3 Misconceptions about Independent Medical Evaluations | Disability Law Show TV – S6 E07

Episode Summary

3 MISCONCEPTIONS ABOUT INDEPENDENT MEDICAL EVALUATIONS on Season 6 Episode 07 of the Disability Law Show with disability lawyer and Partners James Fireman and Tamar Agopian.

Watch above to discover the steps you must take when the insurance company cuts off or denies your long-term disability claim anywhere in Canada, on the only disability law show on TV and radio in the country.

Episode Notes

Loss of employment and LTD coverage

I’m in my 50s and was on long-term disability when I was let go from a senior position. I was no longer capable of working due to deteriorating mental health, and this led to a termination of employment. Will this affect my benefits?

•  Employment and disability insurance overlap: In some instances, there is an overlap of disability and employment issues. Due to the nature of some medical conditions, employees can work for some time before they are told to stop by treating doctors. The perceived ability to work can lead to a denial of benefits by insurers, particularly if a claimant is no longer working at the time of application.
  

Short and long-term disability benefits

Not long after returning to work from short-term leave, my daughter passed away, causing me to develop severe depression. I went back on short-term disability again on my doctor’s recommendation, but when I applied for LTD benefits, I was denied. How can they expect me to work when it is difficult to make it through the day?

• Transitioning from short to long-term disability: The test to qualify for short-term disability benefits is the same as the test needed for long-term disability benefits. Despite this, a transition from short to long-term disability benefits is not automatic.
• Definition of “total disability”: Many claimants, and even medical professionals, mistakenly believe the term “totally disabled” in the disability benefits context means a complete inability to function. This is untrue as the term in reality refers to an inability to perform the basic tasks of a job due to a disability.

3 Common Misconceptions about Independent Medical Evaluations

• Independent medical assessments are optional: It is a common misconception that IMEs are optional and claimants do not have to attend. Insurers can request attendance at an independent medical examination, as long as the request is reasonable.
• Examiners are free from bias: The examiners who conduct IMEs are typically not considered free from bias as they are hired by the insurance company. Insurers hire specific examiners and request the assessor ask specific questions to justify the end of disability benefits.
• It is impossible to prepare for an IME: Claimants are within their rights to seek legal advice from a disability lawyer to prepare before an independent medical assessment. Claimants should make sure they are aware of their medical history and understand that the objective of an IME is to serve the insurer.

Failed attempt to return to work after LTD

I was told to apply for LTD after 4 months off work on STD. My GP believes that it won’t be approved despite support from my chiropractor who has stated I have scoliosis. I attempted to return to work but only lasted a few days. Now I’m using my vacation days to take time off and am worried about further financial difficulties. What can I do?

• Returning to work from LTD: Claimants should only return to work if they are cleared to do so by their treating doctors and medical specialists. Chronic pain claims are often denied as they are conditions that progress with time. Doctors with patients unsure of their next steps with disability benefits should seek legal advice to determine how to proceed.
• Doctor’s reports for LTD: It is necessary for treating doctors to fill in all the necessary documentation for their patients applying for long-term disability.

NEXT EPISODE: Disability Law Show S6 E08 – Guide to disability benefits and depression

PREVIOUS EPISODE: Disability Law Show S6 E06 – 3 Key questions about appealing an LTD denial