Top 5 Reasons for Disability Insurance Denial


GREGORY DELL: Hi. I’m Gregory Dell,
and I’m joined today by attorney Rachel Alters. Hello. RACHEL ALTERS: Hey, Greg. GREGORY DELL: And today,
we want to discuss with you the top five reasons that
long-term disability insurance claims are denied. So Rachel, in preparation
for this video, I know you put together a list
of the five most common reasons that you see people are denied. I know you’ve handled
hundreds, if not thousands, of [? orissa ?]
disability appeals. Let’s start with what’s the
number one reason that you see disability claims are denied. RACHEL ALTERS: Greg,
the number one reason I see disability
claims denied are when the policyholder
happens to be followed around by a private investigator
with surveillance cameras. It happens all the
time, especially when– GREGORY DELL: You mean like
personal video cameras? RACHEL ALTERS: Video
cameras, right. The insurance company will
hire private investigators to follow the claimants
for two days, three days, four days depending
whatever they think is appropriate to see if the
claimant is doing anything that they claim they couldn’t
do on their application or told their doctors
they couldn’t do. GREGORY DELL: And this
is without the knowledge of the claimant, correct? RACHEL ALTERS: Oh, yeah. The claimant has no idea. GREGORY DELL: All right. What are these disability
insurance companies do with this video surveillance? RACHEL ALTERS: With
the video surveillance, what they normally do is,
obviously, they review it, they get a report from
the private investigator. And if they find out that the
claimant is doing something that they claim they can’t do,
then they’ll deny the claim. GREGORY DELL: And do
they reference that video to claimant statements,
medical records? What do they apply
it to the video? RACHEL ALTERS: Well, they
usually will apply the video– they’ll say, for
example, that the person is using a cane in one
instance and claiming that he can use a cane
or has to use a cane, and then they catch him going
to the mall walking around– GREGORY DELL: Without the cane. RACHEL ALTERS: Without the
cane, and so they’ll say, OK, they were lying. They’re lying about their
inabilities to work, and we believe they
can go back to work. GREGORY DELL: What’s the second
most common reason that you see that claims are denied? RACHEL ALTERS: The
second most common reason is when, in the policy,
usually the policy is written in a way that allows the
insurance company to send the policyholder
for an examination, a compulsory
medical examination, which is either an IME, which
is an Independent Medical Exam, or an FCE, a Functional
Capacity Evaluation. And these doctors or therapists
are hired by the insurance companies, and what
they do is they put him through a three-hour,
four-hour examination, trying to test them to
determine whether they can work. And a lot of these times,
after the report’s written by these doctors– no,
not every claim is denied after an IME or an FCE,
but a good majority of them are because these doctors are
paid by the insurance companies to write reports in their favor. GREGORY DELL: Now you said
a three or four-hour exam. That’s usually an
FCE exam, which is a functional capacity exam. RACHEL ALTERS: Sure, and an
IME can be a little shorter. GREGORY DELL: OK. Because I often get
calls where they say, oh, the doctor looked
at me for 15 minutes. He didn’t even touch me. He just had me come in, and
he rendered his report after. Is that something also that
could happen to a claimant? RACHEL ALTERS: That
does happen a lot. GREGORY DELL: What’s the
third reason that you find claims are denied? RACHEL ALTERS: The third
reason claims are denied is when there is a change
in the policy definition. So, for example, most policies–
not all, but most of them have a 24-month own
occupation period, which means that you can’t do
your own job for 24 months. GREGORY DELL: Are you’re
talk about the definition of disability, right? RACHEL ALTERS: The definition
of disability, right. Because you have to you have
to fall into that definition in order to be disabled. So if you can’t do your own
occupation for 24 months, there is a certain standard. And then after the
24 months expires, it becomes another
standard of disability, and it’s a much more
difficult definition to fit into because what you’re
trying to show the insurance company is you can’t
do even sedentary work, sitting at a desk all day long. That’s the standard– GREGORY DELL: Right. And everybody’s policy has
a different definition– of it could be own
occ for 24 months and then the any occupation
definition could have an income component, like unable
to earn 60% or 80% of what you used to
earn, or it could just be unable to do any
gainful occupation, like a social security
disability standard. RACHEL ALTERS: Sure. GREGORY DELL: When do you see
that a disability company, when they’re going to– when a person has a
change of definition, when do they start looking
into whether or not the person is going to be
eligible at that 24-month mark? RACHEL ALTERS: Usually, you’d
see it about six to nine months before the definition change. And at that time, they do
things like they will send out the private investigator
to do video surveillance and see if they’re
doing anything that they shouldn’t be doing
or claim that they couldn’t do. This is when they’ll send
them to IMEs, for example, so they can get a report that
shows that they can work. And this is what happens
approximately six to nine months before the
definition change, and then that’s when
you’ll see a denial. GREGORY DELL: OK. Let’s talk about
the fourth reason that disability claims
are commonly denied. RACHEL ALTERS: The fourth reason
I find that they’re denied is when there is improper
documentation by the claimant’s physicians. A lot of times– and we
know, we all go to doctors, and some of them are
rushed and some of them don’t want to take the
time to write notes very carefully and detailed. The problem with that is
when the notes are written and they’re not
written specifically to show that you’re disabled and
still having many restrictions limitations, and those notes get
sent to the insurance company. And when they see that, oh,
look, Mr. Smith had a good day today, he was
feeling good, that gives him another
reason to deny you. GREGORY DELL: Right. Because I see, unfortunately,
all the time, they get one record, so-and-so
had a good day today or so and so neck was fine when
they have a neck problem, and three or four days later,
there’s a denial letter. RACHEL ALTERS: Absolutely. Right. Even though there’s been 30
records before and two records after that say that
they’re in pain, if you have that one note that
says they’re doing OK, they can deny you. GREGORY DELL: And
what can a claimant do to avoid that
kind of situation? RACHEL ALTERS:
It’s communication with your physician. So if you have a good
relationship with your doctor, you need to tell them,
listen, this is very important that you document my
restrictions and limitations very clearly because,
without that, I’m going to lose my
disability income, and this is something
I need to live on. So if your doctor
is an understanding and willing to discuss
and work with you on that, it usually is very helpful. GREGORY DELL: I mean,
would you recommend that a claimant actually looks
at the medical records that are transcribed? RACHEL ALTERS: Absolutely. GREGORY DELL: And how
often should they do that? RACHEL ALTERS: I would hope on
a monthly basis, if they could. GREGORY DELL: So basically,
every visit that they go, they should get a
copy of the records. RACHEL ALTERS: And
if there’s something they’re not happy
with, then they need to communicate
with their doctor and say, listen,
can we be careful when you document because
this really affects my income. GREGORY DELL: Right. OK. Let’s talk about the
fifth reason that claims are commonly denied. RACHEL ALTERS: The fifth
reason the claims are denied, Greg, is usually– and this happens all too often. I see this when I get
calls from potentials, and they make mistakes
on their claim forms or their applications. And the problem with that is
that when you fill out a claim form and you’re not
filling it out properly, this is something that
stays in the record, and the insurance company will
make denials on this issue often, and doctors
do the same thing. Well, they’ll make
a mistake when they fill out a
claim form that’s sent by the insurance company. So they’ll accidentally check
that the person can work when they can’t. And sometimes that’s because
maybe the office manager or one of the staff is filling it
out instead of the doctor, and they’re rushed,
and they don’t want to deal with the paperwork. And it gets sent to
the insurance company, and then there’s a denial. GREGORY DELL: Right. And I’ve seen things as
simple as the boxes– how many hours in
a day can they sit, and the doctor checks
six hours or eight hours, when the person can’t
even sit for two hours. So, I mean, so you’re
talking about mistakes in the initial application,
claimant forms that are going on a
monthly basis, even someone who’s been on
claim for five years. I mean, they give
claimant statements every month or every
six months, and then the doctors get these
attending physician statements, and they can make
mistakes on those as well. RACHEL ALTERS: Absolutely. GREGORY DELL:
Again, I mean, what can a claimant do to try to
avoid those kinds of mistakes? RACHEL ALTERS: Well, a
claimant could hire somebody to be their advocate so the
mistakes don’t get made. So the claim forms come
through, for example, if we were
representing them, they come through come to our
desk first, we review them, make sure there’s no
mistake before they get sent to the insurance company. And the same thing when
the doctor fills them out, they can get sent
to an attorney first to make sure that everything
was filled out properly, and if it wasn’t, we can send
it back and get it done right. Because once it’s in that
claim file, it’s there, and it’s very hard
to reverse a decision once they make up
their mind to deny, then they’re in the process
of having to appeal the case. GREGORY DELL: Right. And that’s part of that
monthly claim handling service that we offer, where we always
review all the medical records, review the claimant statements,
review the attending physician statements, review all the
communications that come back and forth from the disability
carrier, because look, person gets on
claim, they’re sick. They don’t have experience with
handling a disability insurance policy and knowing every single
thing they have to do in order to keep getting
paid, but you know, if there is one opportunity
to deny a claim, the disability
insurance company is going to jump through
that door and deny it. RACHEL ALTERS: Absolutely. And a lot of times, the
claimants are depressed, and they don’t have the
energy to deal with it either. And so it’s something
that they don’t have the capability of handling. GREGORY DELL: Right. Well, Rachel, I
want to thank you for putting together that list
of the five most common reasons that people are denied
long-term disability benefits. I want to tell our viewers that
if there’s any type of claim that you have, whether it’s an
application, a monthly claim handling issue, or if
you’ve been denied, feel free to call us at anytime
for a free consultation. We’ll be happy to
review your policy, discuss your claim with you,
and if we’re able to help you, we’ll let you know.

38 comments

They sent me a 100 miles to a smaller city than we I live for a CME. I called and advised I couldn't make that drive. They advise no problem we'll get you there and back. So at 10:30 Monday a Toyota Corolla arrives to take me to my appointment, I've got spondylitis and sacrialitis arthritis In my spine. So he drives me there and by time I get there I can hardly feel my legs. I try to gimp around and walk it off. I get a 15-20 minute exam. My right leg was completely non responsive to the reflex test with the little hammer rt below the knee. He didn't say a word just went to my other leg that had a more normal response he tried my right leg again and nothing. I'm just now getting back to "my normal" 3 days latter. He spoke like he was going to put all these restrictions on me ect ect. I just have a very bad feeling about the whole thing. Why would they subject me to a ride in a little car they knew would beat me to death ? I've never heard of such a thing. Does this make sense to you ?

I have 2 questions.  1) Is it true that an orthopedic injury is more difficult to get SSI than a neurological deficit?    2) Does it help for an applicant to receive a medical consultation from an independent physical therapist? I am a physical therapist and have performed approximately 4 CE's with good outcomes and the client pays cash for my assessment..   I would appreciate your feedback, Thank you.  Michele

my sister got a brain damage that left her disabled since August of 2014 and she is still waiting to get paid… she got nothing yet

DESPERATE FOR HELP !! Hello, I am a Chronic Lyme disease sufferer with degenerative brain disease, retention problems, cognitive, brain fog, etc. After much thought I decided to file for disability back in 2010. The onset date that was used was April / 2009. I have been battling Lyme disease since 2002 but not diagnosed until 2003. Finally found a doctor that could help me in 2004 and was put on long-term IV therapy. Later received a one time payout or closed period for two years of pay for me and my children. IV treatments ended in 2005 and I stayed on oral antibiotics. Husband left in 2006 and divorce dragged on for 3 years. Moved from Virginia to South Carolina to be near my long time Lyme disease specialist. The stress of the divorce had made me do a full relapse and I was put back on IV treatments. Again IV lasted almost one year. Nurses came out to my home to care for my me and my pic line. A brain scan done in May of 2009 indicated degenerative brain disease. Nurses urged me to apply for disability. Filed for disability in 2010. After a few denials my case was heard by an Administrative Law Judge. Administrative Law Judge denied me. One year later I have a date to go back in front of the same Administrative Law Judge. This was in April 2015. My advocate who was dealing with many health issues herself retired and two weeks before my second time going before the ALJ, I meet my new advocate. She had been with the firm for many years. I gave her a lot of information on how Lyme disease had affected me. We went over brain scans and a long neurological study that I had done showing how Lyme has affected me. I noticed in her notes the head of this Law firm wrote : " case should have been won by brain scan alone." Right before the hearing, I had some new devastating money issues & a new health problem. I was upset, unable to focus, and expressed concerns with my advocate about my money situation. When it was our turn, the advocate went into speak with the judge. I did not find this unusual as I believe my original advocate had done this. She then came to get me and we entered the room together. I spoke briefly to the judge while she said almost nothing. She whisked me outside into a hallway and says : " Will you take a one time payout ?" Just a closed period like many years back. ( I would NOT be on disability ) she tells me. She could see I was in shock, upset, and did not know what to do. I asked her questions and at this point I could not remember when I filed, if the kids got anything, etc. She was at a loss for words and what she did answer was very vague. Then she says: " The judge will give you a more favorable decision if you don't go back further than 2013. Remember rules change after age 50." I am 52 now and not one time has anyone said anything about age 50. Even with my poor memory I can almost swear no one has ever mentioned anything about age 50 being an issue. I went totally blank . I questioned her over and over…." what does that mean?" I asked. No understandable answer given. She just kept tapping her finger on a piece of paper and saying: " Remember things are going to change because you are over 50." She acted pretty much dumbfounded. I agreed in front of the judge than I disagreed than I agreed again after me and this advocate went out to the hallway a second time. The judge even asked me if I was depressed. I told him I am depressed because I have this disease and I am depressed because of what it has done to me. I have nerve pain and I have lost almost all my taste and smell. Then he asked me something about thinking clearly and I told him: " I think like I am thinking through mud." The next day, I called the Law Firm. I woke up that morning after the hearing crying and thinking I had dreamed that I had accepted the 2013 back date. This advocate would not speak to me until I showed up in person demanding to speak to the head of the Law firm. That advocate knew how to get me turned around. Not only was I upset the morning of the hearing and dealing with brain fog that most neurological Lyme patients experience, but I had just found out my thyroid was not working properly. The thyroid problem alone can put you in a confused state. When I finally spoke to the advocate she turned into one nasty piece. She told me I could appeal but SHE would not be involved. It is a pretty sad state of affairs when someone cannot rely on an individual that is supposed to be on your side and that is taking 25% of your money. It was not to her advantage to settle for less backpay so I am banking on the fact she had some deal with that judge. The advocate knew full well what she was doing. SHE was NOT on my side. Begging for help. The attorneys on AVVO.com have responded with similar responses: " If you appeal the judge will probably throw your case out." I don't know if they are being honest or are covering each others bottoms. MY HEART IS LITERALLY BREAKING RIGHT NOW. I was supposed to get a letter that requires me to approve her fee. Have not seen this letter and it has been almost a month since I received the judge's letter. Can you point me to someone that can help ? Don't trust anyone anymore. Thanks, Elaine
DESPERATE FOR HELP !! Hello, I am a Chronic Lyme disease sufferer with degenerative brain disease, retention problems, cognitive, brain fog, etc. After much thought I decided to file for disability back in 2010. The onset date that was used was April / 2009. I have been battling Lyme disease since 2002 but not diagnosed until 2003. Finally found a doctor that could help me in 2004 and was put on long-term IV therapy. Later received a one time payout or closed period for two years of pay for me and my children. IV treatments ended in 2005 and I stayed on oral antibiotics. Husband left in 2006 and divorce dragged on for 3 years. Moved from Virginia to South Carolina to be near my long time Lyme disease specialist. The stress of the divorce had made me do a full relapse and I was put back on IV treatments. Again IV lasted almost one year. Nurses came out to my home to care for my me and my pic line. A brain scan done in May of 2009 indicated degenerative brain disease. Nurses urged me to apply for disability. Filed for disability in 2010. After a few denials my case was heard by an Administrative Law Judge. Administrative Law Judge denied me. One year later I have a date to go back in front of the same Administrative Law Judge. This was in April 2015. My advocate who was dealing with many health issues herself retired and two weeks before my second time going before the ALJ, I meet my new advocate. She had been with the firm for many years. I gave her a lot of information on how Lyme disease had affected me. We went over brain scans and a long neurological study that I had done showing how Lyme has affected me. I noticed in her notes the head of this Law firm wrote : " case should have been won by brain scan alone." Right before the hearing, I had some new devastating money issues & a new health problem. I was upset, unable to focus, and expressed concerns with my advocate about my money situation. When it was our turn, the advocate went into speak with the judge. I did not find this unusual as I believe my original advocate had done this. She then came to get me and we entered the room together. I spoke briefly to the judge while she said almost nothing. She whisked me outside into a hallway and says : " Will you take a one time payout ?" Just a closed period like many years back. ( I would NOT be on disability ) she tells me. She could see I was in shock, upset, and did not know what to do. I asked her questions and at this point I could not remember when I filed, if the kids got anything, etc. She was at a loss for words and what she did answer was very vague. Then she says: " The judge will give you a more favorable decision if you don't go back further than 2013. Remember rules change after age 50." I am 52 now and not one time has anyone said anything about age 50. Even with my poor memory I can almost swear no one has ever mentioned anything about age 50 being an issue. I went totally blank . I questioned her over and over…." what does that mean?" I asked. No understandable answer given. She just kept tapping her finger on a piece of paper and saying: " Remember things are going to change because you are over 50." She acted pretty much dumbfounded. I agreed in front of the judge than I disagreed than I agreed again after me and this advocate went out to the hallway a second time. The judge even asked me if I was depressed. I told him I am depressed because I have this disease and I am depressed because of what it has done to me. I have nerve pain and I have lost almost all my taste and smell. Then he asked me something about thinking clearly and I told him: " I think like I am thinking through mud." The next day, I called the Law Firm. I woke up that morning after the hearing crying and thinking I had dreamed that I had accepted the 2013 back date. This advocate would not speak to me until I showed up in person demanding to speak to the head of the Law firm. That advocate knew how to get me turned around. Not only was I upset the morning of the hearing and dealing with brain fog that most neurological Lyme patients experience, but I had just found out my thyroid was not working properly. The thyroid problem alone can put you in a confused state. When I finally spoke to the advocate she turned into one nasty piece. She told me I could appeal but SHE would not be involved. It is a pretty sad state of affairs when someone cannot rely on an individual that is supposed to be on your side and that is taking 25% of your money. It was not to her advantage to settle for less backpay so I am banking on the fact she had some deal with that judge. The advocate knew full well what she was doing. SHE was NOT on my side. Begging for help. The attorneys on AVVO.com have responded with similar responses: " If you appeal the judge will probably throw your case out." I don't know if they are being honest or are covering each others bottoms. MY HEART IS LITERALLY BREAKING RIGHT NOW. I was supposed to get a letter that requires me to approve her fee. Have not seen this letter and it has been almost a month since I received the judge's letter. Can you point me to someone that can help ? Don't trust anyone anymore. Thanks, Elaine

I have been in transportation for over 37 years,I work 10-12 hours a day. In and out of a UPS Truck. After two hours my feet and legs are on FIRE. I will call you all tomorrow,

So the doctors that you are sent to,and never even examine you write a negative report stating nothing is wrong with you.Isn't that fraud on there part?

i am glad that they investigate people.there are so many people on disability that can work and shame on those who can and get disability benefits.when people like us,who really are disabled.get denied.good for them for investigating crooked people.

I work all my life I have being whit diabetes for the pass 10 years so this year i became disable wit neuropathy in both feet and hands plus I suffer from panic attack toodisc in the back mess up n the neck too I have work for 19 years I became homeless because I lost my job because of my illness they cut my en Health insurance I depend in a lots of medication I was denial for social security health insurance that really mess up think happen in life so fight it for my case whit a attorney they're out people then never work no pay no tax and then get health-insurance that's messed up and the workingman n woman we get sick and they put difficult for us the working people is a shame

6th reason the insurance company our companies are very dishonest they lie and make up stuff that's not true therefore they save their money and you're out of luck

I was sent to a medical assessment by the insurance company, I got sick during the assessment I was not able to walk, I lied down and I started to throw up, I was there for several hours before to be able to go home, a friend of mine came to pick up me later. I have a rare genetic muscle disorder and with very mild activity I have episodes like the one happened during the assessment. What are the chance they will deny my income protection plan? My specialist filled the form for the insurance where he said I will not able to work never again, he is one of the most important doctor regarding metabolic genetic disorder. My condition is not invisible I can show I sick I am if I have to. It doesn't take so much to get sick, actually my full time job now is trying not to get that sick. My employer knows how sick I am, he had to send me home by taxi so many time when I was sick

They'd have to give me another IQ test to know, which I dread. I know they'll have to do it. Grrness. I can't even remember what I had for breakfast. Lately, I've had a lot of resistance.

The PI filmed me picking up dog poop.

I did go to an IME. I hired a PhD RN to be an observer. She cost $200 per hour but it was worth it.

Next the disability co. tried to claim that my franchise policy was an ERISA policy. It as a policy that I initiated through my professional
organization and for which I paid all 25 years of premiums. Fortunately I had a good attorney and the judge did not classify my franchise policy as an ERISA policy.

This is a very long post, but you need to read it and think about it, this will likely be you one day! Sorry in advance for all the type O's, Ididn't send allot of time on this one, but I hope I get my point across? If I sound pissed off you can bet your ass I am! Please allow a seriously injured man that was recently denied a BWC disability claim to talk about these five reasons for a few minutes. Before I start with the five things I just heard, please keep in mind that I do use a power chair and I do spend a great deal of my time in it, not always, but allot. This is because I had a horrible injury many years ago and I have endured nineteen horrible spinal surgeries because of this injury. My spinal X-rays now look like a God Damn titanium junk yard. I"m fused from L5-S1 up to my T-12 vertebra which is my "entire" 100% lumbar area. My spinal condition has also forced me to be numb in my groin area and I've lost control of my bowels. For many years now I have had to use incontinent products 24-7. OK, do we have my medical condition pretty much clear before we start talking about these fucking cameras? NO, not yet, I need to add that I also have a horrible cancer that is in it's late stages and radiation won't touch it. I'll likely be fucking dead in a few years. Now are we clear about my medical condition? OH NO, not yet, I still need to add that I've undergone a quad bypass and I have a bad heart valve with Afib that absolutely can't be regulated it's so bad. Now are we clear about my medical condition? I just wanted everyone to be perfectly clear about my medical condition, because some of the people out there might feel that I'm not a disable person that can't work. OK, now less address these five things they were talking about. The things I have mentioned above are absolute facts.

1. Less talk about all these fucking cameras and all you pieces of shit that judge people that are being seen on these cameras: You know what I needed at the store yesterday, and I didn't have one damn person to help me get it? I had to have a bag of ICE MELT SALT to put down on the iced up areas where my crippled ass has to run a power chair? You know what I did, I manned up and took my crippled ass to the store myself, I leaned on a shopping cart, picked up a few groceries and and got the salt my damn self. Did I like? Hell no I didn't like, but I fucking did it because I didn't have a choice. I was in much worse pain for the next few days as usual but that's the way it is for many of us disable people. I also at times try to exorcise our legs and try to see how much strength I have left. It's always a constant battle trying to do things for yourself knowing in the back of your mind that your going to eventually lose the fight. Even knowing I'm losing the battle at times, If I'm having a decent day I'll still try to suffer and do some walking trying to regain some strength in my legs and arms. But many of you dumb fuck can't see anything but a man that isn't sick or injured, all you see is a fraud case. Why don't you look at your mother or father that's in medical rehabilitation centers the same way as you do the people in these cameras that are possibly trying to do the best they can? How many of your sorry ass people are worried about disabled people like me enough to stop judging and offer your God Damn help once in awhile. Very God Damn few of you will try to help anyone, your just assholes that are ridiculously judgmental. For those of you that judges people like me, on or off these cameras? FUCK YOU! If a turd had a asshole, that's how low you would be! Wait until you get disabled and it's your sorry ass that's in this situation having to constantly fight for your strength every day trying to do things for your self while losing the battle. I suppose it's just to easy to be a total self-righteous dickhead and just move on down the road, right?

2. Medical Examiners: I swear to God this is true! I was sent to medical examiner recently, the bastard Doctor that was brought in from out of town let it slip that he had to put on my paper work exactly what the BWC expected from of him before he even examined me. I then ask the stupid fuck if he had even look at my medical records and he said no, but that he was going to take a look later. I then very politely asked the man why he was prejudging me if he hadn't looked at my medical record or examined me. Of course I knew it was the BWC's money, but I still ask him why he would put on paper work what the BWC wanted to hear before he had even examine me? He realized what the had said and it was horribly sad to listen to this fucking idiot trying to get out of what he had said. The more he said the more he just made himself look like bias ignorant fool. It would have been funny as hell watching him squirm if it wasn't such a serious issue for me. Yes, I still got the horrible report that he promised, but at least the dumb bastard was honest from the beginning, even if it was a accidental slip from his lips. Please people, don't ever be naive or stupid and ignore about what I'm saying, all of these medical examiner are loyal to whoever it is that's paying them the money. This is just the facts of the horrible county we live in anymore. There is not one ounce of compassion or empathy left in this countries population anymore, politically or otherwise. They don't even care about their own families anymore, let alone their neighbors, the disabled , elder, or disadvantaged. Wait and watch, this will be the total destruction of America. What this county has become has already totally destroyed me! And yes, the stupid ass cold hearted people are the ones that allow their states to do this sort of thing to injured people. It's just to easy to be a total assholes and dismiss the disabled people as being lazy, fraud cases, right! Did you realize that in Ohio the work injured people can't even have their day in court against the state or their guilty employers? I guess the public voted for this one, I heard it was buried deep in some other bill that passed, but this part wasn't advertised or seen by the public.The public is ignorant as hell anymore, they need to admit it, they have no clue what they're even voting for anymore. They just pull a level and hold their heads up in pride and smile while they're wearing their little smiley face sticker that says (I VOTED TODAY). But again, they didn't know shit from shampoo about what they even voted for, and didn't give shit one way or the other about the ramifications of their vote!

3. No documents? This is very important, but the people that paid for me to go to the damn medical examiner had all my medical files right in front of them on their damn computers, they knew perfectly well everything I had medically gone through due to my injury over the years. It's not about the medical injuries people, its simply all about the greed and protecting and hording damn money, never forget that. No one gives a shit when or if you take your next fucking breath. Not unless your one of the very few people that has been lucky enough to have had a good person dealing with your case, but that is very rare to have had this in today's society. The people that have compassion and empathy aren't usually found working on the good side of the personal injury cases, specially in the insurance offices or as State IC Hearing Officers!

4. Hmm, can the inured person do sedentary work? With all the fraud cases today, I'm sure something needs to be done to determined this, specially with the cases that are weak in the medical documentation area. But in my case, anyone that looks at my medical record and question if I should be working with my bad health is totally brain dead. If you think I should be working after reading my heath issues, please get your boss to hire me and put me in the chair right next to yours. That way you can get the full benefit of the smell when my bowels lets go! But that dumb fuck hearing officer at the Ohio Industrial Commission office thought I was able to work and he knew this! Yea, I wish they would put me to work right beside his ass, but you can bet that won't happen!

5. Mistakes: I'm sorry folks, if a person is injured badly enough to receive benefits, it would have to be a whopper of a mistake for a decent sane person not see through it. However, I suppose these crooked and cold hearted assholes working for these insurance companies will use a simple mistake to fuck over people. I will say this, I'm a very spiritual person, but I'm not much on organized religion, having said that I still hope God finds a hot corner in hell for all the people that have fuck over the sick, elderly, disabled, seriously injured and disadvantaged people. If I believe anything at all, I believe that hell is going to be a very crowded place that's full of these people. All of the people that are in these horrible jobs are being pick from the pool of children we raised? What does that tell you! And you might want to go look in the fucking mirror and think about what I've said.

The insurance co. Dr. Are against you. Then you use your Dr. …then they listen to both sides, it's not awlaws fair it's a racket

What I don’t understand is how you can say that the doctor could be paid by the insurance company to falsify the IME or medical report when the insured has the choice of doctor they want to work with.

Imc retired Dont have disability some time I have to use de cane because the pain I on may back an my right jeg and sometimes I feel better.and I not use..I dot like the cane.

I worked for a disability law firm but I handled hearings not entry so I am embarrassingly unsure how to handle my own disability.

These insurance companies force you to see an IME doctor that they are paying – who in turn writes a false report blaming your injury on another medical cause or saying you are fine but they won’t sign off on clearing you back to work. Its just so the insurance can stop paying your claim. Yep my exam was 20 minutes.

what can i do about my claim denied , my claim was ilegally deneid by employer and insurance companies. with zero compliance do you may help?

I have sooo screwed my self by not checking my DRs notes and actually seen every month by a PA and NP who didn’t even understand what Fibro,CF even is so the notes didn’t reflect correctly.

It is very difficult now to get disability. My husband had to wait 2 years before he saw a judge. The judge looked at all his MRI's, his X-Rays, his doctors notes and first thing the judge said to my husband was, I looked at your MRI's and your disability is accepted. His back is so bad that he walks with a cane and his top part of his back is bend down. His whole spine is degrading rapidly and she saw that in the MRI's. He was denied at first then had to hire a person who does this for a living, he is actually not a lawyer but knows all about this. He charged us only 20% of the back payment you will get. A real lawyer would have charged much more! It was easy at one time but not any more. They finally got wise to how many people cheat!

I waited in the exam room for twenty minutes for my doctor and in comes a "doctor" I have never seen before – the whole time I thought he was an MD – he takes me off guard right away by insinuating that my type of injury could not have happened the way it did and demands to know what really happened. I am flustered and confused but telling the truth hold my ground against this "doctor". the doctor turns out not to be an MD but a PA C and also when I get home I research my injury again and find out this asshole lied, the injury is caused by the action I took – so always be on guard against the asshole insurance company antics

Social media surveillance is also a bunch of shit. They take everything out of context and lie about everything.

Leave a Reply