As far as most people are concerned, when their doctor tells them something their word is final. After all, they have years of medical training and know what they’re talking about. So if your doctor tells you that you suffer from a disability and should be able to receive long term disability benefits, then that is the end of the argument, right? Wrong.
Insurers have been pitting doctors against each other for years by asking claimants to have an independent medical evaluation with a physician that they choose. Supposedly, the idea is just to get a second opinion and see if another medical professional will objectively agree or disagree with the original findings. More and more, though, these independent examiners end up “reviewing” the work of the treating physician and searching for ways to call it into question.
While this might seem like an obvious tactic on the part of the insurers who are paying these independent examiners and have no desire to pay out on claims if they don’t have to, in recent years it appears to be working.
Courts Now Skeptical of Doctors – Period
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Not too long ago, courts gave deference to the findings of treating physicians and looked upon the work of “insurance doctors” with more suspicion. Since 2003, though, this deference has disappeared as courts pay more and more attention to “reviewing” doctors who are able to comment on the work of the treating physician and point out any supposed deficiencies in addition to conducting their own tests and examinations.
This doesn’t mean that they now trust doctors who are hired by insurers more – it just means that medical opinions as a whole are given less weight unless they are thoroughly backed up by objective evidence. If you want to have the best chance of winning your claim, you need to make sure that your doctor takes detailed notes and explains any changes in opinion that occur when they are seeing you.
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These are the kinds of things that insurers love and “reviewing” doctors pounce on as a way to show that your doctor didn’t do a thorough job and was instead trying to act as your advocate instead of providing an objective analysis. Additionally, you may wish to have your doctor respond to the findings of the independent examiner so that he or she doesn’t get the last word and they have a chance to explain themselves.
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An experienced medical disability attorney will be able to tell you in greater detail the kinds of things that your doctor should include in their reports, but you can also get a better overall sense of disability policies by reading our free eBook.
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