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Episode 23 Beware of hired gun doctors in disability insurance claims



In this video former Montana Insurance Commissioner John Morrison discusses that the fact that disability insurance companies will use hired gun doctors to wrongfully deny disability insurance claims. Additionally, you will hear a view in defense of hired insurance company doctors from a representative of a pro-insurance lobby organization.

As disability insurance attorneys that only represent claimants, we find it comical that the insurance company representative describes insurance company doctors as “compassionate”.

Additionally, you will learn that disability companies can often get away with using hired gun doctors if the claimant’s disability policy contains a discretionary clause. This video is an excerpt from a Good Morning America story discussing long-term disability insurance claims.

It is always a great thing for disability insurance claimants when a national news story discusses the wrongful and unreasonable practices of a disability insurance company.

Please note: Disability insurance attorney Gregory Michael Dell created Disability Insurance Law TV in order to educate long term disability claimants about common issues related to long term disability insurance claims. New episodes are filmed on regular basis. Our disability videos are for informational purposes only and they are not legal advice.

There are 9 opinions so far. Add your comment now.

Randy T.T.:

Thank you for sharing this video. The tactics the insurance co. use to deny, delay or interpret claims is shocking, but whats more shocking is the hired guns “Doctors” if you will who have taken an oath when obtaining their medical license and in turn, are acting negligently in regards to the oath, by allowing funds (as hired guns) money exchanging hands and provided to them by the insurance company to dispute patients medical conditions and the disabilities that are a result of the patients medical conditions, without having ever seen the patient. Even if the insurance co requests an independent hands on evaluation of the patient, by the hired guns, the hired guns are always, always, going to find for the insurance co.

This same thing happens with the hired guns (Doctors) in workers compensation injuries. They even refuse to order the proper diagnostic tests that will prove the claimants injuries, because they know these diagnostic tests will show the true pathology, but above this, even when the claimant seeks the care of another physician for help and the proper diagnostic tests are performed ( showing this objective medical evidence) Those hired gun doctors will try to refute the medical evidence revealed in these tests and claim that even if the tests show pathology, the patient/claimant should not have a disability as a result of, that the condition should not be painful and limit their ability to function.

This results in the injured/ill/disabled victim sinking into further despair and to lose trust with all medical professionals hired or otherwise that are able to dictate all medical, financial and matters and the impact these acts have on the victims/claimants are an atrocity to human kind.

Unless one has been a victim of such, they will not realize what is going on in the REAL WORLD.

Sure there are some advocates out there, but they are few and far between, and their voice is not loud enough, or in great enough number to make any kind of impact against the power that these insurance companies and Doctors have on patients lives.

The claimants and victims of such can spend years in legal battle with these corrupt companies and Doctors and in the case of ERISA, the end result is the Doctors who have not upheld their medical oath have no punishment handed down to them and the employer sponsored, ERISA Governed insurance policies and companies who act in this mater because they know the ERISA law is always in their favor, have no recourse handed unto them.

The insurance companies know that they worst they face is possible Attorney fee’s and the monies they should have paid the claimant as an end result. After years of legal battle the claimants funds as well as many other claimants funds have been sitting in an account somewhere, gaining high interest and with that interest gained the insurance company has actually made so much money off the interest, they are actually happy then to afford the claimant the back pay, sometimes the Attorney fee’s because they actually made MORE MONEY off the victim.

But where does that leave the victim-claimant?

The victim and claimant are already disabled and depressed because of, the claimant and victim are now the victim of insurance and medical fraud, lost everything they had ever worked for.

The insurance company laughs all the way to the bank.

Who can put a stop to this. Lobbying does no good, there is too much power with the monies that change hands every second of the day directly because of this.

Thank you though, for airing this video, it does reinforce what the disabled already know, but others are not admitting to. (We know who they are.)

Mayleena:

So what is a disabled person to do? This scenario is the rule, as it follows letter for letter what I have experienced. It’s bad enough to have a disabling illness, but to have to fight so hard for benefits, without strength, and dwindling funds, there is no escape. I want to work but I am unable. Recovery is next to impossible because the appropriate treatments aren’t covered by health insurance and I am not able to afford them. Recovery IS possible for me if I have the proper treatment, without it there is no hope.

Harold G.:

I worked as a process operator for a mobile refinery for 12 years before hurting my back. I had back surgery in 2004 and was on workman’s compensation and could not return to work because my back was still damaged, but Prudential denied my benefits after 2 years. My doctors say I can not work but they are fighting me, I have to appeal this discussion. My family is suffering because of this. My problem is: how can you be denied if you are still on workman’s compensation – you can not work. But they can wait, it is a shame, I can lose my house and my family for a benefit I payed for. This company needs to be stopped, please keep fighting for all the people like me. Thanks and God Bless.

Tim:

I had a chronic back problem. Hartford paid for 2 years and quit without notice. My doctor wrote a note in the appeals process and said there is no way this man can do any job and slamed any doctor that said I could. My SSD was started 2 months after they quit paying me benefits. I found an attorney that is a good attorney but I dont think this type law is his speciality like you guys.

Its two and a half years later and the judge that used to work for a large insurance company sent the claim back and said basically do the denial right according to my attorney. I went to the insurance company forensic psychology yesterday over 100 miles away. I was there from 9-5, she stated we did not finish but just after 1 o’clock this day she said we only like an hour. I did puzzles and testa. She stated this was her first to work with Hartford and this type claim. She was nervous around me for some reason.

Today I can’t walk because of the 100 mile trip. It was too much for me. First time I had driven that far after I had five disc replaced with metal and plastic ones. By the way after they denied me. I told my attorney I can’t go that far for the test, it is too dangerous for me to drive and it hurt me severely. My legs went numb on the way home.

What should I do? I am ready to give up. I think this was scheduled by Hartford’s attorneys far away on purpose. Any advice?

Attorney Greg Dell:

Tim,
 
If you need to go back, you should demand transportation or a closer doctor. You should video tape or audio record the meeting with their doctor. You need to request a copy of the RAW DATA from the CME exam and allow your doctor or hired Expert the opportunity to review the data and comment on it. You should make sure that your doctors have the opportunity to comment on the final report before the administrative record is closed. These are a few thoughts. Since you already have a lawyer, we cannot give you any legal advice. You are free to select a lawyer of your choice.

Patricia B.:

Hi, my name is Patricia and I have just watched a few of your videos and they have been pulling these tactics on me for years. I have had multiple lawyers and doctors, have gone without treatments and compensation. The federal government has declared me disabled but workers comp says I can work 40 hours a week at minimum wage. They have buried me alive. I am Forced to go without treatment again and I’m not sure my body can take it anymore. There’s nobody I can trust so you guys are my last hope. I would call but I am crying too hard to talk right now. I have a lot of paperwork to prove what I am going through and hope to speak with you soon.

Attorney Stephen Jessup:

Patricia, If your claim is for worker’s compensation you will need to speak with an attorney that handles those cases. We only handle claims for disability benefits under private or employer provided disability insurance policies.

Patricia:

Hi. I’ve been seeing my one doctor for 3 years now for my lower back and then it continued on form of the polyarthritis fibromyalgia neuropathy and so on. I also have a PCP that I see for the diabetes COPD and my heart issues. He basically manages all my other Dr. I also see an electrophysiologist for my atrial fib and I monitor my pacemaker. I had ongoing heart issues prior to going out of work when I hurt my back. I was on short term disability then long term disability and they cut me off at the 2-year mark. Just heard from my PCP and my rehabilitation specialist that they’ve got a packet from Aetna doctor stating that I’m able to work and his findings. I’m going to lose my house. I’m going to lose my car. I’m going to have to give away my dogs. Never been so scared in my life.

Attorney Stephen Jessup:

Patricia, it is imperative that your doctors respond strongly to the doctor’s report and provide additional evidence to support your inability to work. If your claim is formally denied Aetna will have to explain the basis of the denial to you in detail. Please contact our office to discuss the appeal process and your legal rights going forward.

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