My insurer contacted my doctor, now what?

Your insurance company has asked your treating physician to complete a questionnaire regarding your ability to work and current medical condition, what should you do?

Requesting that updated questionnaires be completed by a claimant’s treating physicians seems to be standard in the review process. Usually, these forms consist of yes or no questions, check boxes and requests for comments on restrictions and limitations.

If you know the insurance company has requested such questionnaires from your physicians it is beneficial for you to make an appointment with your physician to discuss and complete the questionnaires together. By completing the questionnaires together, your physician can accurately answer questions regarding your medical condition. If you are not present during completion of the questionnaire, your physician may inaccurately describe how your condition impacts your ability to function, your restrictions and/or your limitations.

It is also important that all questionnaires completed by your physicians are returned directly to your lawyer, not sent directly back to the insurance company. When questionnaires are returned to the lawyer they can be reviewed for any “red flags” or inaccurately answered questions.

Although your physician may not believe you are able to return to work, he/she may be completing the form in a hurry and mistakenly check a wrong box that can be detrimental to your disability claim.

Keep in mind, although the insurance company requests the forms be completed by your physicians, it is ultimately your responsibility to ensure they are returned in a timely manner. Set a reminder for yourself to follow up with your physician’s office every two to three days regarding the status of your questionnaire to make sure it is completed and returned timely.

If you have an insurance claim which has been terminated or denied, contact Jan Fishman, a former in-house Manulife lawyer, and put his experience to work for you.