In this video Marc Whitehead, a Board Certified Disability Attorney, explains how your Long Term Disability Insurance Company can ignore your Treating Physicians Opinion.
When you make a long term disability claim, chances are good that you are doing so under the advice of your doctor, who has probably already told you that you have a disability and may even have filled out paperwork for you to this effect. Basically you are acting on the professional advice of a medical expert.
Logic would follow that the opinion of such a person would have to be taken into account, after all that’s how it works when your filling a Social Security Claim. They’re required to treat your doctors findings with respect and if they argue against them they have to come up with enough evidence to the contrary with their own experts to call your disability into dispute. But that’s not how it works if your plan falls under ERISA regulations.
Insurance providers can simply call in their own disability doctors and ignore whatever your physician had to say. There is no need to prove him or her wrong to come up with an overwhelming amount of evidence in their favor- they just toss out the evidence that doesn’t agree with them.
All your insurer needs to do is make sure that their disability doctors, people who are on their payroll, provide evidence that calls your disability into question. With this kind of completely legal policy in place, you need an experienced disability attorney who can request that vocational experts review your medical evidence and complete a report which will support your claim.
Combining strong medical evidence and vocational expert reports in your administrative appeal will contribute greatly to the success in your claim for disability benefits. Remember you only have a limited amount of time to fill your appeal so your first step should be to find an experienced disability attorney.
