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My most memorable case of 2016.
The past year has seen many interesting and surprising cases land on my desk. But my most memorable case involved a woman I’ll call April. April had been employed by a financial institution for a number of years when she developed cancer that forced her to stop work in May 2001. She applied for long-term disability benefits under her employer’s group insurance policy. Her claim was approved and benefits were paid starting in November 2001. Although the cancer treatment went well, April developed a number of mental illnesses...
read moreCan my insurer contact my doctor directly?
Your disability 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 a good idea...
read moreWhy an insurer may ignore a treating doctor’s opinion.
Many people, as well as their doctors, believe that when they file a claim for disability benefits their disability insurance company has to accept the medical professional’s opinion that they are disabled. Common sense suggests this is a reasonable assumption – but it couldn’t be further from the truth. Why? Because many insurers simply do not want to pay disability claims and, when armed with discretionary language in the policy, the insurer has the final say as to who is “disabled”, not the treating doctor. Making matters...
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