hello. I’m currently on ltd for depression and anxiety. coming close to 2yr mark. I feel my mental health getting worse. Recently I’ve been waking up from my heart stopping 6 times out of 7 days. Seem to be a bit better now. meanwile I’m waiting for holter to identify for sure if it’s been panic attacks or my heart. Question. What If I develop heart issues or suddenly die of a heart attack or a stroke because of all “active treatments” from insurance company. What can I legally do to document that they should be held responsible. is it even a thing?
Why is your insurance company deciding what your treatment is?!?! That a is very problematic and should stop immediately if not supported by your doctor(s).
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You need your own medical team not one provided by your insurance company.
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Heart treatment (any treatment for that matter) must be prescribed by YOUR provincially regulated cardiologist and YOUR physician, not by an insurance company.
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Any treatments suggested by your insurance company (and their consultants) needs to be approved by YOUR medical team prior to implementing. If your medical teams doesn’t think it’s a good idea, you just tell the insurance company that it is a no go based on reasonable medical advice. If they cut your off because of it, you sue them, and will have a very strong case to win.
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You are responsible for the outcome of your health, and should never do something just because your insurance company wants you to.
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I’m not sure what “active treatments” means. However, I am going to read between the lines here and assume you are talking about suing for emotional distress. If so, you’re not the first person to ask about it. Basically when people go on LTD for depression and anxiety like you, they are usually already at a breaking point and basically unable to function. Then, at this lowest point in their life, they have to apply for LTD benefits which can involve numerous doctors appointments, invasive questions, phone conversations, IME’s, rehab programs, etc. Some people can’t handle these things due to their mental state and it pushes them over the edge and ends up worsening their condition. Basically, the process of getting and maintaining LTD adds to the persons stress.
This happens a lot. It used to happen more often. LTD companies weren’t (and still aren’t in many cases) equipped to deal with mental health issues. A lot of case managers hired are Kinesiologists or RN’s with no mental health work experience. Now-a-days, LTD companies are hiring more Psyc Nurses who have that kind of experience but it’s a slow process. Anyways, for a lawsuit to be successful you’d need to prove gross negligence on their part and that’s pretty hard to prove. How you feel doesn’t matter as much as what they did to make you feel that way. There’s people out there who have full blown anxiety attacks if their starbucks order is wrong, but you can’t sue starbucks for messing up your order. Anyways, hard to answer more without knowing more details.
Otherwise, if your LTD company is actually dictating your medical treatments then @Buckets365 answer is very good.
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Thank you! Those are really good points. I’m kinda on my own here and it’s making it harder to deal with anything. Your support is priceless!
Thank you noticing and validating this. Definitely gives me enough fuel to fight further.
The intensity of this process sure felt like I’m out of the frying pan, jumped into the fire.
Know that the forum is here for you and that you do have the power to make the insurance company do what is right (even when it might not feel like it). Is there a family member or friend that you can bring up to speed to help you navigate this. Follow your gut and only do treatments that are safe. If you can get a medical doctor as part of your team to help that will help with your anxiety. Just remember you are the customer and they are just a service provider. Don’t ever let them make you feel that you have done something wrong. Most of the time these insurance adjusters are just random people hired who really don’t know much, especially when it comes to treatment.
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Thank you! I didn’t even see that perspective before. Just blindly complying with insurance demands, thinking that’s the only way.
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You can get compensation for mental distress caused by a wrongful denial of disability benefits. But for what you are mentioning – injury from the treatment – that would be the responsibility of the treatment providers (doctors, physiotherapists, etc), rather than the insurance company. You would be treated by licensed professionals who have a duty to assess you and only give proper treatment given your medical condition and health risks. You would essentially have a medical malpractice case against the treatment providers, rather than a case against the insurance company. Hope this helps.
Summary
David Brannen
Disability Lawyer with Resolute Legal
The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-917-7050 to speak with a member with our disability claim support team.
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Yes, it helps. Thank you!