One of my primary practice areas is Employer-Sponsored Long-Term Disability (LTD), and as I have long stated, insurance carriers and their administrators are not your friends. No matter how friendly and cooperative an insurance carrier seems to be, the bottom line is their administrators operate for the carrier, and not for you. That means, in keeping with their business plan, they are programmed to deny benefits eligibility first, and deal with your legal challenges later.
But after actually obtaining LTD benefits, the process is not over. Every year or two, or even every 6 months or so, the insurance carrier will require you and your treating doctor(s) to complete a series of forms, attesting to your on-going disability and your inability to resume working. What that means for you, whether your disability may improve with treatment or even if no amount of treatment will help you at all, is that you must, must, must continue to see your doctor on a regular basis. That essentially is a requirement of continuing to receive your benefits.
Of course, maintaining an ongoing relationship with your treating doctor(s) is very important. Your treating doctor knows you, knows how you became disabled, and knows your functional abilities as they relate to working. A sudden disruption in your treatment with your treating doctor may create difficulties in maintaining your benefits.
I have had several clients who although legitimately disabled, decide to move to a different city or state, interrupting the treating relationship they have with a long term medical provider. That means they have had to begin all over again with other treating doctors who don’t know them as well, and don’t really know how their impairments make working impossible. Some clients I’ve had simply move and never establish relationships with new treating doctors at all.
Both of these scenarios can cause significant problems for you. Insurance carriers are at the ready to terminate benefits. Inconsistent or a complete lack of medical information gives them the perfect excuse to cut you off. For those people who rely on their long-term disability benefits as their only source of income, that is devastating.
Sometimes, in the process of becoming established with a new doctor, a client will miss a crucial deadline to report their ongoing disability. That problem may sometimes be addressed by requesting an extension, but sometimes it simply takes too long to find a new doctor in a new place. Or, a new doctor may want to get to know a new patient before providing a medical opinion to an insurance carrier. These delays also may lead to an interruption in benefits or even termination.
Insurance carriers terminate benefits for all kinds of reasons; some of them are simply unjust. However, when a client changes doctors or worse, stops seeing a doctor altogether, that provides the insurance carrier with an easy excuse to terminate your long-term disability benefits.
If your LTD benefits have been terminated and you continue to be disabled, contact The DeHaan Law Firm for a case assessment, free-of-charge.