If you follow our blog or have previously dealt with long term disability insurers in the past, you already understand how getting benefits can be such a frustrating process. Yes, insurers don’t really care about your pain or inability to work, but you would expect that doctors would, right?
So when an insurer has your records reviewed by an independent medical examiner (IME), you may feel like the doctor will understand, and the insurer will follow suit. But when your claim is denied (despite evidence indicating that you are entitled to benefits), is the medical examiner actually “independent?”
Keep in mind that some doctors have deep working relationships with insurers, and may be directed to find benign issues or discrepancies that can be used to deny claims. In fact, courts have questioned just how independent or neutral some examiners may be given that their “bread has been buttered” by insurance companies.
An experienced disability law attorney can challenge bogus reviews and expose conflicts of interest so that you may obtain the benefits you are legally entitled to. For example, I raise questions when an examiner fails to provide specifics on why the claim was denied or does not substantially comply with ERISA’s disclosure requirements. When an examiner ignores prior medical evidence, this could be an indication that he or she is not exercising independent medical judgment.
If you believe that your long term disability benefits have been thwarted by so-called “independent” medical examiners, we invite you to contact us.
The preceding is not legal advice.