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Question

Is my wife being abused?

Asked on October 17th 2023 by Dave k.
My wife broke her foot on June 13 2023, she works at WDW Florida. She has been out on short term disability since June 23? Injured while on vacation time. Her doctor puts her out on disability two weeks at a time. Every two weeks she must submit a doctor's evaluation to get paid her supplemental short term benefits. The doctor should have known how long this type of injury takes and should have put her out a month at a time. Now, she is entering the time frame where suplimental long term disability takes the place of short term payments. Now, she is ask to fill out 34 pages of nonsense about banking info and other information they already have. She has not had regular payments since the beginning. Her payments are scattered and not very accurate because of her constant two weeks at a time resubmitted forms. This whole episode is total BS. Starting with the doctors unwillingness to cooperate. We also have no idea how long these type of injuries take believing maybe a couple weeks or a little longer. Does she have a complaint that has any merit?

Answer

Answered on October 16th 2023 by Attorney Alex Palamara

Dave, with regards to her doctor, I do not believe she has any type of complaint to file. With regards to the disability insurance company, so long as they are paying benefits, there is not much that can be done. And while I do find it shocking that the same insurance company that handles the short term disability claim requires an entire new set of application documents for the long term disability claim, you must realize that sometimes the different arms of the insurance companies do not communicate, or if they do, it isn’t done properly. With regards to the Long Term Disability claim, please keep in mind that it is always your and your wife's responsibility to prove her disability to the insurance company. Thus, beyond completing the application documents, you must provide the proof of her claim. Proof is typically in the form of medical records and support of the treating providers. While the insurance company will certainly have your wife sign an authorization so that they can order records, I always make sure that we always send in all my clients supportive records because you just do not want to rely upon the insurance company to competently gather the records to prove to itself that they should be paying your wife thousands of dollars per month. They will do a bad job at it. Plus, when they send requests to your providers for the records, the providers' office may or may not respond. And even if they do respond, the insurance company may deny receiving those records. Thus, complete the forms and send in all the proof. Should you wish assistance on this claim, please do not hesitate to contact us. We always offer a free consultation.