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Do I need to send the “medical authorization release” form to the disability insurance company?



Disability attorney Gregory Dell discusses why a claimant must be careful when returning the “medical authorization form” to their disability insurance company.

You need to be extremely careful in returning these medical authorization forms to the long-term disability carriers. The disability carriers have the right to obtain any of you medical records that they want. The problem is, and what I consider to be a trick that they’re looking to play on disability claimants, is that these medical authorization forms are not just “medical authorizations.”

What they actually include in them, if you read them closely, is they ask for all of your financial information, they ask for permission to speak with any of your employers, they ask for tax records, they’ll ask for any kind of employment records, they’ll ask for the right to pull your driver’s license, and they’ll also ask for the right to pull your credit report. Many of these things have absolutely nothing to do with your long-term disability claim, and you do have the right to modify the medical authorization form should you desire to. So I would encourage you to read your medical authorization form very closely and cross out anything that you do not want the long-term disability carrier to get.

There are 66 opinions so far. Add your comment now.

Paul:

I noticed the information posted concerning “personal information authorizations”. The following is the terminology of the one I am to submit. Very uncomfortable with it. How do I limit without having benefits stopped?

1. I authorize any physician, medical or dental practitioner, hospital, clinic, pharmacy, benefit manager, other medical care facility, health maintenance organization, insurer, employer, consumer reporting agency and any other provider of medical or dental services to release records containing the personal information of:
– Claimant/Patient Name:
– (Last) (First) (Middle)

2. Personal information includes medical history, mental and physical condition, prescription drug records, alcohol or drug use, financial and occupational information.

3. You may release information to:
– Group Insurance Claims Management
– Mutual of Omaha Insurance Company/United of Omaha Life Insurance

4. I understand that the personal information that is disclosed will be used only by Mutual of Omaha Insurance Company and United of Life Omaha Insurance Company to evaluate my claim for disability benefit plan reimbursement and that if I refuse to sign this authorization my claim for benefits may not be paid.

5. I understand that if the person or entity to whom information is disclosed is not a health care provider or health plan subject to federal privacy regulations, the personal information may be re-disclosed without the protection of the federal privacy regulations.

Attorney Greg Dell:

Paul,

We cannot provide a specific answer since we don’t represent you, but usually it is in a claimant’s best interest to limit the release to medical providers only. This means eliminate any request for financial and occupational information, or request to consumer reporting agencies. A medical authorization should be for medical records only. If the carrier needs something else, then they need to ask you for it.

Keith:

This is also in regard to filling out the PHI, Protected Health Information.

I have been on LTD since 2005 and I had filled out the PHI back then. The specific request to authorise then was:

Any and all medical information including but not limited to information which relates to psychiatric or mental health, drug, substance abuse, and / or HIV infection, including AIDS and related illnesses, concerning health care, advice and treatment (including but not limited to, medical records, histories, physical or diagnostic examinations reports and treatment notes.

By signing this form, you will authorise Aetna to request PHI described above from the following persons or organisations (or classes of persons or organisations):

Providers, including but not limited, to physicians, therapists, medical practitioners, health care professionals, diagnostic facilities, hospitals, clinics (including individuals or facilities which provide rehabilitation services or treatment.

I now received a new PHI form requesting it by the middle of April 2013.

The difference being:

By signing this form, you will authorise Aetna to request PHI described above from the following persons or organisations (or classes of persons or organisations):

They added Workers Compensation Professionals, saying:

Providers, including but not limited, to physicians, therapists, medical practitioners, health care professionals, WORKERS COMPENSATION PROFESSIONALS, diagnostic facilities, hospitals, clinics (including individuals or facilities which provide rehabilitation services or treatment.

My questions are:

1) I received this packet several weeks back and filled out the other forms with the physician statement and did not fill out the PHI. The reason is, it clearly states that you do not have to fill this out and this form is voluntary. Now, about a week after I sent in the other forms I received a letter from Aetna saying that they need this form filled out in order to continue authorisation of my LTD benefits. So, by the sounds of it, Aetna will shut off my benefits if I do not fill this out. Is this possible since it clearly states this is voluntary?

2) As you stated before, these forms are to be for medical information only. Now they added Workers compensation professionals. I was involved in a workers comp claim, but I feel this is unnecessary. Is this going a little overboard on their part?

Attorney Greg Dell:

Keith,

I think you should write to Aetna and tell them that you will sign medical authorisations that are specific to the medical providers that they want records from. Tell them that you are concerned about signing general authorisations. You will cooperate, but you want to protect your privacy. If they want any other records, then ask Aetna to send specific authorisations. They should send specific Authorisation for Worker Comp claim as well.

Kim:

First of all, thank you Mr. Dell,

Thank you for helping out many people that are in the unfortunate position to have to rely on these insurance companies that look for ways to get out of their commitment. My husband paid into his LTD for 28 years. He has received his benefit for 1 year. Today we received the same pack that is mentioned above.

Would it be best just to cross through mentioned items above and send it back with to package? Or prepare a letter.

Do the insurance companies just count on people not reading these things and signing them. I was contacted by a company called GENEX and was advised not to respond to them. Same reason, I did not want to give a 3rd party personal information. Now the LTD company is doing an end around with this request. I read on the GENEX form, they can actually charge you in some instances for obtaining any information…

This is a very stressful. My husband suffered a severe brain injury. If you were to look at him, you would say “you look great” no sign of injury there. But in reality he is a very sick person. His days consist of sitting around the house or on the porch. He cannot drive because of seizures. He does go on short walks. I am afraid someone will come spying on him taking a walk and say, he’s not disabled. Sorry for the ramble…

Again, thank you.

Attorney Stephen Jessup:

Kim,

Genex is typically hired to secure Social Security disability insurance benefits so that the insurance company can offset the monthly disability benefit by same. You do not have to use Genex for any services and are more than free to hire your own SSDI attorney. Pursuant to the SSA rules, any attorney fee is recovered from any award by the SSA.

Kim:

Hello again,

My daughter just received her tax information from Social Security. They paid her $8200.00. Long term disability “American Life” is not aware of this income. My personal SS records do not show this information. I am currently going on my 2nd year of LTD payments. Can you offer an opinion how to handle this?

Thank you.

Attorney Stephen Jessup:

Kim,

If your daughter’s Social Security benefit is dependent SSDI (DSSDI) based on your disability and If your American Life policy allows them to offset your monthly benefit by the amount she receives, then you could be potentially facing an overpayment. Chances are American Life will find out about the DSSDI at some point in the future.

Jan:

My brother recently passed away and I am the beneficiary of his life insurance. Included in the claim form are three different forms that concern me. An Authorization for release and disclosure of health-related info, Authorization for release and disclosure of psychotherapy notes, and Authorization for release and disclosure of non-health-related information. My brother was an alcoholic. He had severe back problems and also took prescription meds. We may have to wait 90 days to get the death certificate so don’t yet know the cause of death, but are concerned that mixing the alcohol with prescription drugs may have contributed to his death. Do I have to complete these forms and if so, how might this affect the outcome of his life insurance?

Attorney Stephen Jessup:

Jan,

Many life insurance policies contain provisions that benefits will not be paid if the cause of death was related to the use of narcotics / illegal activity or suicide. This is most likely the reason why they have sent the authorizations so they can rule out those incidences. You will need to check the policy language, as benefits could be precluded based on the cause of death.

Mindi Rose:

How long after an LTD company has stopped paying a claim do they have the right to continue to obtain medical records? We were told that a claim would be continued if we continued to have the doctor send the requested forms, and now we are finding out that it isn’t. My husband put in 2 weeks noticed and then was injured outside of work. They paid his two weeks with his LTD and then said his employer would continue the claim until he was able to work… This seemed suspicious to us, but really needed the income since his injury delayed his start date with his new employer. They continued to ask for information and we gave it to them, and then we were told that it would be paid by his old employer through the 10th (the 2 extra weeks that he was unable to work and cleared to go back on the 11th). So now what? We have no idea if they are required to pay or if they even had the right to access those records since he was actually no longer employed by the company providing the LTD. Do you have any advice?

Attorney Stephen Jessup:

Mindi,

Presumably they would only seek to obtain medical information while conducting any review of a denial of benefits to determine eligibility. If they determine that benefits should have been paid, or in the alternative, to uphold their denial of benefits they would not continue to request any information.

Mark:

I am applying for LTD though my employer’s Group Disability Plan from Prudential. The Authorization for Release of Information Form states it is intended to comply with the HIPPA Privacy Rule. Without typing the whole Authorization, here are a few of the excerpts:

1) I authorize any insurance company, employer, the Social Security Administration, or other person or institutions to provide any information, data, or records relating to my Social Security, Worker’s Compensation, credit, financial, earnings, activities, or employment history to Prudential.

2) I understand that any information that is disclosed pursuant to this authorization may be re-disclosed and will no longer be protected by the HIPPA Privacy Rule governing privacy and confidentiality of health information.

When contacting Prudential concerning Item 2, they stated that disability was not covered under the HIPPA Privacy Rule and they don’t release information.

Is release of information for LTD disability covered under the HIPPA Privacy Rule? Also, how do you believe Prudential will use Item 2? It appears they could release any of my information to anyone? As I said before, this is not the entire release as it also contains…

3) This includes information on the diagnosis or treatment of human immune deficiency (HIV), infection and sexually transmitted diseases. This also includes information on the diagnosis and treatment of mental illness and the use of alcohol, drugs, and tobacco. But excludes psychotherapy notes.

Your comments would be appreciated.

Attorney Stephen Jessup:

Mark,

Provision 2 would relate in most cases to Prudential sending medical information to a reviewing doctor they hire to examine your claim. However, the authorizations are generally very ambiguous and broad in scope so no one can say with certainty who they will disclose information to.

Jason:

I have a private short and long term disability insurance with Liberty mutual and I live in California. I am in a chemical dependency program for mental health issues. Is it legal for them to ask for my medical records with mental health concerns?

Attorney Stephen Jessup:

Jason,

If your claim for benefits is based on a mental health condition, then it is completely reasonable for them to request your mental health records to determine eligibility under the policy.

Lucille Gilmore:

I am a month away from a (deposition) wrongful termination, discrimination case with former employer. Their attorneys have requested medical history for last 10 years, tax documents, (last year) employment history. And it also states history of HIV, mental health, alcohol and drug use may not be kept private. I don’t understand what having disclosed has to do with my case. And if I refuse to agree to release personal info. Because I feel this has nothing to do with what was done to me. This in fact has overwhelmed me! And has added on to my stress and humiliation! Do I have to sign and release these forms? Don’t know what to do. I feel so violated! I am so angry! It is such an invasion of privacy by a company that allowed all the wrong doings to happen to me in the 1st place. Now I’m to place my entire life history in their hand. It is not right!

Attorney Stephen Jessup:

Lucille,

Unfortunately, I will not be able to give you any guidance as it relates to your employment action. You will need to discuss your concerns with your attorneys so they can best advise you of your rights.

Sarah:

My workplace insurance just changed companies. The new form included the paragraph below, which I was uncomfortable with and crossed out before signing my name to the overall form and handing it in. Two months later, the insurance company is now strongly implying that they will deny me coverage if I don’t sign a clean form (they have already paid some claims). They claim that without this paragraph, they cannot use the clearinghouses to process my medical claims. I was under the impression that HIPPA already allowed release of the forms as necessary to process claims, and explicit permission from the patient was not required to perform these tasks.

I submitted an addendum that looks very like the paragraph below but with the phrase “as required to process current medical claims” in a couple places, and this change near the end: “I understand that information I authorize a person or entity to obtain and use, **beyond the need to process my claims and other uses expressly permitted by HIPPA,** may be re-disclosed and no longer protected by federal privacy regulations.” The insurance company will not accept my addendum in place of the original wording.

Two questions:

1) Do insurance companies require this explicit permission from me to perform their job of filling my claims; and

2) Is it legal for them to deny me coverage if I do not sign off on the statement below?

Thanks!

I authorize *** Insurance Company and its affiliates (“***”) to obtain, use and disclose my current medical, claim, or benefit records, including any individually identifiable health information contained in these records. I understand these records may contain information created by other persons or entities (including health care providers) as well as information regarding the use of drug, alcohol, HIV/AIDS, mental health (other than psychotherapy notes), sexually transmitted disease and reproductive health services. I authorize any health care provider, pharmacy benefit manager, other insurer or reinsurer, hospital, clinic, or other medical facility, health care clearinghouse, and any of their affiliates, representatives, or business associates, to disclose my information to ***. I understand the purpose of the disclosure and use of my information is to allow *** to make decisions regarding eligibility, enrollment, underwriting and premium risk rating. I understand this authorization is voluntary and I may refuse to sign the authorization. My refusal may, however, affect my ability to enroll in the health plan or receive benefits, if permitted by law. I understand I may revoke this authorisation at any time by notifying my *** representative in writing, except to the extent that action has already been taken in reliance on this authorization. As required by HIPPA, *** also request that I acknowledge the following, which I do: I understand that information I authorize a person or entity to obtain and use may be re-disclosed and no longer protected by federal privacy regulations. This authorization, unless revoked earlier, expires 30 months after the date it is signed.

Attorney Stephen Jessup:

Sarah,

Ultimately, an insurance company can chose to provide or deny coverage based on its evaluation of forms and applications. Failure to comply with requested information could result in the company denying to provide you coverage. I would discuss your concerns with your HR department.

Carol:

I am going on 2 years of receiving long term disability from my insurance company Unimerica. I have just received a form OMB NO 0960-0566 which they are wanting me to sign to give authorization to SS for any SS Consult exams. Should I sign this?

Attorney Stephen Jessup:

Carol,

I am not familiar with the form you reference by the number alone. It is not uncommon for an insurance carrier to seek authorization to obtain information from the SSA as it relates to a claim for disability. If the information in the SSA file is helpful to your ongoing claim for benefits with Unimerica, then it may be in your best interest to make sure they have the information.

Yelena:

I have been on LTD (after a car accident) since Aug 2014. I signed two authorization forms that were part of the initial claim package: medical records authorization and “Financial”. This financial form included my credit history, any financial institution and tax info, Working Comp, former employers and education details. Now I understand that I gave them too much of authority. Can I revoke some items from the previously signed “financial” form? Thank you sooo much for helping us!

Attorney Stephen Jessup:

Yelena,

You will need to review the form you signed to see what the rights of revocation are. You can also contact the carrier in writing advising them you wish to revoke portions of the authorisation.

Carol Needs Help:

My psychiatrist shared the following with me.

Psychotherapy notes: Insurance companies cannot require your authorization as a condition of coverage nor penalize you in any way for your refusal to provide it. It’s a statement they put on the privacy notice.

So, my question is, where does this statement come from in law and can I hang my hat on it and tell CIGNA they cannot deny my LTD claim because I refuse to give them access to my psychotherapy notes?

I think your answer to this question will help a lot of people who are frightened to death about this. Thanks.

Attorney Stephen Jessup:

Carol,

I would most certainly not hang your hat on that. If you do not provide sufficient evidence of disability Cigna will more than likely deny your benefit for not having evidence of a disabling condition. Many psychiatrists/psychologists will not release session notes, but will usually provide summaries and opinions.

Carol:

I received a SSA-3288 form from my Long term disability Company that they want me to sign wanting all my records from Social Security including complete medical records, denial letters, diagnostic testing an SS consultation exams, my question is do I have to sign this form giving them that information? I am awaiting a hearing date which I am is in the works. I know and understand if I receive SSD I will have to give the long term disability company that money but not sure if I should sign these forms so they have the right to my file.

One more thing I just thought about, my long term disability company is wanting me to sign a Medical release for HIV results, Alcohol and/or drug abuse treatment and Psychiatric records which I don’t have any of these problems and there are no records. I am on long term disability for complications following back surgery including severe back, shoulder, neck, and arm pain and headaches. I do see a therapist because of the pain issues but this is not the reason I am on LTD. Should I sign these authorization requests?

Thank you.

Attorney Stephen Jessup:

Carol,

Both forms are common practice for disability carriers. If your SSA file contains helpful information in support of disability then it would be to your benefit to provide the contents of same or allow Unum to obtain. With respect to the second release – the language used is standard.

Samantha:

I’ve been asked to give my LTD carrier full authorization to interact with SS regarding my SSDI claim which isn’t due for any review for at least 2 years due to my disability. They already have all the documentation and judge’s decision from my recent hearing where I was given a fully favorable result, the best result.

I’m very uncomfortable giving anyone carte blanche access to my SS file, especially given the ambiguous writing in their privacy policy. My LTD policy only states they may ask for documentation from SSDI,IRS etc to be sent when requested from me, the only clear authorization is for medical disclosure which they already have.

I’m concerned because my ex wife made a claim (without my knowing as we haven’t talked in a long time) on her own for my child who she has full custody of and lives with in a different state, and that my LTD carrier will try to get details of this claim from SS. SS have told me since I didn’t make the claim I can’t get any information on what my ex wife gets due to my disability and it’s against the law for me to access anther persons SS claim (even if it’s linked to my file for disability), but I’m not sure if the carrier can access more info than the SS department is willing to share with me? I would hope that my carrier will be told the same thing I was told, that there is a claim but no details can be shared whatsoever?

I would prefer not to sign this authorization especially when the policy doesn’t state I have to.

Attorney Stephen Jessup:

Samantha,

It is certainly your prerogative not to sign the Authorization. You can certainly advise them as to your concerns and notify them that you are more than willing to provide any and all information requested as it relates to SSDI.

Rebecca:

I receive benefits from my Group LTD plan as well as a private LTD policy I purchased. I was awarded SSD benefits (group LTD plan provided a company that filed the claim on my behalf). My group LTD benefit is now off-set by the SSD benefit. However, now my private LTD carrier has asked I sign a release so they can obtain a copy of my SS claim file. As there is no off-set provision in the private policy, I don’t know why they want this information.

Their letter states “In order to determine the effect your award of Social Security disability benefits may have on your claim, we need your authorization to obtain a copy of your Social Security claim. If you do not provide us with your signed authorization to obtain a copy of your Social Security claim file, we cannot apply significant weight to the Social Security decision. However, we will consider the facts available to us at the time of our decision regarding your Social Security award”.

Should I sign the release allowing them to receive a copy of my SS claim file? I already provided a copy of the SS award letter. I believe SSD is awarded only if you are unable to do any job whereas my private policy provides benefits for 12 months for “your job”. Following the first 12 months they will only provide benefits if I am unable to do any job. So, is it likely that providing them with a copy of my SS claim file could only help me rather than hurt me with regard to my future benefits? I have received benefits for 9 months to date so am still in the “your job” phase.

Attorney Stephen Jessup:

Rebecca,

Typically private policies are own occupation in nature, but it appears from what you’re indicating that yours has an occupation definition switch. If so, the information in the SSDI claim file could be helpful to your claim. Please feel free to contact our office should you have any questions.

Anneliese:

Has ths law makers changed HIPPA Law?? It seems they have.. I am on short term disability for a broken foot. Liberty Mutual is asking for medical release of Psychiatric Records. Pretty sure my broken foot is not all in my head.

thanks, Anneliese

Attorney Stephen Jessup:

Anneliese,

You do not have to sign a release for psychiatric records if it does not relate to your claim.

Eric Mandoza:

The insurance company that is dealing with my doc visit for my wrist problem want me to sign a form that will authorize them for access to medical records. What happens if I refuse to sign? They want me to list the name of the providers that I have seen in the past 10 years.

Attorney Stephen Jessup:

Eric,

Is this request related to a disability insurance policy/claim?

Eric Mandoza:

Stephen,

not for disability claim just to cover my doctor visit. They did only x-ray and may be therapy in the future.

Attorney Stephen Jessup:

Eric,

Unfortunately, in the context of a medical insurance related claim I am not sure what the ultimate outcome could be if you refuse to sign. There does stand a chance your insurance company could attempt to avoid to cover the cost of treatment. It may be worth a call to your carrier to find out.

Dwayne H.:

I am 25 days into the 45 days that LTD Insurance Company has to inform me of their decision to restore my benefits. What’s puzzling to me is that they have requested an “Authorization to Obtain Information” (Medical records and other Information). Don’t they already have this information about me; and if so, why are they requesting it again?

Attorney Stephen Jessup:

Dwayne,

Typically an authorization is provided with initial claim forms. Additionally, please be advised that under the law it is ultimately your duty to provide the carrier with medical proof of disability (your records). I would strongly recommend you contact your claims person for an update and to find out what information may still be outstanding.

Jami:

Aetna want me to give them the right to credit, work, education and all kinds of information that has nothing to do with this claim, what should I do? I feel my civil rights are being violated for grocery money. Please help.

Attorney Stephen Jessup:

Jami,

You are free to limit the authority of the authorization to obtain information.

Tony s:

I am on LTD. I did not sign authorizations to allow the company collect my medical or other data. The previous one expired about a year ago. Can the insurance company collect the information without my authorization?

Attorney Stephen Jessup:

Tony,

They shouldn’t be able to secure the information- but that doesn’t mean that a doctor’s office wouldn’t accidentally send the records if requested. You may also want to contact your treatment providers to advise them not to send records to the carrier without your authorization.

Pam:

I am on long term disability and suffer from PTSD the insurance company is asking for my therapist notes for when im in session. I am not comfortable giving them tjis information. Can the3cut off5my benefits for me not wanting to provide that information. Isn’t that a HIPPA violation.

Attorney Stephen Jessup:

Pam, you can ask your therapist to write a summary of the notes. If you do not supply any “proof of loss” (as in notes and documentation of disability) then the carrier can very well terminate your claim due to lack of information.

Bill:

I filed a short term disability. I was in a car accident that wasn’t my fault. I have in my medical records previous drug abuse that my employer doesn’t no about. If I sign an authorized release form to the insurance co could my employer fire me?

Carrie:

If you are not being treated for any kind of psychological issues can you be forced to sign an authorization form for psychotherapy notes? My health issues are all medical. Can they deny your appeal even if you have no psych issues / aren’t being treated for any… if you don’t sign the authorization for psych notes?

Attorney Stephen Jessup:

Bill, we would not be able to advise you as to any potential ramifications this may have with your employer. You would need to consult with an employment attorney.

Attorney Stephen Jessup:

Carrie,if you don’t have psychiatric treatment or notes I don’t see how they could reasonably deny your claim for failure to sign the authorization.

Joao V.:

After trying to get an attorney to appeal for on my behalf against reliance, and since I was told to do it myself, can I get the medical records instead of the insurance, I don’t like the form that they ask me to sign, I’m waiting for there response, I left them a message that I already have medical records ready to be sent to them. I want to have control of the documents they are asking for. Is this ok for me to do it.

Attorney Stephen Jessup:

Joao, you can certainly get your own records to be submitted to RSL as part of your appeal.

Joy S.:

My husband has been disabled since 2003. His life insurance policy contained a clause indicating his premiums would be waived upon verification of disability. Every couple years the insurance company sends forms for his doctor to complete updating his condition. This year I noticed a Compliant Authorization-Insurance Claims. Authorization for Release of Information which includes permission to review any & all financial information as well as criminal background. This information has absolutely nothing to do with waiver of his life insurance premiums, plus allowing them to review financial records awards them access to my financial information. He spoke with an insurance representative that indicated he could not alter anything on the form. I understand they have the right to his medical & employment records, but can they legally require permission to check non related information? Can they refuse to continue to waive the premiums? I’ve read the policy & found nothing that indicates this is required. Thank you for your help.

Attorney Stephen Jessup:

Joy, we have redacted portions of authorizations for clients that had no bearing on a claim for benefits and advised the carrier that we would be willing to consider providing information based on specific request. That being said, the carrier is certainly within its legal rights to draft the authorization as they have. The most important information to be provided to is the medical information and information ancillary to same, that establishes ongoing disability for purposes of the waiver of premium benefit.

Joe:

I receive disability benefit from a personal disability policy I had when i was hurt. I am trying to obtain medical records from prior operations I had 10-12 years ago. Several of my prior doctors have destroyed those records. Can i request this information from my disability insurance company since they collected this records to make decision on my claim.

Attorney Stephen Jessup:

Joe, you can certainly request copies from the insurance carrier.

Johnny:

I have been on STD for almost the full amount of our contract. At first I was not sure I would be able to return, and asked for the LTD paperwork. They sent it and I filled it out, but never sent it in. Through exercise and physical therapy I began to feel much better. It now looks as though I wii be in great shape in time to return to work in time. I told Cigna as well as our HR department, medical department and my supervisor that I believe I will be back before I will need LTD. Cigna asked only for my Drivers License and or Birth Certificate and a signed release of information form. They said I don’t even have to fill out a LTD application. That. I would be evaluated for LTD by one of the managers in the LTD Dept, and that this would initiate my LTD Claim?!? Our HR dept Rep insists that I may need to and vehemently urges me to apply. Would I not be committing insurance fraud if I apply for LTD, if I do not feel I am in actuality going to be disabled for Long Term? Why the big push to get this authorization form?

Attorney Stephen Jessup:

Johnny, you would not be committing any fraud by applying for the LTD. If you do not need the LTD benefit then the claim will simply close. However, if you are unexpectedly out longer than anticipated it would be wise to have that claim already started.

Delores:

I have DJD with neuropathies. I have been disabled since 2011. I receive SSD and long term disability. Due to the stress of my condition and the inability to work , my Dr. Sent me to see a psychotherapist. Can the disability company ask for my psychotherapy notes?

Attorney Stephen Jessup:

Delores, yes, they can inquire about the doctors you treat with while on disability.

Jason:

I have been asked by Aenta to sign authorization for all the psychologist//therapist notes. Is it ok to write on the form DO NOT AGREE and send it back to them? Will they be able to close down the claim? I was in a car accident involving a pedestrian and it wasn’t my fault. She was standing on a highway at 4:30 A.M. and the street lamps were not lighted. I’m in treatment and have been diagnosed with Anxiety, I’m also on prescription sleep aids and anxiety medication.

Attorney Stephen Jessup:

Jason, if your claim is based on Anxiety, then Aetna would need to see your records to verify if you are disabled on account of same. If they do not have access to your treatment notes then they will likely deny your claim for a lack of medical evidence. Please feel free to contact our office should you have any additional questions.

Kay:

I am going to have surgery for a tear in my rotator cuff. When I called to find out about my FMLA and STD, Hewitt(the benefits administrators for my STD) said they will need to know ALLof my medications and medical conditions. My STD will be strictly because of the shoulder surgury. Can they legally require info regarding unrelated conditions and medications?

Attorney Stephen Jessup:

Kay, it is not unusual for a third party administrator to request detailed medical information. Have you discussed with them that it has nothing to do with anything except your rotator cuff?

Brandi:

I stopped receiving Ltd benefits through my employer in January of this year. I previously signed the form that allows them access to my financial information. Does the access stop once the claim is stopped? Will they have access to my tax return filed in 2017 for income in 2016 or other financials while receiving benifits now that it’s closed?

Attorney Stephen Jessup:

Brandi, if your claim ended there is likely no chance your insurance carrier would take any additional action on your claim unless you are in the administrative appeal process. When you say stopped receiving benefits do you mean your claim was denied/terminated or that you went back to work and stopped receiving them?

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