Disability Insurance Benefit Tips

What is the advantage to a person having an attorney present for a field interview?As we were discussing earlier, these interviews are made to elicit certain statements from you. It's almost like a deposition. Obviously you are not making objections, you are making a record but what you are telling them can be used against you and it's important that you have your lawyer there representing your interest, u...

It really depends on the policy language. If it says in the policy that they are required to submit to a field interview or submit to an independent medical examination then, obviously, they have to do it. But if it doesn't, I think it's really a grey area. I think, in the abundance of caution, it would always be prudent to go ahead and participate in a field interview. Because, as I tell my clients - Listen, ...

In today's issue we are going to discuss the process of what happens when a long term disability insurance company requests to do a field interview regarding your claim and they may just call it an interview or a meeting. But essentially what that means is that the long term disability insurance policy carrier calls you up and they say - we would like to come meet with you. Generally it's at your home and we w...

In addition to just these doctors that are biased, the in-house doctors and the outside doctors that are hired, we know that they also use these third party companies that are supposed to set up these independent medical exams. Do you guys see that as well?Correct. There is one PMI, that I see a lot, you'll see multiple doctors under that company that will go and send some files of the review and it's almo...

Let's talk a little bit about the bias of these particular so-called independent medical examiners. I think we have seen through our cases of litigation, through the ERISA appeals and information that we have obtained, after seeing hundreds of disability cases that these doctors are not really independent doctors, they are doctors who are paid to say whatever the disability insurance company wants them to say....

What if anything could you recommend to people who are watching could do to try to protect themselves during an alleged independent medical exam?In some states, for instance in Florida a disability claimant has the right to take a third party with them to that independent medical examination in individual disability insurance cases. If you have a private policy you have that type of right to take your atto...

Can a disability carrier deny benefits to a claimant if they have never had an independent medical exam done on a particular claim?They certainly can. Just because the insurance company fails to request an independent medical examination of an insured person, doesn't mean they don't have grounds on how they evaluate the claim, to terminate the claim. It's usually done to further seek support for perhaps so...

When the independent medical exam is done, the doctors generally generate a report, correct? Is that report generally made available to the clients or is that report made available to client's treating physicians?Usually for the treating physicians. Most of the time when I request them, they say it's not our policy to turn them over, in the event of litigation or in a denial on a group claim, a lot of time...

When an insurance company sends this notice to the claimant and says - we want to do an independent medical exam, what are they really looking for? Why are they asking for this exam?Well, realistically what they are going to be looking for, in my opinion, is some way to try to justify the denial of a claim. It may have been that they have reviews of medical records, they have one of their internal reviewer...

When you get one of these independent medical exam notices or letters from a disability carrier, does that mean you have to go to this exam or can you say - no, I really don't want to go?It's not advisable to refuse to go to an independent medical examination in most cases and the reason is because often times in most policies attending an independent medical examination at the request of an insurance comp...

Video surveillance is directly representative of the occupational duties that the person was doing at the time he became disabled. Meaning, does the video surveillance have any weight at all if it does not relate to the type of the job that the person does?It's kind of a difficult question to answer. The reason is because what they capture in that disability video surveillance is not necessarily or evenly ...

A lot of people call and say - what am I supposed to do, sit home all day? I can't live a life, I can't do any activities because they will put me on video. Can I go to the gym, can I go grocery shopping? And there is a quote here from a recent case, the California Federal court, and it says - "the court has repeatedly asserted that the mere fact that a claimant has carried on certain daily activities does not...

When do you guys think that a disability claimant should be most concerned that they are going to go under video surveillance? And something that comes to my mind right of the bat which I see a lot, is, if a claimant is asked to submit for an independent medical exam or functional capacity exam, I see tons of times that they will do disability video surveillance either couple days or couple weeks before the da...

Let's talk a little bit about why they are doing this video surveillance. Obviously they are not looking to see if you are doing criminal activities. The reason they are looking to doing this video surveillance is to see whether you are doing anything that is inconsistent with what you are telling the disability insurance company that you are not able to do. So, let's start by actually quoting a line from a re...

Can these disability insurance companies do a video surveillance of a person when they feel like it or where they feel like it?The answer is, they can do video surveillance, absolutely, they can do it as part of their investigation into your claim. Now, there's obviously certain places they can't do it. They just can't come into your home and do video surveillance there or come into your business and do vi...

The answer to this question depends on whether you purchased an individual disability policy or an ERISA governed group long term disability plan. If you have an individual disability policy then you should either call or send a letter directly to your disability insurance company. Most disability companies will charge a small fee for a duplicate copy of your disability insurance policy. Review your policy ver...

I am regularly asked with regards to field interviews in a long term disability insurance claim whether a claimant should allow a long term disability insurance field rep to come into their home and do a field interview.In almost all of these field interviews the disability insurance company will request to do it at your home. I would tell you that you should absolutely not to do this interview at your hom...

Disability insurance companies will often rely on either an Independent Medical Exam (IME) or an External Medical File review without examination in order to deny a long term disability claim. I never consider a an IME exam to be independent because you are required pursuant to the terms of your disability policy to appear at the exam and the allegedly independe...

Be very cautious if your disability insurance company wants to interview you.In this episode disability insurance attorneys Gregory Dell, Stephen Jessup and Cesar Gavidia of Dell Disability Lawyers discuss issues to be aware of when a disability insurance company request an interview with a disability claimant.Our disability lawyers have participated in ...

Your disability insurance company may be watching you at anytime.In this episode Disability insurance attorneys Gregory Dell, Cesar Gavidia and Stephen Jessup discuss the ways in which long term disability insurance companies rely on video surveillance to deny disability claims.Relying on our experience of representing thousands of disability claimants a...