Case Manager on my back. Opinions please

Case Manager is on my back. My medical doctor says Case Manager is trying to trick me and confuse me.

Case Manager has not contacted my new psychologist as yet who diagnosed me with more severe illnesses than previous ones and said my recovery is unlikely. I was thinking to have my psychologist send a brief letter to CM explaining my new diagnoses. I think this may get CM on the right track. CM does not know about these new diagnoses. I do not want some rehab worker ringing my door bell based on old dated info. I want to be fair to myself and all parties involved.

My psychologist got the DTC approved for me until 2023.

Comments please

Feel free to PM me for more info. Thanks.

You can request the CM ask your doctor directly for updates and not contact you.

Rehab was already scheduled?

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I can’t speak to your specific situation, but in my experience most case managers are not trying to trick or manipulate people. Most are just trying to do their job and are under tremendous pressure. Certainly there are bad apples and some case managers may be experiencing their own mental breakdown due to how stressful their work is. I always urge people to give the benefit of the doubt and to try and work with the case manager as much as possible. Get them the information they are requesting, but recognize in certain claims there can be no agreement between you and them – and that is when appeals are needed.


David Brannen

Disability Lawyer with Resolute Legal

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No Rehab scheduled yet as least I was not informed.

Thank you for your response Jammer.

My previous CM sent forms directly to my doctors. This current one is asking me questions which I have no way of knowing. CM wants my GP to comment on IME findings. Note IME is a specialist. This is like comparing apples to oranges.

CM supervisor has contacted me threatening to stop my disability payments if they do not hear from my doctors. I am not responsible for my doctors actions.

Thank you David for responding.

I think you need to bug your doctor and if your payments are cut off, hire a lawyer.
It is an unfortunate situation.

Your current CM refuses to ask your doctor directly?

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That’s correct. I am getting it from both ends. You are correct if I get cut off then hire RL.

Thank you for your feedback Jammer.

I have always had the case manager contact me in addition to my dr. This happens about every 6 months. In the early days it was every 3 months and I preferred to answer via email. Although the questions are very hard to answer, they seem to paint a larger picture of my functioning (or lack thereof). It has also given me the chance to highlight things my dr did not. While stressful, I view it as a chance for my voice and experiences to be heard. I take my time and reflect carefully.
I’d send a report from your psyc to your case manager. More info supporting your issues seems better IMO.

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I’d also book an appt with your Dr to explain that they need to respond ASAP. Or send in the letter that threatens termination to the drs to encourage a prompt response. They get busy. Mine forgot a few times even though LTD pays for the time to write the letter. The dr(s) usually have 4-6 weeks to respond. It seems understandable to me that if no info has been received, LTD has to take some action.

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If your CM hasn’t written your Dr a letter asking for specific info, then I’d suggest you ask your dr for a brief letter (still unable to work) and forward it to CM. This would seem to be a very odd situation, but I’d personally rather first pay a dr for a letter that may assist me vs go through stress of cut off and legal action…
Lastly, your GP works with you regularly. I was glad my GP could comment on IME findings. The IME saw me once and got a snapshot of my functioning. I wanted my GP to be able to agree or not. We discussed the IME, my perspective as well as my drs and then dr wrote a letter supporting IME findings. This was in my favour.

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Thank you ‘searching’ for your your feedback. I have done all the above. Some of my doctors and therapists do not seem to care about my well being.
I am not sure how much I can share on this forum. You are welcome to pm me for more details.

Basically, I was physically abused by my mom and many women during my childhood. I was able to work and maintain a job. Recently, I was verbally abused by women in my job. I filed many complaints and my manager and supervisors supported me. There were many meetings. None of my abusers were disciplined. This abuse made me scared and I was afraid these women will hit me.
I became very ill and I had to go off work. This abuse triggered my childhood abuse.

As you can see my condition maybe considered pre-existing.
Male doctors do not listen to me. They tell me women never abused me. They tell me I am the problem.

The women who abused me are the ones who should be paying for my therapy. Not me.

My policy specifically says that I have to pay all costs.
Thankfully I have a permanent physical disability so I don’t need medical reports (so far).
It is weird to say “fortunately”.

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That matters in some polices but not others.
I think with “big” companies it tends not to matter (generally).

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That is just wrong.
I hope you get the treatment you deserve.

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Thank you jammer. I appreciate your kind words.

Yes, good point. It varies based on policy

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Yesterday I received another letter from my insurance threatening to stop my disability payments if they do not hear from my family doctor. Several weeks ago I told my insurance my family doctor told me he is not a specialist therefore he cannot answer their questions.

I am stressed out with this system. I cannot take it much longer. I am trying my best but they are not satisfied. I am not responsible for my doctor actions. I cannot force him to do things.

I am so worried I have not slept all night. This system is doing more harm to me.

Do you see a specialist who could answer the questions?
Will your family doctor try to guess at the answers (eg. maybe this, maybe that)?

I understand how stressful it is.
Good luck.

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I have to give you some history. I was seeing a specialist for many years. He retired. I told him to refer me to a specialist. He ignored my request. I wrote a letter to him and faxed it to his office and I hand delivered a copy to him. He refused to refer me to a specialist. There were several specialists right in his suite/building. I spoke to the other specialists over the years and they were very friendly and they even called me by my name. He referred me to him best friend who is a GP. I am now seeing this new GP.

Now I have two GP. My family doctor is a GP and this new guy is a GP.

I keep my insurance informed of any changes.

My insurance wants my family GP to comment on their IME findings. My GP told me he cannot comment because my IME doctor is a specialist and he is not.

I hope this is clear as mud. :wink:

Will your GP refer you to a specialist?
I don’t see any point in seeing 2 GPs unless the 2nd GP is experienced with your condition?
Will the 2nd GP fill out the forms?