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Does the reviewing physician (the doc hired by the insurance company) have to be licensed to practice medicine in the state where the claimant resides?

Name: Dell Disability Lawyers
Brand: Dell Disability Lawyers
Rating: 5 (746 reviews)

Asked on August 28th 2023 by Judith

Claimant lives in California. Reviewing pychiatrist lives and works in Connecticut. There's been no contact, just records review. The psychiatrist rendered an opinion that the claimant is not disabled. Does this violate any California laws regarding practicing without a license?

Answer

Answered on August 28th 2023 by Attorney Gregory Dell

Judith,
This is a great question. Our understanding is that since the doctor is not establishing a doctor patient relationship with you then the doctor does not need to be licensed to practice in your state.

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Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?

When it comes to securing your disability insurance benefits, it's vitally important that your disability insurance lawyer thoroughly understands the symptoms and impact of your disabling condition. Doctors can help you create strong medical records, but they're not accustomed to dealing with the rigorous documentation disability insurance companies require. Lea...

Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak

If you're seeking long term disability benefits from an insurance company, you may be concerned that you're facing an uphill battle. Fortunately, the stronger your medical evidence, the greater the odds that your claim will be approved. On the other side of the coin, one of the most common reasons for denial of long term disability benefits involves too-weak med...

Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company

When you're seeking disability insurance benefits, your medical records and treating physician's statement are two of the most important components of your claim. But because the insurance company has a vested interest in denying your disability insurance claim, it often will rely on tactics like ambushing your doctor with a phone call in an attempt to get them ...

Disability Benefit Denial Reason #3 - Video & Social Media Surveillance

One thing many disability insurance claimants don't know about (or expect) from the claims review process involves video and social media surveillance. Disability insurance carriers often hire people to follow claimants around with a telephoto lens - or even send social media friend requests from fake accounts - to glean whatever information they can about the c...

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Paralegal Wins Principal Financial Disability Appeal

Principal Life Insurance Company terminated our client’s long-term disability benefits for POTS and dysautonomia at the 24-month mark on the strength of a paper review by an internal-medicine doctor and a handful of social media photos showing her on a hike. That was the “evidence” that overrode two years of paid benefits, a TPN line, and a multi-system au...

New York Life Wrongfully Denied Disability Benefits to Lockheed Martin Employee with Eye Disorders

New York Life paid our client's long-term disability benefits for two years — and the moment the policy definition shifted at the 24-month mark, the insurer cut her off. She had spent 38 years at Lockheed Martin Corporation as an Information System Security Officer in Georgia, doing work built on classified cybersecurity, technical guidelines, sustained computer use, and det...

Lincoln Financial Disability Denial Reversed For Project Manager With Cardiac Condition

Lincoln Financial terminated long-term disability benefits for a North Carolina Hitachi Energy project manager after more than three years of payments — cutting him off precisely when the policy definition shifted from own occupation to any occupation. Our client had suffered a heart attack, required coronary stent placement and a pericardial window procedure,...

Commercial Real Estate Agent with Lyme Wins Northwestern Mutual Appeal

Northwestern Mutual denied a self-employed Texas commercial real estate agent's long-term disability claim by farming his file out to four separate paper reviewers — and then denied it a second time after his treating doctors disagreed. None of those reviewers ever examined him. None of them treated Lyme disease.Our client had spent years building a succes...

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Reliance Standard Disability Denial Upheld Due to Claimant's Lack of Strong Medical Record Support

In the case of Amy Wright v. Reliance Standard Life Insurance Company (Reliance), Plaintiff was the vice-president of health information services at Integrity Health Care when she stopped working on August 7, 2017. She brought claims for benefits under an LTD insurance policy and a waiver of premiums under a life insurance policy.In order to be approved for LTD benefits, Plaintiff ...

Unum Wrongfully Terminated Disabled Lawyer’s Disability Claim of Depression and Anxiety Despite Improvement in His Condition

This Unum lawsuit and appeal in federal court is a great victory for all Unum disability claimants. This case supports all claimants that are disabled and claim that they cannot return to work as the requirements of their job will aggravate their symptoms and make them unable to work.Mark was a personal injury litigation attorney, when he began struggling with symptoms of...

SunLife Released From Any Lawsuits Due To Claimant Giving Up Right To Sue In Severance Agreement

The signing of a severance package when leaving a job is not uncommon, but you may be signing away your right to pursue either a short or long term disability insurance claim. A recent lawsuit decision from the Federal Court in New York is a sad result for a SunLife policy holder that waived her right to challenge a SunLife disability benefit denial. This claim ...

Federal Court Overturns Aetna Denial Of Disability Benefits

In the recent case of Ferrin v. Aetna Life Ins. Co. a federal judge from the Northern District of Illinois determined that Aetna improperly terminated Ferrin’s claim for long term disability benefits and ordered Aetna to reinstate Ferrin’s claim and pay all past due benefits with interest. Prior to filing for long term disability Ferrin was an employee of Southwest Airlines. In 2008, while at work, she suf...

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Reviews from Our Clients

Keith G.

They were very professional with their responds and on time with keeping you inform about everything with your case. I would recommend My lawyer Stephen Jessup, he was on point with everything, thank you. You guys are awesome people to work with. God bless you guys.

Keith L.

I was not able to work as a physician for about 14 months due to neck/back issues. Even though I had 3 medical doctors explicitly state that I was not to work AT ALL as a physician at that time, New York Life (NYL) Disability Insurance denied my long term disability claim (which apparently they deny a high percentage of people similar to me- only they know why they do this to so many- I have my own suspicions). I was in pain from my medical issues and so frustrated with NYL considering I had many bills coming due. I then decided to call Dell Disability Lawyers. One of their attorneys, Alex Palamara, spoke to me on the phone right then to hear and understand my story and then offer ways he could help. Long story short, within a few months of me returning back to work, he was able to persuade NYL to pay me my long term disability claim. He (and his kind assistant, Tabitha) were always very helpful, informative, and available to me. I feel quite certain that NYL would NEVER have paid me what was appropriate based on my insurance agreement/ contract with them without the help of Alex. I highly recommend him/Dell Disability Lawyers. If you find yourself in a similar situation of disability insurance denial of your own personal/group policy, especially if you are a medical provider/physician like me, then consider contacting them for advice/direction PRIOR to appealing your claim on your own.

Kyle D.

Jay Symonds and his assistant, Sonia helped me tremendously. The insurance company that worked for my former employer did everything they could to make my life literally miserable. That all changed when I hired Jay. He and Sonia fought for my rights and forced the insurance company to pay what they should have.

If you have a disability claim hire Jay as if you go it alone the insurance company will screw you. Jay and Sonia will fight for everything you are entitled for. I couldn’t recommend them more highly.

Frank R.

I cannot say enough positive things about my experience with Dell Disability Lawyers. Attorney Stephen Jessup and Amanda offered an opportunity to provide clarity on a complex issue regarding my disability claim. Mr. Jessup offered advice on an offset to my claim after my insurance company asked for additional information from Social Security. With counsel from Mr. Jessup, I was able to address the outstanding issue with the Social Security office and provide my insurance company with the required documentation to address their concerns. Mr. Jessup always responded in a timely manner with expert advice and offered the opportunity for follow up. I strongly recommend Dell Disability Lawyers to those seeking legal counsel for disability matters.

Wesley D.

I have been able to help others as a soldier, a police officer, and a pharmacist. I needed help forcing the insurance company to keep their commitment to take care of me and my family. I called Dell. Alex, Tabitha, and their entire team were very compassionate, extremely patient, and extraordinarily knowledgeable. Many thanks Dell!

Samar A.

My husband had applied for Long Term Disability and was denied. We sought out Rachel Alters at Dell Disability Lawyers to help us with our appeal. Rachel and her team were so diligent and meticulous in every aspect of the process. The process was seamless, and we never had any doubts that she would get it done and that she did! We are forever grateful to Rachel and Catherine for all of their determination and tenacity to get us the outcome we needed and deserved.

We could not recommend better representation and are indebted to them for making us whole again. Thank you so much Rachel and team!

Jam

Alex Palamara is one of The Best lawyers in the world and Dell Disability Lawyers are the Best by Far. Alex and his Assistant Tabitha helped me get the compensation I needed for a Horrific Disabling heath condition I’ve been dealing with for over a year. Alex and his team were so professional and caring. They treated me like I was there own family. Alex Knowledge, Expertise and skills as a Lawyer is among the Best of the Best in his field and I would HIGHLY recommend that if you ever have any issues with any Insurance Company over your Disability issues, please don’t hesitate to seek out Dell Disability and Alex Palamara. They truly are Amazing and caring. Thank God for them. Outstanding Job Alex and Tabitha

G.T.

9 years ago when I had to apply for disability benefits from my private disability policy the insurance company ignored my inquiries until Dell and Schaefer represented me and I have received the benefits without interruption til my policy expired at age 65. I have appreciated not having to deal directly with the insurance company and having attorney Greg Dell and assistant Danielle Lauria handle all communications which included monthly progress reports. I thank them for their efforts on my behalf and highly recommend them to all those in need of disability benefits.

Misty A.

I’m so thankful I chose to reach out to the attorneys at Dell. They have always been quick to respond to any and all questions I have had. The anxiety I had while dealing with Lincoln Financial on my own has decreased immensely since Alex and Danielle took my case. They were able to get my LTD denial reversed and I am so very grateful!

View All Reviews (503)

Question

Does the reviewing physician (the doc hired by the insurance company) have to be licensed to practice medicine in the state where the claimant resides?

Answer

Resources to Help You Win Disability Benefits

Submit a Strong Appeal Package

Sue Your Disability Insurance Company

Get Your Disability Application Approved

Prevent a Disability Benefit Denial

Negotiate a Lump-Sum Settlement

Paralegal Wins Principal Financial Disability Appeal

NY Life Wrongfully Denied Disability Benefits to Lockheed Martin...

Commercial Real Estate Agent with Lyme Wins Northwestern Mutual ...

ERG International Customer Service Rep Wins Two MetLife Disabili...

Hardford Denies Republic Services Truck Driver Disability Benefi...

GIC Executive Wins Mass Mutual Disability Benefit Appeal

Lincoln Financial Disability Denial Reversed For Project Manager...

Dental Hygienist with Wrist Injury Wins a Standard Disability Ap...

SAP Employee with Neck Surgery Wins Hartford Disability Appeal

Nurse with Neck, Back and Hip Disorders Wins Standard Disability...

Nurse With Gastro Issue Wins Lincoln Disability Appeal

A Disturbing Prudential Disability Denial Reversed for the 4th T...

Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?

Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak

Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company

Disability Benefit Denial Reason #3 - Video & Social Media Surveillance

Paralegal Wins Principal Financial Disability Appeal

New York Life Wrongfully Denied Disability Benefits to Lockheed Martin Employee with Eye Disorders

Lincoln Financial Disability Denial Reversed For Project Manager With Cardiac Condition

Commercial Real Estate Agent with Lyme Wins Northwestern Mutual Appeal

Reliance Standard Disability Denial Upheld Due to Claimant's Lack of Strong Medical Record Support

Unum Wrongfully Terminated Disabled Lawyer’s Disability Claim of Depression and Anxiety Despite Improvement in His Condition

SunLife Released From Any Lawsuits Due To Claimant Giving Up Right To Sue In Severance Agreement

Federal Court Overturns Aetna Denial Of Disability Benefits

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