know insurance company is, we're making a claim, give us the forms and don't talk to anyone without us being involved, right?
That stops the clock running on any further obligations once the notice of claim is submitted. Typically you're going to get in the mail after you submit that notice of claim, you're going to get a letter from the insurance company with the claim forms that they want you to fill out to prove that you're disabled. That's going to include the claimant's forms and the attending physician statement form or forms that need to be filled out and submitted to the insurance company for them to evaluate whether or not they believe you meet the definitions of disability contained in the policy and are entitled to receive benefits. Notice of claim comes in and then ordinarily there's a timetable within which the insurance company is supposed to send you claim forms. They send in the claim forms and then the process of dealing with those begins.
I will tell you that in these policies, proof of disability or proof of loss or proof of claim is separate from those of claim. Typically the individual policies, some of the group policies, but the individual policies give the insured a year and 90 days typically, from when the claim was actually, not when the claim was made, but when the disability occurred and when covers was triggered for them to submit proof of loss. Ordinarily the insured, unless they've come to you extremely late is not going to be in some time crunch and you are going to have adequate time to prepare for and, or submit this claim.
Giving notice is important and it's particularly important in states like New York, for example, that allow an insurance company to refuse to pay certain claims or certain benefit amounts if they believe the notice to them was late and was not timely furnished by the insured, right? New York, for example, when it comes to these things has a rule that says, that they can deny claims if the notice was late and there was no reasonable excuse for being late. Then the rule in New York is they don't have to show prejudice to deny the claim. Now, the distinction there is, in New York a claim under these policies is not viewed as an all time yes or no proposition from a notice perspective. Meaning, if I submitted my notice a year late, then I may forfeit my entitlement to benefits for that year, but I haven't forfeited my entitlement to benefits going forward from the date that I provided notice, or maybe even sometime earlier than that.
And so you could be very late with a claim. You could be two years late, but if there's another 30 years left on the policy, the tail is the two years of late claim and the 30 years of the other 28 years is the doll. And so understand at least in New York that you're not forfeiting the entire claim if it's late. Now, other states are less draconian about notice. And they would say, even if your notice is late, the insurance company has to show that it was prejudiced by the lateness of the notice. And if they can't show they were prejudiced, then the notice will deem to be timely. And showing prejudice is not the easiest thing necessarily, because ultimately records will need to be destroyed and witnesses unavailable, or some documentation that can't be accessed in order for the insurance company to say they were prejudiced by the lateness of the notice. And again, a lot of things that go on in individual benefits policies or individual policies that are governed by state law involve the specific state law that's going to apply to your client's claim, to your client's lawsuit and understanding that is beyond the scope of this particular review. But I can tell you it's a complex and important issue.
Okay. Moving on to the next topic, we're going to of talk a little bit about establishing necessary medical support. We've had many, many clients over the years who come in and they don't have sufficient or adequate medical support. It's a major, major problem. You become in certain ways an amateur medical professional when you're exploring and meeting with these clients and you learn from experience that there are certain things that you need to do and not do. But ultimately, as I always like to say, I can do a lot to help a client get paid on a long term disability claim or on a long term disability lawsuit, but without medical support, I'm doomed. You need to have the appropriate support of an appropriate doctor. Someone comes in and, have they seen a doctor? What are their symptoms?
Is the doctor appropriate to diagnose their symptoms and tell them what is going wrong with them? Is that the right doctor to treat those symptoms and will that doctor support disability if the client needs to stop? Now, I always tell clients that one of the last things they need to do before they decide whether they're going to hire us to submit a claim for them, is to ask their or doctor, will they support them stopping work and filing a claim. It doesn't mean they need to get any more involved in the process as a client than that. We can take it from there, but we need to know their doctor's going to support them before they stop, and that doctor is the right doctor to support the claim and that the doctor's medical records are going to be consistent with the support for that claim.
One of the other things I talk about with clients all the time is something that I like to call documented deterioration. Is it documented in the medical chart that your condition has been deteriorating over time? Because you started to not feel well and you continued to do your job, and then you fell worse, but you're still doing your job. Well, are you going to the doctor? Are you reporting more and more symptoms saying you're having more and more difficulty and is the doctor recording that stuff in the doctor's chart? Documented deterioration so that when you reach the point where you say, I need to stop, and the doctor says, yes, I'll support you, there is a paper trail showing that you've been getting worse over time, that you need to stop. Now, I'm not saying that works for every client that comes in, but there are many times when you need to make sure that's curbed. Because a lot of times the client's working and then just stops, and the insurance companies think of what changed between Wednesday and Thursday. Why did you stop? What's the problem?
You were working on Wednesday, how was your conditions such that it was so bad you couldn't do it on Thursday? We all know that these things run along a spectrum, pain and limitations and ability to do things. If you can have some documents deterioration in the medical charts sufficient to show that drop, so that when you decide to stop work the record support it, is something that I'm always talking about. Again, qualifications of the doctor. Okay? If you have an arthritic condition, you want a rheumatologist. If you have a spinal condition, you're going to want an orthopedist or a neurologist or a pain management specialist. If you have a mental or nervous condition, you're going to need most likely an MD psychiatrist, but at a minimum a licensed psychologist. A social worker is not enough.
Does the person have a diagnosis? Do they understand what's wrong with them and is there a doctor going to support the claim? Those things are critical if someone is going to submit one of these claims and ultimately get paid. A lot of times also you want your doctor to be able to advocate a little bit, to write a narrative, to fill out a little bit more of an expressive attending physician statement that explains a little bit of the conditions and limitations. Some doctors don't want anything to do with this process at all. Some doctors understand completely and know it's part of their job. Some doctors, especially surgeons like to say, hey, I fixed you and now don't want to be part of an ongoing problem where the surgery wasn't successful, where the patient still has pain and limitations. They just want to say, hey, I went in and I cut. It was all good and I'm done with this. Generally speaking surgeons are not a good long term play to support these claims.
Ultimately you're going to need to see whether or not that surgeon's going to help you after they say expected recovery date is six months from now and you're not recovered. In any event, getting the appropriate medical support is a critical thing to supporting the claim. Sometimes you have multiple disabling conditions and sometimes you need more than one doctor, because one condition in and of itself may not totally disable or disable you at all, but it may be a combination of conditions. What we call comorbidity in the business. Multiple conditions that together disable you, and that needs to be assessed and evaluated the purposes of determining who is going to and who needs to support this claim. At the end of the day, that is a very, very important component, is getting that medical support, getting it right, getting those medical records, making sure when you read them, that they show some level of deterioration and support for the person's claim, because the insurance company's going to gather up all those medical records, and they are going to look at everything before they acknowledge liability to pay these claims.
When an insurance company gets these claim forms, they're going to do a detailed medical review. They're going to look at your occupational duties and they're going to look at the history of the policy. They're going to look at a lot of things to make sure that they've dotted their eyes and crossed their T's before they go ahead and authorize a determination that you meet the definition of total disability and that you're entitled to benefits. As I talk about this medical review issue, this morphs us into the manner in which insurance companies respond to the receipt of these claims. Obviously the medical review is one of them, which is why I'm talking about the importance of ensuring that both the attending physician statement, which will need to be submitted by or on behalf of the disabled individual insured, along with the medical records themselves which the insurance companies going to gather, are going to support this disability claim.
When the insurance company gets these, that's one of the things they're going to do out of the box, is a medical review. I can't stress enough the importance of that. Okay? The next, what comes up. One of the things that they do is a financial review. A lot of someone's an employee and they're making a W2 income and it's pretty simple, but a lot of my clients and a lot of the insureds in the long term disability world are business owners or have multiple earning endeavors. And so it gets a little bit more complicated and the insurance company is always going to demand tax returns as part of its review. They want to verify income. They want to verify that the income came from your occupation and they want to see whether or not you have any other sources of income that could affect your claim for total disability benefits or affect your claim for partial disability benefits.
If you are going to make a partial, residual disability benefits claim, one of the other things that the insurance company's going to want to see is monthly profit and loss statements during the period of claim disability, to show that you have a drop in income sufficient to potentially entitle you the benefits under the policy. I'll just conclude on this topic by telling you that some policies, in addition to the right to receive that financial information, give the insurance companies the right to conduct a full financial audit of your business and personal books and records, and that you have a duty to cooperate. Draconian? Yes. Does it make sense in certain circumstances? Yes. When someone has a complex series of businesses and a complex structure, they can do a lot of sheltering and hiding of income that may be relevant for purposes of the insurance company's evaluation.
One of the other things that the insurance companies like to do when they get a claim, is something called an application review or rescission review. This is where they want to see whether or not you the insured made any misstatements on your application that could be used to avoid the policy. And in doing that, one of the things you need to understand is that the contestability clause of these policies, there are two types. The older type, which mostly doesn't exist anymore, said that the insurance company could only contest the policy within two years of its issuance and couldn't contest thereafter. But most policies will say that no statements, quote, except fraudulent misstatements can be used by the insurance company to rescind the policy. In that case, when that language exists, I can tell you that for the first two years under the policy, the insurance company would not be obligated to prove that you lied with intent on your application for the insurance. Because for the first two years, they don't need to prove fraud in order to seek to rescind the policy.
But after two years, they're going to have to prove that you made a material misrepresentation and did so deliberately. And so they are going to be looking at that very carefully, anytime submits a claim under one of these policies, including going back through your entire medical record, to see if there's anything that you the insured willfully failed to disclose or deliberately misrepresented on the application, giving them a basis to get out of the claim that we're looking at now, and any other claim to actually take back the policy in the concept of rescission where they take back the policy, they give you back all the premiums you paid with interest and the relationship is over. Now, there are a lot of, a lot of permutations and issues that surround those types of cases that I'm not going to get into with you now, but suffice it to say, they're not typically slam dunk cases.
Now, two other things you can expect during one of these processes includes, I'll just tell you what they are. A field interview and surveillance. A field interview is when a representative of the insurance company comes down to meet with the insured, usually preferably in the insured place of residence, where they sit down and ask him a series of questions about your occupational duties, your restrictions and limitations, the medications you're taking, your life activities and get a sense of who you are. I will tell you that in our practice, the field interview is done in the presence of one of our attorneys, typically at our offices or at some location if the insured doesn't have an attorney outside of their home. We counsel the insureds not to have the field investigator come to their house, because the field investigator looks around and makes judgements about the insured's abilities based on their financial circumstances, based on what they see there.
If you don't have a lawyer, then we recommend that the client meet them somewhere else, at a restaurant, at a library, at some space that is isn't at their home. In addition, having done so many of these field interviews, we already know all the same questions from the script that are going to be asked and we're able to prepare the client how to present themselves in the best light to the field interviewer. The field interview is one example of what you're going to typically see these days when one of these claims is submitted and the insurance company is evaluating it. Another one that's tried and true for many years now, is surveillance. Insurance companies, I tell my clients, surveillance is not something that you consider whether it's going to happen, just assume it's going to happen. It's the rule more than the exception. Typically the insurance companies hire outside companies and investigators to conduct surveillance.
It's usually a three day stint and a lot of times to make sure that they can find the insured, they'll have the surveillance run at the same time as either the field interview, so they know where the insured is going to be or an IME when the insured is going to be examined by a doctor that's been hired by the insurance company to evaluate their medical condition, their restrictions and limitations. That leads us of course to the IME. One of the final tactics or tools that the insurance companies use to evaluate whether or not someone meets the definition of disability. Now, of course anyone that's not familiar with the world of independent medical exams, they're not independent. Typically a doctor's hired by an insurance company not to find that the insured is disabled. I'm not going to say that's always the case, but that's been our experience of the vast majority of cases. And so you want to make sure that the doctor doesn't have a reputation and do some research and get some scuttlebutt if you can.
You want to make sure that the doctor is of the appropriate discipline to evaluate the client's condition and restrictions and limitations. You want to make sure that the doctor understand that they're evaluating this insured's ability to perform their occupational duties and understand what their occupational duties are. Lastly, you want to make sure that that doctor has all of the relevant medical records in their possession, so that they're not overlooking anything that's very supportive of clients claim for disability. Those are some of the tactics that the insurance companies use. That for today is the basics of navigating the complexity of long term disability claims. Again, I am Evan Schwartz, founder of the law firm, Schwartz, Conroy & Hack, representing business and individual insureds in claims and lawsuits against their insurance companies. Making insurance companies keep the promises they made to their insurance. Thanks for listening. Stay well, stay healthy and I'll see you on the next one. Bye-bye.
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Social Security and disability law
1h 40s
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text:
Jewish World Review Oct. 27, 2008 / 28 Tishrei 5769
Obama nears the 'now what? ' moment
http://www.JewishWorldReview.com | Across the electric wires, the hum is ceaseless: Give it up, loser. Don't go down with the ship when it's swept away by the Obama tsunami. According to newspaper reports, polls show that most people believe newspaper reports claiming that most people believe polls showing that most people have read newspaper reports agreeing that polls show he's going to win.
In the words of Publishers' Clearing House, he may already have won! The battleground states have all turned blue, the reddest of red states are rapidly purpling. Don't you know, little fool? You never can win. Use your mentality, wake up to reality. Why be the last right-wing pundit to sign up with Small-Government Conservatives For The Liberal Supermajority? We still need pages for the coronation, and there's a pair of velvet knickerbockers with your name on it.
Yes, technically, this is still a two-party state, but one of the parties is like Elton John's post-Oscar bash and the other is a church social in Wasilla. As David Sedaris put it in The New Yorker:
"I think of being on an airplane. The flight attendant comes down the aisle with her food cart and, eventually, parks it beside my seat. 'Can I interest you in the chicken?' she asks. 'Or would you prefer the platter of s--t with bits of broken glass in it?'
"To be undecided in this election is to pause for a moment and then ask how the chicken is cooked."
Well, to be honest, I've never much cared for chicken.
McCain vs. Obama is not the choice many of us would have liked in an ideal world. But then it's not an "ideal world," and the belief that it can be made so is one of the things that separates those who think Obama will "heal the planet" and those of us who support McCain faute de mieux. I agree with Thomas Sowell that an Obama-Pelosi supermajority will mark what he calls "a point of no return."
It would not be, as some naysayers scoff, "Jimmy Carter's second term," but something far more transformative. The new president would front the fourth great wave of liberal annexation - the first being FDR's New Deal, the second LBJ's Great Society, and the third the incremental but remorseless cultural advance when Reagan conservatives began winning victories at the ballot box and liberals turned their attention to the other levers of the society, from grade school up. The terrorist educator William Ayers, Obama's patron in Chicago, is an exemplar of that most-recent model: 40 years ago, he was in favor of blowing up public buildings; then he figured out it was easier to get inside and undermine them from within.
All three liberal waves have transformed American expectations of the state. The spirit of the age is: Ask not what your country can do for you, demand it. Why can't the government sort out my health care? Why can't they pick up my mortgage?
In his first inaugural address, Calvin Coolidge said: "I favor the policy of economy, not because I wish to save money, but because I wish to save people." That's true in a more profound sense than he could have foreseen. In Europe, lavish social-democratic government has transformed citizens into eternal wards of the Nanny State: the bureaucracy's assumption of every adult responsibility has severed Continentals from the most basic survival impulse, to the point where unaffordable entitlements on shriveled birth rates have put a question mark over some of the oldest nation states on Earth. A vote for an Obama-Pelosi-Barney Frank-ACORN supermajority is a vote for a Europeanized domestic policy that is, as the eco-types like to say, "unsustainable."
More to the point, the only reason why Belgium has gotten away this long with being Belgium and Sweden Sweden and Germany Germany is because America's America. The soft comfortable cocoon in which Western Europe has dozed this past half-century is girded by cold hard American power. What happens when the last serious Western nation votes for the same soothing beguiling siren song as its enervated allies?
"People of the world," Sen. Obama declared sonorously at his self-worship service in Germany, "look at Berlin, where a wall came down, a continent came together, and history proved that there is no challenge too great for a world that stands as one."
No, sorry. History proved no such thing. In the Cold War, the world did not stand as one. One half of Europe was a prison, and in the other half far too many people - the Barack Obamas of the day - were happy to go along with that division in perpetuity.
And the wall came down not because "the world stood as one," but because a few courageous people stood against the conventional wisdom of the day. Had Margaret Thatcher and Ronald Reagan been like Helmut Schmidt and Francois Mitterrand and Pierre Trudeau and Jimmy Carter, the Soviet empire (notwithstanding its own incompetence) would have survived, and the wall would still be standing. Sen. Obama's feeble passivity will get you a big round of applause precisely because it's the easy option: Do nothing but hold hands and sing the easy-listening anthems of one-worldism, and the planet will heal.
To govern is to choose. And sometimes the choices are tough ones. When has Barack Obama chosen to take a stand? When he got along to get along with the Chicago machine? When he sat for 20 years in the pews of an ugly neo-segregationist race-baiting grievance-monger? When he voted to deny the surviving "fetuses" of botched abortions medical treatment? When in his short time in national politics he racked up the most liberal - i.e., the most doctrinaire, the most orthodox, the most reflex - voting record in the Senate? Or when, on those many occasions the questions got complex and required a choice, he dodged it and voted merely "present"?
The world rarely stands as one. You can, as Reagan and Thatcher did, stand up. Or, like Obama voting "present," you can stand down.
Nobody denies that, in promoting himself from "community organizer" to the world's president-designate in nothing flat, he has shown an amazing and impressively ruthless single-mindedness. But the path of personal glory has been, in terms of policy and philosophy, the path of least resistance.
Peggy Noonan thinks a President Obama will be like the dog who chases the car and finally catches it: Now what? I think Obama will be content to be King Barack the Benign, Spreader of Wealth and Healer of Planets. His rise is, in many ways, testament to the persistence of the monarchical urge even in a two-century old republic. So the "Now what?" questions will be answered by others, beginning with the liberal supermajority in Congress. And as he has done all his life he will take the path of least resistance. An Obama administration will pitch America toward EU domestic policy and U.N. foreign policy.
Thomas Sowell is right: It would be a "point of no return," the most explicit repudiation of the animating principles of America. For a vigilant republic of limited government and self-reliant citizens, it would be a Declaration of Dependence.
If a majority of Americans want that, we holdouts must respect their choice. But, if you don't want it, vote accordingly.


text:
John Franzen talks to Yatzer
And the winner of the Rosa Barba European Landscape Prize 2010 is...
CMYK and The Four Seasons of Vivaldi
Image Courtesy of Mot studio
Her name is Laia Clos and after receiving her first degree in History of Art from the University of Barcelona she moved on to study Graphic Design at the Escola Massana. Graduating in 1997, she begun her professional experience, first with Compañía General de Ideas and later at the studio Enric Jardí. In 2006 she opened her own studio - 'Mot' and today she is teaching design at the Escola Eina - Universitat Autònoma de Barcelona - and is a board member of the ADG FAD.
One of Clos' latest projects is called "Lesquatrestacions" - otherwise 'The Four Seasons' - and refers to the musical composition of the Italian 18th century composer, Antonio Vivaldi. It is essentially a graphic interpretation of the four violin concertos that compose this baroque masterpiece.
To create 'Lesquatrestacions', Mot studio designed a prototype - 'SisTeMu' - a graphic notation system which looks at interpreting musical texture." 'SisTeMu' translates musical score into simple geometric forms and basic printing colours, exploring as such the rhythmic and melodic harmonies found in musical composition. It somewhat simplifies the complexity and mathematical structure, making it accessible to the viewer through a visual narrative."
Each of the four posters is the entire translation of one concerto – one season – played by the lead violin. The score played by all three violins can be found in the 'Lesquatrestacions' book which may be produced in the future! At the moment the entire collection of four posters (Offset printed, CMYK, A1 size, Munken Linx 135 gr paper) is available at TOM Editions and each one costs €30.00. Each poster comes in a cardboard tube with a complementary leaflet of explanations. So, what are you waiting for?


Whilst not situated along the main stretch of London's Theatreland in Covent Garden, the Peacock Theatre still enjoys a central location close to Holborn tube station. The local area is mainly used by businesses but also has a number of cafés, restaurants and bars to cater for workers and tourists alike, and both the Bloomsbury and Covent Garden areas are within walking distance of the theatre.
By Tube: The nearest station to the Peacock Theatre is Holborn on the Central and Piccadilly lines.By bus: Numbers 8, 19, 38, 22B, 25, 188, 501 and 521 all stop along High Holborn, close to the theatre building.By taxi or car: The busy interchange outside Holborn station is an ideal spot to find a taxi. The nearest car park to the theatre is on Parker Street.
The Peacock Theatre is a pleasant venue that has excellent sight-lines from all over the theatre. Based on two levels both the Stalls and the Circle offer clear views of the stage giving a more intimate experience than most larger West End venues. The Peacock can seat just under 1000 audience members, and its modern style means that obstructions are minimal. The Stalls are divided into three main sections by two aisles running length-ways, with further division in the very front section around the stage. Best seats tend to be further back from the stage as the stage can seem very high and restricted for seats right at the front.
The Circle is a little shallower than the stalls and is divided into a front and rear section, each with three smaller blocks of seating within. The rows are not particularly curved, meaning that even seats towards the edge of the auditorium offer good views of the stage. There is a good rake throughout the section making the view over people's heads on the whole very good.
The Peacock Theatre has two main levels, the Stalls and the Circle. There are 4 steps up from the street to the main entrance, but there is also a fixed steep ramp that wheelchair users can make use of. Inside the foyer there are 44 steps down to the Stalls and 29 steps to the Circle, with 2 steps between each row. Concessions are available for disabled users and their carers, and the theatre's Access Scheme means that visitors can be kept up to date on accessible events and performances that are taking place.
There are 2 spaces for wheelchair users in the Circle, although unfortunately the Stalls are not accessible for those with wheelchairs or scooters. There is an adapted toilet in the foyer, and the theatre bars can only be accessed via the stairs; however, drinks can be brought to patrons in their seats if required.
There has been a theatre building on the site of the Peacock Theatre since the 17th century, although the current venue only opened in 1960 as the Royalty Theatre. Prior to this there was a building known as the London Opera House. Due to the competition from the Royal Opera House it renamed itself the National Theatre of England in 1914, going on to host productions of Tchaikovsky's The Queen of Spades and Madama Butterfly. In 1916 the theatre was renamed yet again, becoming the Stoll Theatre and showcasing a range of opera, cinema, variety and drama before closing in 1957 and being demolished.
The present building was erected in 1960, with a reduced seating capacity of 999. In its opening years it focused more on cinema, becoming London's third Cinerama venue before returning to live theatre in 1966. It had moderately successful runs of the shows Oh! Calcutta! and Bubbling Brown Sugar and was used as a recording studio for the television programme This Is Your Life, before being bought by the London School of Economics and being renamed the Peacock Theatre. Today, it is mainly used as a venue for lectures, presentations, award ceremonies and open days, although it is also used by the Sadler's Wells ballet company for contemporary dance presentations, with The Rat Pack playing in 2002 and Doldrum Bay in 2003. During summer 2012 the Peacock Theatre will show a run of The Wah! Wah! Girls.