Question

Can Metlife force me back to work part time if my doctors are saying NO?

Asked on November 4th 2017 by Bluetechseeker
I am on LTD with Metlife due to severe degenerative disc disease and radiculopathy in my back. I’ve had 3 level cervical spinal fusion as a result, and also deal with seronegative rheumatoid arthritis, fibromyalgia, precancerous anal cancer lesions with repeated surgeries, and hypothyroidism. My doctor has said the last two years I’ve reached maximum medical improvement and will not release me to work. The most recent forms sent indicate I can sit/stand intermittently 4 hrs daily, turn/twist 1 hr, and lift up to 20 pounds. I had a call from the vocational expert with Metlife last Thursday. From the tone of the conversation, it sounds like she’s trying to fit my existing skills into a part time job. She said they reached the decision that I cannot obtain gainful employment in my area due to my previous wages (their calculations make the wage I’d need to earn too high), and that my current condition of radiculopathy do qualify me for permanent disability. I was extremely blunt with her, telling her exactly what I can and cannot do, and even provided comparisons to previous employment with my current condition and how ridiculous it’d be to believe I could do them. At the end of the conversation, she said she’d get with the nurse and my claims manager to see what the next steps would be. My 24 months of the “own occupation” ends January 8, 2017 then I’m to transition to the “any occupation”. My question boils down to CAN Metlife force me back to work part time if my doctors are saying NO?? Can they say I AM able to work even though the doctors are saying NO?? I went on short term disability June 29, 2015 and immediately qualified for SSDI; I’ve been receiving SSDI since the waiting period expired in December 2015. I’ve provided substantial medical evidence and documentation to Metlife, timely, and have been very diligent to handle any questions or documents immediately. I cannot believe the conversation from Thursday and am at a loss if I should be concerned, let it rest for right now, or get ready for a fight.

Answer

Answered on November 4th 2017 by Attorney Cesar Gavidia

Bluetechseeker, MetLife cannot force you to return to work, but they can determine that based upon their review you would be able to return to work and deny the claim. The any occupation review is a common point in the claim that any insurance carrier denies a claim based upon the medical review of one of its doctors. Please feel free to contact our office to discuss your claim in greater detail, with specific attention to the pending any occupation review.