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Are All Medical File Reviews By Disability Insurance Companies a Sham?



Not every medical file review by a disability insurance company is sham, because there are rare occasions when the disability company actually hires a legitimate doctor to review your disability claim.

In this video, disability insurance lawyers Alex Palamara and Gregory Dell discuss medical file reviews conducted by insurance companies and their experience in challenging these medical reviews. If you have any questions about your STD or LTD claim, please contact any of our disability insurance attorneys for a free consultation.

There are 4 opinions so far. Add your comment now.

Henry W.:

To whom this may concern I am on disability and have been for sometime now. However my employer have switch my calm over to Liberty insurance. My understanding is that once you have been on disability for sometime they have the power to do this. The insurance company wants me to give them authorization to pull my medical records which I have no problem but I have an understanding that if I give them authorization they can pull more than my medical records is this true. The doctors that I am seeing say that I am in need of surgery to my lower back.

Attorney Stephen Jessup:

Henry, if you have been on disability for a period of time your claim should not change to another insurance carrier, as the company that was responsible for paying benefits would remain responsible regardless if your employer changed carriers.

Nikki:

I have been awarded a lump-sum Workers Compensation Settlement when I separated from my company after 22yrs.. I am receiving LTD from MetLife. They say I must give the mseveral thousand dollars from this as an offset. I am being phoned by a recovery company. I spoke to the company once without committing either way to paying or not paying them the money. MetLife sent a letter which states “benefits are reduced for periodic benefits for loss of time due to a work-related injury or illness or by reason of any Worker’s Compensation, occupational disease law or other similar law. It was my prior impression this referred to when I was receiving (as I had during my first absence due to this same injury prior to separation from the company before returning to work for 1 1/2yrs) the monthly disability checks from my companies wc insurance company. MetLife said they will deduct $200 per month from my check of $1658.30. They are also doing another evaluation only 7 months after doing a 2nd level denial appeal which I won. This after i received a phone msg from my adjuster saying it would b about a year. Interesting timing. The paperwork was a day late. it is postmarked 4 days before the cutoff date. I wasn’t very concerned about the close timing because MetLife never has before. So they closed my case. It said they do not have to reopen it. They received the info. Now someone has phoned me. Am I required to have a verbal discussion when I have provided documentation from 4 Doctor’s? Thank You

Attorney Stephen Jessup:

Nikki, if your claim has been closed/denied MetLife will have to send a formal denial letter detailing the reasons why. It may be in your best interest to contact them to get clarification. If you have received a denial letter please feel free to contact our office to discuss how we may be able to assist you.

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