At home insurance visit - LTD


#1

Hi, My long term disability just started and has just called to set up an appointment in my own home next week. The intent is to facilitate my return to work. I am freaking out because I am not ready to return to work. How should I approach this meeting in my home next week. It feels very invasive to me and it is certainly not helping how I feel right now.


Home Visit required for LTD?
#2

You do not have to meet them at your home. Call back and schedule another place and ensure you do not go alone.
You can meet at their office, coffee shop or any public place.


#3

What to expect on your appointment and questions you are likely to be asked.
The rep will likely be a nurse or occupational therapist. They will likely be very nice, however the questions they ask all have a purpose. They likely have recently requested a job description from your employer and recent medical information from your doctors. This is an assessment but they call it an interview. Answer all questions honestly, do not exaggerate and avoid absolute statements. Avoid words such as can’t do, always bed ridden or can only walk 1/2 block and such unless it is 100% true. It is better to use I struggle, it is hard, or I can do that but it causes a pain flare…

They will ask if you like your job. How you get along with others at work. ( Goal to show you are not as disabled but trying to avoid a bad work situation)
They will ask what your limitations are. They will try to get you to say definite restrictions and talk in absolutes. Answer honestly and give examples of struggles you are having.
If you have children they will ask how you are managing. Are you saving in child care costs.
They will ask about your sleep, your mood, your concentration, memory.
They will ask about household tasks and what you can do.
They will ask about your eating, have you gained or lost weight, can you cook?
They will ask about your hobbies and what you do for fun.

Their goal will be to offer assessment/treatment services. This could be an activation program such as work conditioning and counseling or vocational assessments. They will know the perfect providers of these services and will get back to you for referrals. They will comment in their report about your appearance, how you move, and anything they observe. It may or may not be accurate so take someone with you for support.

After the Insurer rep meets with you they will prepare a cost/benefit analysis to see what services they will offer.
Ask that any plan they come up with you be given an opportunity to review with your Doctor. If your Doctor will agree to it ask that it only be for 2-3 weeks and follow up with your Doctor to review how everything is going.


#4

Would I not be viewed as uncooperative for not allowing them into my home?


#5

Not at all. Trust me-you don’t want them in your home.


#6

What is the reason for not wanting to let this person into my home. Wont the questions be the same no matter where we meet? I just feel like I am going to antagonize him by denying him access to my home environment. I have nothing to hide. Thanks.


#7

Good luck James. Please don’t be alone.
Most people are honest and have nothing to hide. You do not need them to invade your space, comment on your housekeeping, comment on your personal items.
Anytime an Insurer is spending money there its because they think it will pay off.
You may be honest and nothing to hide…don’t expect that to be returned.


#8

Do they really meet you at the start of LTD to facilitate return to work? Can he ask them to talk to his doctor instead of the meeting?

My case manager sent the return to work proposal to my doctor. She said “no” to it. That was the end of the process.


#9

The intent is to reduce the claim cost and get you back to work, the fasted and least expensive way possible. This may not be in your best interest.
The reason they send you to their chosen providers is to medically police/surveillance you.
You may be fully compliant, find them nice and on your side-their reports may shock you otherwise.
This is a business relationship governed by contract. Go in with open eyes and keep regular visits with your treatment providers.